Skin lightening, or skin bleaching, is a cosmetic procedure that aims to lighten dark areas of skin or achieve a generally paler skin tone.
It's usually used to improve the appearance of blemishes such as birthmarks and melasma (dark patches).
Skin-lightening procedures work by reducing the concentration or production of melanin in the skin. Melanin is the pigment that gives skin its colour and helps protect it from the sun.
The main techniques used to lighten the skin include:
Trying a skin-lightening procedure is a major decision. It can be expensive, time-consuming, and the results can't be guaranteed.
If you're thinking of going ahead, be absolutely sure about your reasons for wanting to try it and don’t rush into it.
It's a good idea to discuss your plans with your GP first. They might want to chat about your reasons for wanting to lighten your skin, and there might be a medical reason why the procedure isn't appropriate for you.
Skin-lightening techniques can result in serious side effects and complications. People with darker skin tones are particularly at risk of these problems.
Skin-lightening creams
Powerful skin-lightening creams are available on prescription from a doctor. These usually contain one or both of the following medications:
Products containing these ingredients that haven't been prescribed by a doctor are banned in the UK, as they can cause serious side effects if used incorrectly.
Products containing other potentially harmful substances such as mercury are also banned.
Make sure you check the ingredients of any product before you buy it. Avoid it if hydroquinone, corticosteroids or mercury are listed in the ingredients, or if it doesn't come with a list of ingredients.
Many alternative skin-lightening products containing natural ingredients are available online and in shops without prescription. These are legal and unlikely to be harmful, but there's no guarantee they work.
How to use your skin-lightening cream
Your doctor will advise you how to use your skin-lightening cream.
You'll normally be advised to:
- use it sparingly once or twice a day on the darkened area of skin only
- avoid getting the cream on the surrounding skin or in your eyes, mouth and nose
- apply the cream with a cotton bud, or wash your hands thoroughly before and after applying the cream
- avoid touching the treated area against another person's skin for at least a few hours after applying the cream
- use sun cream to protect your skin from the aggravating effects of sunlight
Most people will need to continue the treatment for around three or four months. Your doctor may recommend stopping treatment after this time, or only using it very occasionally.
Possible side effects
Side effects of skin-lightening creams can include:
- skin irritation and inflammation (redness and swelling)
- a burning or stinging sensation
- itchy and flaky skin
What could go wrong
Possible risks of creams containing hydroquinone, corticosteroids or mercury include:
- skin turning dark or too light
- thinning of the skin
- visible blood vessels in the skin
- scarring
- kidney, liver or nerve damage
- abnormalities in a newborn baby (if used during pregnancy)
If you’re prescribed skin-lightening cream by a doctor, they should let you know about the potential risks and how common these are.
What to do if you have problems
If you experience side effects while using a prescribed skin-lightening cream, contact the prescriber for advice.
If you have any alarming symptoms that require urgent medical attention, such as a nasty rash, swelling or increasing pain, go to your local accident and emergency (A&E) department.
Laser skin lightening
A laser can also be used to lighten blemishes or dark patches of skin. This works by either removing the outer layer of skin or damaging the cells that produce melanin.
The results of laser skin lightening tend to be quite variable. It may work for some people, while for others it may not have any effect, or the skin lightening may only be temporary.
Cost
Laser skin lightening isn't usually available on the NHS, so you'll normally have to pay for it privately.
The cost of each session may vary widely across practitioners and is dependent on the size of the skin area, the extent of the lightening, and the equipment used. Several sessions are often needed to increase the chances of the procedure being effective.
What it involves
Before the procedure starts, a test may be carried out on a small area of skin to see how it reacts. If you don't experience any problems, you'll usually have your first session a few weeks later.
You may experience a stinging or pricking sensation during the procedure, so a local anaesthetic cream may be used to numb your skin beforehand.
During a session:
- you'd be given special goggles to wear to protect your eyes from the laser
- a small handheld laser device would be held against your skin – this may feel like a rubber band snapping at the skin
- a jet of cold air may be blown onto your skin to keep it cool throughout
Each session will usually last around 30 minutes to an hour. You can go home when it’s finished.
Recovery
It can take a week or two for your skin to recover from laser skin lightening. You may want to take a few days off work until your skin's appearance starts to improve.
Your skin would normally be red and swollen for a few days, and may be bruised or crusty for a week or two.
Over the next few weeks, your skin should start to fade to a lighter colour. It will be sensitive to the sun for up to six months.
You can aid your recovery by:
- only washing the treated area gently with unperfumed soap and carefully dabbing it dry
- regularly applying aloe vera gel or petroleum jelly (such as Vaseline) to cool and soothe the treated area
- not picking at any scabs or crusts that develop
- taking painkillers such as paracetamol for any discomfort and holding an icepack to the skin to reduce any swelling
- applying sun cream to the treated area for at least six months to protect it from the aggravating effects of the sun
Side effects to expect
It's common after laser skin lightening to have:
- redness and swelling
- bruising
- crusting
- blistering
These effects normally pass in a week or two.
What could go wrong
Serious complications of laser treatment are generally uncommon, but can include:
- scarring
- skin infection
- the skin turning darker or too light
You should be told how likely these complications are, and what could be done about them if they occurred.
What to do if you have problems
Cosmetic procedures can sometimes go wrong and the results may not be what you expected.
If you have laser skin lightening and are not happy with the results, or think the procedure wasn't carried out properly, you should take up the matter with the hospital or clinic where you were treated.
It is best that you go back to the practitioner who treated you if you have any complications. If this is not possible, you can go to your GP or local A&E department.
Your health, your choices