Teenagers and skin-lightening creams

What it is

Skin-lightening (bleaching or "toning") creams, soaps, injections and pills are widely sold and heavily advertised to young people, often through social media and market stalls. Teenagers may use them to clear acne marks, even out tone or because of pressure about colour.

How it works

Many of these products work by poisoning or suppressing pigment cells. Unregulated products often contain mercury, which is absorbed through the skin and can damage the kidneys and nervous system; strong steroid creams, which thin the skin and cause stretch marks, acne and infections; or hydroquinone at high strength, which over time can cause ochronosis, a blue-black darkening that is very hard to treat.

Why it matters on darker skin

Darker skin responds to irritation by making more pigment, so harsh products often leave patchy, darker, uneven skin: the opposite of what was wanted. Teenagers' skin is still developing, and steroid stretch marks and ochronosis can be permanent. Messages that lighter skin is better also affect how young people feel about themselves.

Causes and triggers

Advertising and influencers, comments from family or friends, acne and acne marks, and the easy sale of lightening products without age checks. "Natural", "organic" or "glow" labels do not mean a product is safe.

What helps — and why it works

Talk openly and without shaming: ask what they are hoping to change and why. For acne marks, the most effective steps are treating the acne itself (so new marks stop forming), daily broad-spectrum sunscreen (sun darkens marks) and patience: most marks fade over months. A doctor or pharmacist can suggest safe products such as adapalene or azelaic acid for acne and marks. Use the Melanin & Me product check to look at the ingredients of any cream they are using. Expected timeline: acne marks fade over 3 to 12 months once new spots are controlled.

What to avoid and why

Avoid any cream without a full ingredient list, products that promise lighter skin in days, mixed creams containing steroids (such as clobetasol or betamethasone) bought without a prescription, and lightening injections or pills. Do not stop strong steroid creams suddenly after long use without advice: the skin can flare.

Common mistakes

• Thinking a product is safe because it is sold in a shop or online.
• Scrubbing or bleaching acne marks.
• Shaming a young person, which makes them hide what they use.

Caring for children's skin

Children's skin is thinner, loses water faster and absorbs more of what is applied to it relative to body size, so simpler is safer. For most children a short lukewarm bath, a fragrance-free soap substitute and a plain emollient are all that is needed, plus shade, clothing and sunscreen from six months of age. Avoid adult products, essential oils, antiseptics in bath water, bleaching or 'toning' creams, and cosmetic treatments such as relaxers and gel nails. Medicines and medicated creams should be used only as a doctor, nurse or pharmacist advises, and in children Melanin & Me does not offer photo checks: a clinician should see the child. Trust your instincts as a parent: a child who is unusually sleepy, floppy, not feeding, breathing fast or has a rash that does not fade when pressed with a glass needs urgent care. Keep a simple record — photos and dates — of rashes that come and go, as this helps the doctor.

Products, medicines and when to worry

When choosing products for children, look for fragrance-free formulas with short ingredient lists, and avoid adult acne, anti-ageing or lightening products, essential oils and talc. Medicated creams — including steroid creams, antifungals and antibiotics — are safe and helpful when prescribed for the right condition and used for the right length of time, but mixed creams sold over the counter can contain strong steroids that are unsafe for children. Sunscreen is suitable from six months of age; younger babies should be kept in the shade and covered. Do not give medicines intended for adults, and ask a pharmacist about the right medicine for a child's age and weight. Seek urgent care for any rash with fever and a very unwell child, a rash that does not fade under a glass, swelling of the face or lips, or blistering of the mouth or eyes.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.