India’s Fair Skin Obsession Takes Risky Pharma Turn

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The Indian obsession with fair skin has turned a little known drug meant to help cancer patients cope with chemotherapy toxicity into the latest rage. This drug is an anti-oxidant called Glutathione, and skin lightening is a side-effect of its use. Glutathione’s ominous provenance hasn’t kept it from being a runaway success in India’s whitening revolution, and it is now far more popular as a skin-whitening agent than its original use in cancer drug regimens.

Glutathione capsules come in strengths of 100 mg and 500 mg which lightens skin tone by two shades when had once a day for two to three months. Even more dangerous is the off-label use of the drug in injectable doses of 1,200 mg, usually prescribed for 10 consecutive weeks after which people are asked to switch to the capsules to retain their newfound lighter complexion.

According to the FDA, the US drug watchdog, side-effects of the injection range from skin rashes, disruption in thyroid function, kidney damage, Stevens-Johnson syndrome and toxic epidermal necrolysis. The last two life-threatening conditions cause fever, severe rash, blisters and skin peeling. Affected people have to be treated in the hyper-sterile burns wards of hospitals.

Each vial costs Rs 7,000 but Delhi techie Rita Saxena, 35, is not complaining. “I wanted to be fairer all my life and now I noticeably am two shades lighter. The treatment set me back by almost Rs 90,000 but every shot was worth it,” says the Hauz Khas resident.

Age and gender is no bar when it comes to seeking fairness at a cost ranging between Rs 10,000 to Rs 2 lakh. “Most people come to us (dermatologists) after experimenting with over-the-counter fairness products or after having scrubbed themselves pink with a loofah. Fixing the damage takes as much time as customising solutions for clients,” says dermatologist Dr Rashmi Shetty, who runs a clinic in Mumbai. Some of her clients are well into their 70s.

Almost all skin-lightening products come with risks. “Most fairness creams contain steroids that increase risks of skin infections, acne, and slow wound healing. Hydroquinone inevitably causes dark patches (hyper-pigmentation) or untreatable skin (ochronosis), which are difficult to treat,” says senior dermatologist  Shehla Agarwal, who runs Mehak Skin Clinic in Delhi.

Skin-lightening is among the fastest-growing beauty segment, standing at Rs 3,000 crore in 2013. “Over the past two years, the skin-whitening sector has grown by 20-25%,” says Ajay Kumar Babel, general manager at Ethicare Remedies, a pharma company.