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Fairness Creams: How fair is it for your kidney health?

Rabindranath Tagore once beautifully remarked, “Her neighbours call her dark in the village-but she is a lily to my heart, yes, a lily though not fair………. She may be dark as they say in the village, but I have seen her black eyes and am glad (কৃষ্ণকলি আমি তারেই বলি,   কালো তারে বলে গাঁয়ের লোক …….. কালো ? তা সে যতই কালো হোক, দেখেছি তার কালো হরিণ-চোখ ….- কবিগুরু রবীন্দ্রনাথ ঠাকুর ) These poetic lines encapsulate a profound truth about beauty and perception. However, in today’s society, the obsession with fair skin continues to thrive, driving the booming market of fairness creams and cosmetic products, especially among the young. These products promise the allure of a lighter complexion, playing on deep-seated biases and cultural ideals. But beneath the surface, there are often hidden dangers that can pose serious health risks, including potential kidney disease.

Fairness Creams

This blog explores the critical link between fairness cream and kidney health, shedding light on the possible consequences of using these popular products.

A recent study published in the Kidney International journal has shown a concerning link between using fairness creams and kidney damage. The research, conducted at Aster MIMS Hospital, Kottakkal, from July 2021 to September 2023, found 22 cases of Membranous Nephropathy in people who had used fairness creams suggesting that using these chemicals over time can cause Membranous Nephropathy, a kidney condition where kidney filters get damaged, leading to protein leakage.

The harmful effects of fairness creams are mainly due to toxic chemicals like hydroquinone, mercury, and steroids. These substances are commonly used for their skin-lightening properties.

The damage caused by these harmful chemicals is significant. Inorganic mercury can be absorbed through sweat glands, sebaceous glands, and hair follicles. Once absorbed, it spreads to all tissues. Extended use of these topical applications can lead to systemic toxicity, affecting both the kidneys and the nervous system.

  • Hydroquinone is a strong bleaching agent that can enter the bloodstream and reach the kidneys.
  • Mercury, a heavy metal, blocks melanin synthesis and is therefore added to skin-whitening creams. However, it is a well-known nephrotoxin and neurotoxin. It accumulates in the kidney in inorganic form leading to poisoning causing tubular necrosis, nephrotic syndrome, or even kidney failure and CNS damage in addition to membranous nephropathy.
  • Steroids, included for their anti-inflammatory effects, can upset the body’s natural balance and cause various health problems, including kidney damage.

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The symptoms of kidney damage include:

  • fatigue,
  • swelling,
  • changes in urination patterns,
  • high blood pressure
  • increased frothing of urine. 

In severe cases, kidney failure may require dialysis or a kidney transplant.

Membranous nephropathy (MN) is a condition characterized by the accumulation of immune deposits on the external part of the glomerular basement membrane and is a usual cause of nephrotic syndrome in adults.

Interestingly, mercury, which has a strong affinity for sulfanyl groups on the glomerular basement membrane, acts as a hapten. Consequently, it triggers the antibodies to target antigens on the membrane, including possibly NELL-1 (Neural epidermal growth factor-like 1 protein), resulting in the deposition of immune complexes. Furthermore, mercury accumulates in the proximal convoluted tubule, where NELL-1 is abundant. This accumulation potentially contributes to autoantibody formation, leading to this autoimmune disease.

NELL-1-associated membranous nephropathy has specific characteristics, such as partial staining of the kidney’s tiny blood vessels and a high presence of the IgG1 antibody. This condition is more often connected to cancer than other types of membranous nephropathy.

The rate and degree of mercury’s dermal absorption depend on the skin’s hydration, skin integrity, concentration of mercury, and lipid solubility of the vehicle in the skin-lightening creams. Additionally, genetic polymorphisms may contribute to susceptibility to mercury-associated membranous nephropathy and mercury exposure from face cream.

The Drugs and Cosmetics Act of 1940 bans mercury in fairness creams. Rules 145D and 135A of the Drugs and Cosmetic Rules prohibit the manufacture and import of cosmetics having mercury, except for eye products. The U.S. Food and Drug Administration (FDA) allows a maximum of 1 ppm of mercury in cosmetics, excluding eye products. However, the FDA has found few products with mercury levels above this limit that do not disclose mercury on their labels (Agrawal and Sharma, 2017). Consumers should be informed and warned about these products, as they pose a serious health risk.

The chance of reversing kidney damage depends on how severe the harm is and how soon it is found. If the damage is mild, stopping the use of toxic products and getting proper medical treatment can often reverse it. However, if the damage is severe, it might be permanent and require long-term solutions like dialysis or a kidney transplant. Typically, treatment includes discontinuing the harmful product, detoxifying the body, and managing symptoms with medical help.

Skin colour is a natural trait determined by the amount of melanin synthesized and its distribution pattern in the skin. Genetic variation and environmental adaptations again control this. Darker skin, for example, offers increased protection against skin cancer due to higher melanin levels. Embracing and appreciating your natural skin tone is not only a step towards self-confidence but also a choice for better health. Always remember, your well-being should never be sacrificed in the pursuit of beauty. Don’t allow marketing industries to take advantage of your low esteem. Keep faith in your natural beauty, be confident in who you are, and live a healthy life with a healthy kidney.

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Dr Pratim Sengupta's Team (Nephro)
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