Self-tanning creams produce a golden skin color overnight without sun exposure. The golden color appears natural on persons with blonde or light brown hair who tend to have golden hues to their skin, but it may appear less natural on Mediterranean individuals with an olive complexion or extremely fair persons with pink skin tones.
The active ingredient in self-tanning creams is 3-5% dihydroxyacetone incorporated into a glycerin and mineral oil base to form a white cream that turns the stratum corneum golden. Chemically, the dihydroxyacetone acts as a sugar to interact with amino acids in the stratum corneum to produce melanoidins. Formulations are available for the face and body, but most do not incorporate a sunscreen, and the golden skin color is minimally protective against actinic damage. Higher concentrations of dihydroxyacetone are used to produce darker coloring of the stratum corneum. The color is not permanent and is lost as the stratum corneum desquamates; thus, continued use is necessary. The major disadvantage of these products is that they stain all contacted skin surfaces, including the palms of the hands, if the cream is not removed. These products also produce deeper staining of the follicular ostia and may accentuate seborrheic keratosis, actinic keratosis, porokeratosis, and ichthyotic skin. Many patients are not aware that they have these skin conditions until the self-tanning cream highlights the irregularity.
Allergic contact dermatitis from use of the product is infrequent, but several cases of dihydroxyacetone allergy have been reported. Self-tanning creams can be open or closed patch tested as is.