Following a woman taken ill from using a skin care product laced with steroids, British doctors warned about using illegal skin lightening creams.
The woman was extremely obese, had thin, bruised, stripy skin and suffered from muscle weakness. She had been trying unsuccessfully to conceive for the previous 18 months even though she had regular periods.
Physicians initially believed she had a disorder called Cushing's syndrome, caused by the adrenal or pituitary glands. But blood tests turned up no sign of excess levels of two hormones that are the usual telltales of this syndrome.
After further inquiries, the patient admitted she had been using a skin-lightening cream for seven years, bought not from a pharmacist but from a local shop that was unauthorised to sell it.
The cream contained the steroid clobetasol, a powerful corticosteroid usually used against psoriasis and eczema. The woman had been using two tubes of it, amounting to about 60 grammes (three ounces), a week.
Reporting the case study in next Saturday's British Medical Journal (BMJ), the doctors at London's Hammersmith Hospital urge physicians to be aware of the risk of illegal skin whiteners.
"The market is worth millions of pounds (euros, dollars) a year, in the UK alone. Creams can contain toxic substances, such as steroids and hydroxyquinone -- and patients are typically unaware of the risks," they say.
Skin lightening is used in parts of Asia, Africa and the Middle East where a fairer skin is associated with attractiveness. Campaigners against whitening say the practise reinforces discrimination and ancient stereotypes.