Bleaching is more than skin deep
Tieca Harris, Contributor
As pharmacists, we are charged with the responsibility of guiding the public on the safe and responsible use of drugs and chemicals. There is growing concern about the tendency of Jamaicans to bleach their skin, often putting their life at great risk.
It is unsettling to see fellow Jamaicans mixing chemicals such as household bleach and hydrogen peroxide with various creams, lotions and gels - which are all made up of possibly the same drugs plus other chemicals (leading to drug toxicity) - to bleach the skin.
The history, social, cultural and mental aspects of skin bleaching has all been discussed at length.
This article serves to bring to light the dangers of mixing toxic chemicals and the way they are applied to the skin. How these chemicals are used and stored is also another serious concern, putting at risk the lives of adults and children alike.
Noteworthy, is the fact that both bleach and hydrogen peroxide are commonly listed among products accidentally swallowed by both children and the elderly. Hydrogen peroxide and bleach possess 'water-like' consistency and can easily be ingested mistakenly by a child. The increased presence of such chemicals around the home increases the risk of accidental poisoning, especially among the paediatric population.
Cosmetic creams, gels and lotions are made up of several chemicals. It's important to note that some of these creams may even contain the same ingredients. Mixing these will have an additive effect, thereby increasing the strength of multiple chemicals. This means more drugs will cross the already-thin and damaged skin that skin bleachers naturally develop. What does this mean? Larger amounts of the combined chemicals will be entering the body, triggering serious problems, whether immediate or delayed.
Drugs have been proven to enter the blood through the skin and may result in changes unknown to the users. These chemicals do not just stay in the blood, but are further carried around the body to various sites with the potential of altering body processes. One typical example is the drug hydroquinone, a popular bleaching agent that has been implicated in several cancers and blood-related problems.
The aggressive rubbing in of these multiple mixtures adds to the dangers of the practise of skin bleaching. The already-thinned skin plus the presence of abrasive fine particles, acting as body scrub, all increase the speed at which drugs enter the blood (the body). Studies have shown that removing the thick layer of skin that protects the body can increase the rate at which drugs enter the body by up to 15.4 per cent. This means more drugs in the body and, hence, increasing possibilities for complications, mutation of genes and added disease states to occur.
DANGERS OF PLASTIC WRAPS
Wrapping the body with plastic is another dangerous practise that must be discouraged. To the persons who practise this, yes, the bleaching process will be faster because more drug is entering the skin and, hence, working more rapidly. But the hidden danger is that more drugs are also entering the blood.
In April 2007, a 17-year-old track athlete and cross country athlete died in her sleep because of poisoning from high levels of a drug called methyl salicylate. It was later revealed that she had combined multiple sports creams - all having the same drug - and wrapped herself with an adhesive pad. What happened? The concentration of the multiple mixture plus the wrapping caused a large amount of the drug to enter her body. The levels were toxic and too large for her body to handle.
The combining of chemicals such as bleach and hydrogen peroxide that give off fumes, along with exposure to other chemicals, has proven to cause reactive airway dysfunction syndrome (RADS). RADS manifests as a sudden onset of asthma-like symptoms and persistence airway reactivity. This is also called 'irritant induced asthma'. The extent of airway damage and complications is dependent on the extent of exposure to such irritating chemicals. Skin bleachers using bleach and other household chemicals are not excluded from this phenomenon.
Accidental swallowing of caustic chemicals, including bleach and hydrogen peroxide, continues to be a major health hazard in developed and developing countries. In one study, a total of 50 cases were reported, with the smallest ages being 22 months old. Bleach was listed among the agents accidentally swallowed.
In another study, the constant inhaling of bleach caused asthma-like symptoms in housewives, especially when mixed with other chemicals (acids). Symptoms include problems breathing, coughing, wheezing, chest tightness and headache. The biggest risk group for accidental poisoning was reported to be children under the age of five years, specifically the two-year-olds, who cannot tell harmful from harmless chemicals. Swallowing large amounts of bleach can cause damage to the esophagus, the airways and stomach.
Hydrogen peroxide is seen as safe for the home and is an effective cleaning agent. It is also available as a one per cent cream used in treating acne. However, it is available locally as three or six per cent strength. Studies have shown that when applied to the skin, it can cause irritation, redness, scarring of body tissue, and even local skin embolism. An embolism is known to be a clot, air (gas), or fat causing blockage.
This chemical has also been known to cause accidental poisoning, with 11 cases being reported in one study. The mixing of multiple chemicals can cause unstable and harmful chemicals to be formed. The presence of bacteria can also worsen problems if handled in non-sterile and contaminated environments. Fortunately, both bleach and hydrogen peroxide are available in very weak strengths as household chemicals.
Another unseen danger in mixing chemicals in the home and applying them to the skin is the presence of bacteria and other infectious agents. The presence of water, warm areas and contaminated environments can all cause spoilage of these medicaments and cause harm to the users.
TIPS ON SAFE USE OF MEDICINES
Skin bleaching has proven to be an international concern. Despite aggressive campaigning on all levels to reduce this trend, it still continues. However, we cannot give up on efforts to educate the public on the harmful effects of the practise.
As such, here are some tips on the safe use of medicines, whether to be swallowed or applied to the skin:
All chemicals - medicines and household agents - must be clearly labelled, properly secured and stored away from children.
Pay attention to the application and method of using all medicines and chemicals.
Always read the labels.
Combining multiple medicines can cause poisoning if the same ingredient is contained in the medicines being mixed.
Never mix creams, gels or ointments unless instructed by your pharmacist or health care provider.
Never mix creams, gels or ointments in an unclean environment, the presence of bacteria and other 'germs' can cause skin infections, especially if the skin is 'broken' (cut/bruised).
For medicines being applied to the skin, it matters if it is to be gently applied or massaged into the area specified, therefore, adhere to the instructions given by your pharmacist.
Wrapping the skin after applying large quantities of some drugs can be harmful, never do this unless instructed to do so.
Steroid-based drugs must be used under the supervision of a physician and must not be used for long periods.
Despite applying drugs to the skin, once pregnant, consult the doctor/pharmacist since drugs can enter the body through the skin.
Mixing multiple chemicals (medicines) may destroy the drugs present or prevent the drugs from working as they should.
When applying creams, ointments or gels to the same areas of the body, always apply the ointment last.
Wash hands thoroughly before and after application or use of these preparations.
Protect the eyes from all chemicals, including potent drug chemicals, such as steroids.
Always consult a health care provider when unsure about the use or application of medicinal products.
Tieca Harris is a registered pharmacist at the School of Pharmacy, University of Technology; email: email@example.com.