History

• Skin bleaching dates back to ancient Persia, when farmers used pure hydroquinone (the active ingredient in most bleaching agents) to keep their skin delicate and clean. Skin bleaching is also affiliated with the practices of Japanese geisha, whose white painted faces symbolize high social class, grace and beauty.
  
  

Uses

• Skin bleaching targets highly pigmented areas like moles, age spots and birthmarks that can be faded to match the surrounding skin. Alternatively, in treatment of vitiligo, a chronic disorder that causes the depigmentation of skin, unaffected skin can be lightened to create a more even appearance.
  
  

Topical Treatments

• Hydroquinone is the most commonly used topical treatment because it is safer, less expensive and produces a similar effect to chemical peels and laser treatment. Arbutin derivatives, mercury, tretinoin, kojic acid, azelaic acid and vitamin C are alternatives to hydroquinone.
  
  

Invasive Procedures

• Laser treatments and cryosurgery using liquid nitrogen are other more invasive options.
  
  

Adverse Effects

• Hydroquinone has been shown to cause cancer in laboratory rats. Laser treatments can scar, create hypo- or hyper-pigmentation and are not always consistent in means of method, while cryosurgery's skin-bleaching outcome depends on the pigmentation depth.