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 dark patches (melasma).
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:
- skin-lightening creams
- laser treatment
Trying a skin-lightening procedure is a major decision. It can be expensive, time-consuming, and the results cannot be guaranteed.
If you're thinking of going ahead, be absolutely sure about your reasons for wanting to try it and do not rush into it.
It's a good idea to discuss your plans with a GP first. They might talk to you about your reasons for wanting to lighten your skin, and there might be a medical reason why the procedure is not appropriate for you.
Skin-lightening techniques can result in serious side effects and complications. People with dark skin tones are particularly at risk of these problems.
Prescription skin-lightening creams
Powerful skin-lightening creams are available on prescription from a doctor. These usually contain one or both of the following medicines:
- topical steroids, such as hydrocortisone
Skin-lightening creams you can buy without a prescription
Many alternative skin-lightening products are available to buy online or in shops or pharmacies without a prescription.
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 the product does not list the ingredients.
Creams that contain hydroquinone, corticosteroids or mercury, which have not been prescribed by a doctor, are banned in the UK because they can cause serious side effects if used incorrectly.
Many skin-lightening creams containing natural ingredients are also available. These are legal and unlikely to be harmful, but there's no guarantee they work.
How to use skin-lightening creams
Your doctor will advise you how to use your skin-lightening cream.
You'll usually be advised to:
- use the minimum amount, 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 3 or 4 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:
- redness and swelling (skin irritation and inflammation)
- a burning or stinging sensation
- itchy and flaky skin
What could go wrong
Possible risks of skin-lightening creams containing hydroquinone, corticosteroids or mercury include:
- skin turning dark or too light
- thinning of the skin
- visible blood vessels in the skin
- 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 tell you about the potential risks and how common these are.
What to do if you have problems
If you get side effects while using a prescribed skin-lightening cream, contact a doctor for advice.
If you have any severe symptoms that need urgent medical attention, such as a nasty rash, swelling or increasing pain, go to your local accident and emergency (A&E).
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.
Laser skin lightening may work for some people, while for others it may not have any effect, or the skin lightening may only be temporary.
Laser skin lightening is not usually available on the NHS, so you'll usually have to pay for it.
The cost of each session can vary widely across practitioners and is dependent on the size of the area being treated, 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 done on a small area of skin to see how it reacts. If you do not have any problems, you'll usually have your first session a few weeks later.
You may get 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'll be given special goggles to wear to protect your eyes from the laser
- a small handheld laser device will be held against your skin – this may feel like a rubber band snapping against your skin
- a jet of cold air may be blown onto your skin to keep it cool during the treatment
Each session will usually last around 30 minutes to an hour. You can go home when it's finished.
It can take a 1 to 2 weeks 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.
It is common for skin to be red and swollen for a few days afterwards, and it may be bruised or crusty for 1 to 2 weeks.
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 6 months.
To aid your recovery you should:
- wash the treated area gently with unperfumed soap and carefully dab it dry
- regularly apply aloe vera gel or petroleum jelly (such as Vaseline) to cool and soothe the treated area
- not pick at any scabs or crusts that develop
- take painkillers, such as paracetamol, if you have any discomfort and hold an ice pack wrapped in a towel against the skin to reduce any swelling
- apply sun cream to the treated area for at least 6 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
These effects usually pass after 1 to 2 weeks.
What could go wrong
Serious complications of laser treatment are generally uncommon, but can include:
- 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 happen.
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 was not done 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 a GP or contact NHS 111.