KARACHI, Dec 11 Various preparations used at beauty salons to make facial skin look fairer contain high concentrations of mercury (a dangerous toxin), corticosteroids (a class of steroid hormones) and hydroquinone, a skin-lightening chemical banned in some countries on the basis of studies that suggest it may act as a cancer-causing agent, Dawn has learnt.

Experts believe that the widespread use of such preparations is made easier by the fact that there is no law specifically covering the manufacturing of cosmetic products, nor is there one to regulate the functioning of beauty salons. No section of the Drugs Act 1976 deals with the use of chemicals in cosmetic products.

The lack of government regulation and public awareness are major reasons why so many people, particularly girls, end up damaging their skin, at times for life.

KU findings

According to Dr Nasiruddin Khan, head of the centralised science laboratory at the University of Karachi (KU), the preparation is usually made by mixing four different types of cosmetic creams and ointments already available in the market. One of them is a popular fairness cream that contains hydroquinone as a major ingredient.

Hydroquinone, Dr Khan said, was a strong inhibitor of melanin production. That means it prevents skin from making the substance responsible for colouration. “Hydroquinone actually disrupts the synthesis and production of melanin hyper-pigmentation and the skin starts looking fairer. The chemical is already banned in some countries after some studies suggested that it may act as a carcinogen. The chemical has also been linked to the medical condition, ochronosis, in which the skin becomes dark and thick.

“Dermatologists differ on the

use of products containing this chemical. Some regard it as safe when used as directed while others maintain that the prolonged use of such products can be dangerous as it causes the skin to break up and chemicals to penetrate into the bloodstream and reach different organs where serious damage can occur,” he told Dawn.

Another important point, he adds, was the limit set for the chemical's use. “Currently, products that contain up to two per cent hydroquinone may be sold in the US without a prescription, and prescription skin-lightening products may contain up to four per cent hydroquinone. Besides, all products are tested for efficacy before their launch in the market.

“In our case, however, there is no body to regulate the use of chemicals in cosmetics. Also, beauty salons have been given a free hand to make money at the cost of public health. Poor quality fairness creams and beautifying agents are widely used and are available at prices as low as Rs20.”

In this situation, the question of evaluating the impact of chemicals when used in higher proportions didn't arise, he said.

The analysis of the preparations, collected from various beauty salons, at the KU lab showed the concentration of mercury as high as 252ppm (parts per million). The permissible level of mercury in cosmetic products is 1.0ppm. The preparations also contained large quantities of hydroquinone.

About the use of mercury in fairness creams, Dr Khan explained that mercury, a dangerous toxin that can cause severe damage to the skin as well as the brain and kidneys in case of penetration, inhibited the synthesis of melanin.

The analysis of the preparations also showed the presence of corticosteroids. “Corticosteroids are a class of steroid hormones often used for reducing skin inflammation. The ointments with corticosteroids are used to reduce the side-effects of other creams mixed in the preparation.

“Prolonged use of steroids triggers the release of an undesirable amount of substances in the blood that cause the blood vessels to widen, causing the affected area to turn red, swollen, itchy and painful. It makes the skin thinner and rough and leads to growth of facial hair.”

'Women need to

change attitude'

The Institute of Skin Diseases, Sindh, receives up to 25 patients weekly complaining of skin problems after getting treatment at beauty salons. Of these patients, 60 to 70 per cent are girls between the age group of 15 and 25. The head of the institute, Dr Sikandar A. Mahar, told Dawn that usually women, mostly from low-income groups, come with allergic symptoms such as redness, acne and itchiness. “The treatment is symptomatic and patients are advised to stop going to beauty parlours for skin treatment,” he said.

At the Jinnah Postgraduate Medical Centre (JPMC), Professor Azam J. Samdani, head of the dermatology department, says that the use of steroids on the face can lead to irreversible damage if such products are used for a longer period. “Once the skin gets thinner, it becomes difficult to bring it back to its normal condition. Though we get few patients, the trend to use substandard fairness creams, especially at beauty parlours, is increasing.”

Criticising the role of the media, particularly television channels in this respect, Professor Dr Zarnaz Wahid of the Civil Hospital Karachi (CHK), said that a code of ethics needs to be made and implemented to telecast programmes on public health. “There is no problem in explaining the causes of different ailments, but their treatment should not be discussed as it required a thorough individual examination.”

The various preparations, she said, used at beauty salons did make the skin look fairer, but for a very short while. “Soon, the 'nice' effect goes away and the client is once again at the salon. The uneducated class is usually the main victim in such cases.”

Dr Wahid is of the opinion that normal skin can easily be taken care of at home and women should consult a dermatologist rather than a beautician for skin treatment. “The markets are flooded with products with European brand names, but actually they are made in China and Taiwan, many of which are not allergy tested. Second, their shelf-life expires quickly as they are usually kept in low temperatures. So, one has to be careful while choosing cosmetics.”

Need for regulation

When approached by Dawn, the executive district officer of the city government's health department, Dr A.D. Sajnani, conceded that a legal vacuum existed. “Yes, there is a need for laws on the use of chemicals in cosmetic products since chemicals can be allergens or carcinogenic,” he admitted. “Beauty salons used to be inspected in terms of the working conditions when some bylaws were formulated by the defunct KMC. There is no such arrangement right now.”

On behalf of the Pakistan Medical Association, Dr Samrina Hashmi said that there was a dire need of public awareness on this issue since government checks existed only on paper.

According to a Pakistan Standards and Quality Control Authority official, various standards on cosmetics exist, but they have not yet been adopted by the government. At the moment, only 67 standards are on the government list of enforcement.