To address mounting concerns over the misuse of skin-bleaching products, the International League of Dermatological Societies (ILDS) has issued an updated position statement on the Safe and Appropriate Use of Topical Corticosteroids.
The ILDS points out that skin-bleaching is widespread in some regions of Africa, Asia, South America, and the Caribbean, where it is driven by sociocultural pressures that favor lighter skin tones.
In certain countries, facial skin-bleaching products—often containing potent or super-potent corticosteroids—constitute a significant segment of the skincare market. Alarmingly, these products are frequently sold without medical oversight, posing severe risks to public health. The misuse of corticosteroid-based bleaching agents may be linked to:
- treatment-resistant fungal infections
- irreversible skin damage
- systemic side effects
- negative impacts on mental health
Updated ILDS Statement
The updated ILDS position statement calls for:
- the stricter regulation and enforcement of regulations that prohibit the use of monotherapy and/or fixed-dose combinations, containing potent or super potent corticosteroids without a prescription from an appropriately trained healthcare professional
- clearer guidelines to protect patients and the public from the risks of overuse and misuse of potent topical corticosteroids
- improved patient and public education on the dangers of skin-bleaching
- advocacy efforts to promote safer dermatological practices globally.
“The widespread misuse of skin-bleaching creams containing corticosteroids and sold over the counter is a serious public health concern,” says Dr. Ramesha M Bhat, Professor of Dermatology & Head of Research, Father Muller Medical College in Kankanady, Mangalore, India [PICTURED], in a news release. “It is exacerbated by the misapplication of combination creams, containing potent corticosteroids, antifungals, and antibiotics, as antifungal treatments. Used in this way, they provide temporary relief but ultimately worsen the condition by suppressing the patient’s immune response.”
He continues, “Unregulated access and misleading marketing are fuelling this crisis, particularly in communities where lighter skin is preferred culturally. We hope the updated ILDS position statement will encourage national governments to enforce stricter regulations, promote the rational use of corticosteroids, and ban potent topical corticosteroid combinations marketed as skin-lightening or antifungal treatments.”
Reaching Epidemic Levels
Dr. Ncoza Dlova, Head of Dermatology at the University of Kwa-Zulu Natal in South Africa, adds, “Skin-bleaching is reaching epidemic levels and, for the first time, cases of squamous cell carcinoma are being reported, which is a serious concern. The dermatology community must work together to address this problem, both through education and by tackling the sociopolitical influences on this practice.”
“Our updated position statement underscores the growing concerns raised by our member societies about the misuse of corticosteroids in skin-bleaching products. It also outlines key recommendations to combat this serious public health crisis,” says ILDS President Henry Lim, MD, former Chair of the Department of Dermatology at Henry Ford Hospital and Senior Vice President for Academic Affairs at Henry Ford Health in Detroit, MI. “We are delighted that more than 50 of our member societies from different regions of the world have already reaffirmed the updated position statement and look forward to working with them, our wider membership and other stakeholders to bring about the changes necessary to promote the safe use of topical corticosteroids worldwide.”
