Concerns over chemical contained in skin-whitening creams raised by UAE doctors

ABU DHABI // People across the country who want lighter skin are opting for skin-whitening creams, many of which contain hydroquinone, a chemical that could be harmful if used incorrectly, according to experts.

The creams are widely available over the counter in the UAE.

Hydroquinone is an agent that reduces the production of melanin, which is sensitive to sunlight. But its safety is being debated by industry and medical professionals.

“It’s dangerous to see that many of these creams containing hydroquinone are being sold as sunblocks,” said Dr Zbigniew Ruszczak, head of dermatology and allergy at Al Noor Hospital in Abu Dhabi. “Also, these creams are available over the counter and people can use these products without any control.”

Even when prescribed, he said, the creams should not be used for more than two or three months. Hydroquinone-based creams can cause rashes, redness or irritation if misused. Long-term misuse can lead to ochronosis, a condition that makes the skin appear grey and makes it leathery or hard.

One of Dr Ruszczak’s patients was a 35-year-old engineer from the Mediterranean area working in the UAE who used a cream containing hydroquinone for many months. At first he applied it only at night and later twice during the day as the initial rashes subsided. After a few months he noticed that the skin on his face was taking on a greyish tone. He then used a stronger depigmenting cream also containing hydroquinone, which made the lesions worse.

After more than a year of such treatment ochronosis was diagnosed, a result of the misuse of hydroquinone.

A pharmacist in Abu Dhabi said that people often mistook redness on the skin as a sign that the cream was working, while it is actually a symptom of the reaction.

“Many people continue to buy these products and use it for an extended period of time, although we warn them that this is not safe,” he said.

Hydroquinone has been banned in several countries in Asia, Africa and the European Union. The US Food and Drug Administration banned the drug in 2006, but in 2009 stated more research was required and reduced the ban to a warning. It is not known if hydroquinone is carcinogenic.

“We get so many patients who want to appear fairer,” said Dr Elham Abd El Zaher, consultant in dermatology and venereology, at Burjeel Hospital.

The situation is an ironic one, Dr Ruszczak said, because while fair people wanted to appear tanned, people who are darker skinned wanted to appear fair.

Darker skin is also prone to pigmentation anomalies that make it appear patchy and people apply these creams hoping to get a clear and even complexion. Pregnant women are also prone to melasma, which causes the skin to look patchy. Pimples or acne on darker skin may also leave a brownish spot or mark. Although people use hydroquinone creams in many of these situations, they are not the answer, experts said.

“People need to see a dermatologist who can assess their skin type and give them a suitable lightening agent. If the pigmentation is too deep, the creams won’t have an effect on them,” said Dr Zaher.

“We recommend safe depigmenting agents to patients but they work slowly. Patients often demand instant results. They want to look fair overnight. There is social pressure involved as well. Because friends or family members have used a cream, which they think is effective, then they want to use it as well.”

arizvi2@thenational.ae