Abstract
BACKGROUND: The skin lightening industry has seen exponential growth in India. Consumers often present to the dermatologist with adverse cutaneous reactions to these 'fairness' (skin lightening) creams. The composition of these creams has not received sufficient attention. OBJECTIVE: To identify fragrance, sunscreens, botanicals and potential allergens in the bestseller 'fairness' creams available in the Indian market. METHODS: Twenty fairness (or whitening or lightening) creams were selected based on the 'bestseller' creams of one of the largest electronic commerce websites in India, and availability in local stores and unlabelled brands were excluded. Fragrance, sunscreens, botanicals and potential allergens were identified from the ingredient labels. RESULTS: Twenty bestseller fairness creams were included. The number of the listed ingredients in the fairness creams ranged from 6 to 49 (mean = 32.2). The most frequently listed ingredients included water, fragrance or parfum, glycerin, tocopherol/tocopherylacetate and titanium dioxide. Hydroquinone, monobenzyl hydroquinone, corticosteroids, tretinoin and mercury were not listed in any of the creams. Unspecified fragrance was listed in 19 (95%) creams and linalool (8,40%) was the most frequent specified fragrance. Titanium dioxide (14, 70 %) was the most common inorganic sunscreen and ethylhexyl methoxycinnamate (12 creams or 60% of creams) was the most common organic sunscreen. Twenty-seven botanicals were identified. Eight ingredients were potential allergens according to the Indian Cosmetic and Fragrance Series. The cost of the creams ranged from 95 to 1,095 in Indian rupees (mean 300.5). CONCLUSIONS: Consumers are exposed to a vast range of compounds in the quest for a lighter skin tone. Several potential allergens, particularly fragrance allergens, are present in addition to the eight allergens that were identified with the Indian Cosmetic and Fragrance Series. Increased awareness of the composition of skin lightening creams available in the market and strict regulation of these creams is needed.