Skin color in humans is determined by several factors, such as hemoglobin in our blood, carotenoids eaten through certain foods, and most importantly, by melanin, the pigment produced in the skin. Cells called melanocytes produces melanin, which is packaged inside organelles called melanosomes. The pigment-laden melanosomes present inside these melanocytes are distributed to the surrounding skin cells called keratinocytes, via their claw-like tentacles known as dendritic processes. Racial and ethnic differences in skin color are determined by the number, size, shape, distribution and degradation of these melanosomes.
Normal skin color is basically of two types: constitutive color, which is one’s genetically determined skin pigmentation, and facultative, which is inducible skin color such as tanning due to sun exposure. Thus, one’s natural skin color is genetically determined, and this may show temporary changes in its shades, depending on the degree of exposure to ultraviolet rays.
However, this physiological phenomenon has been allegedly subjected to ‘disease mongering’ which, in simple terms, means selling the notion of illness or disease in order to sell remedial products. With regard to fairness and its related business, disease mongering may be regarded as the promotion of a particular skin color or quality as the ideal one and then selling fairness products claiming to attain it. It would be fair to say that this craftily generated notion of a fair skin as healthy and beautiful skin has been exploited by fairness product manufacturers to a significant extent in order to promote their sales.
Skin lightening agents such as hydroquinone, glycolic acid, salicylic acid and azaelic acid have been used for a long time, both in prescription drugs and cosmetic creams. These agents work by reducing the formation of melanin pigment in the skin and are scientifically proven to be effective but are not free of side effects, which therefore, must be used only under medical supervision. Newer such chemicals are kojic acid, arbutin, niacinamide, etc, and the list is still growing. Though most of these newer agents claim to have skin lightening properties, adequate scientific evidence of its efficacy is still lacking.
Most fairness creams contain a combination of skin-lightening medications and sunscreens, albeit in sub-pharmacological amounts, which means it can be marketed as a consumer cosmetic product without the legal bindings required of a pharmaceutical product. Furthermore, at these doses, a mild beneficial effect may still be seen upon its regular usage. Manufacturing products containing pharmacological amounts of active ingredients would require a pharmaceutical license and would have to meet all the other stringent standards required of a pharmaceutical company.
The product would then be classified as a drug and would be legally available only on doctors’ prescriptions. It therefore seems more convenient and beneficial for companies to market their products as a cosmetic, but also attempt to give it a genuine touch by associating it in any way with professional medical practice. It is also common to see labels stating ‘FDA approved’ or ‘dermatologically tested’ in many of these product claims. However, it is worth knowing that the food and drug administration (FDA) regulates the approval of only medical drugs and equipment, and has no jurisdiction over cosmetic products. In fact, as part of the ‘prohibition against false or misleading information,’ FDA regulations state that ‘no cosmetic may be labeled or advertised with statements suggesting that FDA has approved the product.’ It is also essential to understand that medical doctors are bound by professional ethics to strongly consider genuine scientific evidence before recommending treatment to their patients.
Therefore, claims such as ‘dermatologically tested’ or ‘recommended by dermatologists’ are just unethical attempts at justifying unproven beneficial claims in pursuit of increasing the sales of cosmetic products.
The Internet is the source of information most people turn to, and one can find numerous sites providing information regarding fairness products for the skin, along with literature made to look as genuinely scientific as possible by associating it with medical societies, institutions, journals and even famous doctors. Most of the information is basically designed for self-promotion, with biased opinions, literally and sometimes poetically presented, all aimed to enhance product sales.
There are also sites that seem to be specifically designed to malign or defame other competing products. It needs to be known that anyone is free to promote their products through Internet and publish supporting claims, and it is up to the wisdom of readers to assess the genuineness of such information. Scientific research is an ever progressing field, and findings and theories keep changing. No wonder, even websites carrying genuine scientific information shields themselves with skillfully written disclaimers at the bottom of their pages.
My personal opinion is that one should accept their natural genetic skin color and learn to be happy and comfortable with it. If not, then either the concerned individual is obsessed with fairness, which requires psychological help, or the fairness product companies have done a successful marketing job! Despite all the facts and fallacies, human desire reigns supreme, and thus the quest for fairness will be prevalent for such a time until a new ideal skin image is again promoted by companies trying to market their skin remedies.
The writer is a consultant dermatologist and medical director at DI Skin Hospital and Research Center Pvt Ltd, Maharajgunj, Kathmandu.
Related story
Messi makes dream start to World Cup quest
