The Effect of Whitening Creams Usage on the Adrenal Gland .

BACKGROUND: This cross-sectional study assessed the impact of long-term use of skin-whitening products containing corticosteroids on the function of the adrenal glands. OBJECTIVES: Evaluate morning serum cortisol levels among habitual users of corticosteroid- containing skin whitening creams compared with non-users. METHODS: This research, executed at the Hawija Technical Institute from January to April 2025, included 57 participants aged 20 to 40. Before enrolling, all participants gave their written consent. Individuals with chronic endocrine disorders or those receiving systemic corticosteroids were excluded. They were split into two groups: 38 regular (14 male and 24 female) users of skin-whitening creams (≥3 months) as the experimental group and 19 (7 male and 12 female) non-users as the control group. The Mindray CL-900i, a fully automated chemiluminescence immunoassay analyzer, was used to measure the levels of cortisol in the serum. RESULTS: In comparison to controls (7.85 ± 3.54 μg/dL; p = 0.0004), users had a significantly lower mean cortisol level (4.25 ± 2.23 μg/dL), with 42% of users exhibiting morning serum cortisol levels <5 μg/dL, which may suggest reduced hypothalamic-pituitary-adrenal (HPA) axis activity. There were no discernible variations in BMI between the groups or between male and female users. These findings suggest an association between prolonged exposure to corticosteroid-containing skin whitening creams and reduced morning serum cortisol levels, consistent with possible suppression of the HPA-axis activity. CONCLUSIONS: Prolonged use of corticosteroid-containing whitening creams was associated with lower morning serum cortisol levels, suggesting reduced HPA-axis activity. Further studies are needed to confirm HPA-axis suppression.