Efficacy of skin-lightening creams; safety of permanent cosmetics

Q. How effective are cosmetic skin-lightening creams?

The currently popular botanical skin lighteners include fresh soy milk, arbutin and kojic acid. Fresh soy milk contains a substance known as soybean trypsin inhibitor. Soybean trypsin inhibitor interrupts the transfer of melanosomes to the keratinocyte, thus decreasing skin color. Both arbutin and kojic acid interrupt melanin synthesis.

Q. Are permanent eye and lip cosmetics safe?

A. The use of tattoo pigment to simulate eye and lip cosmetics is very controversial. Typically, red pigments are inserted along the vermillion of the lip to create permanent lip liner and a black, brown, or other colored tattoo pigment is place above or below the eyelashes to create permanent eyeliner. Some women even elect to have permanent eye shadow in a variety of colors placed on the lower upper eyelid. If the individual is not allergic to the tattoo pigment, the process is considered safe; however, it still may not be a good idea.

The tattoo pigment does not stay in place, as macrophages engulf the pigment and move it toward the lymph channels and ultimately the lymph nodes. This blurs the fine line that was created when the tattoo was placed. It also lightens the tattoo, so most permanent cosmetics must be touched up three to five years after pigment placement.

Perhaps the main reason that permanent cosmetics may not be advisable for some is that the pigment is indeed permanent. For older individuals with poor vision and decreased manual dexterity, permanent eyeliner may be a good idea since the face is fully mature. However, I am not sure that permanent cosmetics are a good idea for teenagers and young adults. At this point in life, the facial features are still maturing, and the tattoo may not be attractive 40 years later.

A Zoe Diana Draelos, M.D., is a clinical associate professor of dermatology, Wake Forest University School of Medicine, Winston-Salem, N.C., and primary investigator, Dermatology Consulting Services, High Point, N.C.Questions may be submitted via e-mail to zdraelos@northstate.net
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