title: Toxic effects of skin-lightening products in Canadian immigrants.
abstract: BACKGROUND
  The cultural practice of skin bleaching is highly prevalent in Africa. Most reported cases of toxic effects of skin-lightening products occur in this region.
  
  
  OBJECTIVE
  To describe cases of misuse of over-the-counter (OTC) cosmetic skin-lightening products occurring in Canadian immigrants.
  
  
  METHODS
  Two cases of Canadian immigrants with severe complications from OTC skin-bleaching agents were identified in a community-based dermatology practice in Toronto. The case histories were reviewed and analyzed.
  
  
  RESULTS
  A 28-year-old African-Canadian woman developed extensive striae from long-term use of a topical cream containing clobetasol that she had purchased in a Caribbean health food store. A 55-year-old African-Canadian woman developed exogenous ochronosis from the use of a topical bleaching agent she had purchased in Ghana.
  
  
  CONCLUSIONS
  Cosmetic skin lightening with unregulated topical products occurs in Canada. Dermatologists working in Canada need to be aware of this practice to provide appropriate directive care.
authors.affiliation: Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC. nmistry@interchange.ubc.ca
authors.forename: Nisha
authors.initials: N
authors.lastname: Mistry
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shapero
authors.forename: Roopal V
authors.initials: RV
authors.lastname: Kundu
authors.forename: Harvey
authors.initials: H
authors.lastname: Shapero
mesh_terms: D000328:Adult; D000349:Africa / Q000208:ethnology; D057886:Bleaching Agents / Q000009:adverse effects*; D002170:Canada; D003357:Cosmetic Techniques / Q000009:adverse effects*; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D008875:Middle Aged; D009794:Ochronosis / Q000139:chemically induced
chemical_list: D057886:Bleaching Agents