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In a world where beauty standards are often defined by social media trends and celebrity endorsements, the colour of your skin can sometimes feel like a determinant of self-esteem and confidence.
While some pursue lighter skin tones through bleaching, others seek a darker complexion via tanning – both ends of the spectrum can come with health risks that need to be considered.
According to Dr Dilshaad Asmal, Dermatologist at Mediclinic Cape Town, the desire to lighten one’s skin stems from deep-rooted socio-cultural and psychological factors. “In many cultures, including Indian, Asian and African communities, lighter skin has historically been associated with beauty, status and even marital prospects. Global media continues to reinforce this ideal, portraying lighter skin as more attractive or aspirational.
The most common bleaching practices
In South Africa, skin lightening methods range from over-the-counter products to unregulated treatments based on folklore. “Hydroquinone is a widely used ingredient, available in topical creams. Though effective in reducing pigmentation, prolonged use can cause serious side effects such as ochronosis – a disfiguring blue-black pigmentation that is irreversible,” Dr Asmal explains.
Other products commonly used include corticosteroids and mercury-based creams, often sold at informal markets. These can thin the skin, disrupt healing, and in the case of mercury, damage the kidneys and nervous system.
“We’re also seeing the rise of IV glutathione drips offered in so-called IV bars. These are unregulated and largely unsupported by scientific evidence. Critically, they pose risks to the liver and kidneys,” Dr Asmal warns.
Chemical peels and lasers are safer options when performed under professional medical supervision. However, Dr Asmal notes that unsupervised use - particularly the trend of mixing household products like toothpaste and detergents - can cause burns and worsen pigmentation issues.
The risks behind the glow
Aside from physical side effects like thinning skin, eczema, acne, and increased sensitivity to sunlight, the psychological toll of skin bleaching is also significant.
“Many users start off wanting to correct pigmentation from acne or sun exposure. However, repeated use of harsh products can cause paradoxical darkening, especially with hydroquinone. The result is not only emotional distress, but also permanent skin damage,” says Dr Asmal.
Even seemingly “natural” methods are not without danger. Tanning beds, sun exposure and oils marketed for tanning carry well-documented risks. These include DNA damage, premature ageing, and dramatically increased chances of developing skin cancer - particularly melanoma.
“Tanning beds are classified by the World Health Organization as Group 1 carcinogens. Using them before the age of 35 increases the risk of melanoma by up to 75%,” he cautions. “They can also cause eye damage, cataracts and even ocular melanoma.”
Tanning oils, often used to accelerate melanin production, exacerbate the harmful effects of UV exposure. They block pores and may cause folliculitis and acne in addition to increasing the risk of burns.
Safe approaches to skincare
While there is no completely risk-free way to lighten or darken the skin, there are safer alternatives for those concerned about uneven tone or dullness.
“A dermatologist can help you choose appropriate skincare products. Ingredients like azelaic acid, kojic acid, vitamin C, niacinamide (vitamin B3), retinoids and alpha- or beta-hydroxy acids can all improve skin tone when used correctly and under guidance,” says Dr Asmal.
Chemical peels and medical-grade lasers may also assist with pigmentation correction, but again, only when performed in controlled environments by qualified professionals.
For those wishing to darken their skin, self-tanning lotions and sprays containing dihydroxyacetone (DHA) are safer options. However, Dr Asmal notes that even these carry minor risks such as skin irritation or respiratory issues when used in spray booths.
The golden rule: protect your skin
Regardless of skin tone preferences and desired aesthetics, Dr Asmal says the most important skincare habit is using a broad-spectrum sunblock daily. “It helps prevent darkening of hyperpigmented areas, protects against premature ageing, and reduces your risk of skin cancer,” she explains.
Sun damage is cumulative and can result in conditions such as actinic keratosis, melanoma, and basal or squamous cell carcinomas. It also contributes to photoageing - the wrinkling, sagging and textural changes that prematurely age the skin.
“People underestimate the long-term impact of UV exposure. Even a single severe sunburn can damage skin cells and blood vessels, increase sensitivity, and pave the way for chronic skin disease,” Dr Asmal explains. “Whether the goal is to lighten or darken, altering your natural skin tone should never come at the cost of your health,” she concludes.
Doctors 1
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