The skin lightening trend may be going strong, but that doesn’t mean you should try it.
While it’s completely normal for the skin around the anus to be darker than the surrounding skin due to genetics or everyday friction, according to Dr. Rabia De Latour, M.D., a gastroenterologist at New York University’s Langone Medical Center, some women want to lighten the area. Here’s everything you need to know about anal bleaching:

1. Porn popularized the anal bleaching trend, which is still going strong.

It first gained traction in the early aughts after adult film actress Tabitha Stevens had her anus bleached on the unscripted series Dr. 90210 to look more pleasant on camera. Around the same time, U.S. search volume on the procedure peaked, according to Google Trends data. Several years later, Kourtney Kardashian revealed she’d tried anal bleaching during a 2010 episode of Kourtney and Kim Take Miami, and online queries for at-home anal bleaching products surged.

Anecdotally, people continue to show interest in lightening the intimate area: “It’s the treatment people ask us about the most,” says licensed aesthetician Graceanne Svendsen, who manages Shafer Plastic Surgery and Laser Center in New York City, which receives up to 10 anal bleaching inquiries a week.

“We’ve noticed this is increasingly becoming a group activity,” says Jamie Sherrill, R.N., owner of Beauty Park Medical Spa in Los Angeles and Abu Dhabi, adding that she’s even treated bachelorette parties.

2. The cheapest approach to anal bleaching is DIY, but it’s risky.

You can buy an at-home skin-bleaching serum, cream, or peel online or at a drugstore, salon, spa, or cosmetic surgeon’s office for $6 to $44. Depending on the product, it may contain ingredients such as hydroquinone, azelaic acid, Kojic acid, niacinamide, or other botanical extracts, all of which chemically exfoliate dead skin cells responsible for hyperpigmentation, aka skin darkening caused by excess pigment, according to Dr. Joshua Zeichner, M.D., New York City dermatologist and director of cosmetic and clinical research in dermatology at Mount Sinai Hospital.

The problem: Some chemicals in skin-lightening products, like kojic acid and hydroquinone, may be considered carcinogenic, as per data from the National Institute of Health. When you DIY, “you’re more likely to apply the product improperly, which can injure the area and increase the chance that the product gets into the rectum and enters the bloodstream,” De Latour says, adding that it’s best to stick to products manufactured in the U.S. to minimize exposure to potentially dangerous ingredients.

Although each product’s directions may differ, you should always begin with clean, dry skin that’s free of cuts or infections, Dr. Zeichner says. Typically, you apply the product with clean hands, avoiding the anus itself. Then, you either leave it on or rinse it off shortly after. Results vary, but because OTC products are generally more mild than professional grade alternatives, according to Dr. Zeichner, it could take two to three months of applying the product as often as twice a day to see results, which can last up to six months.

3. Side effects of chemical bleaching products can seriously suck.

Beware of severe itching, burning, and stinging during and after treatment, Dr. Zeichner says. “Skin irritation is common when you use lightening creams, and it is even more likely to develop when you treat sensitive areas like perianal skin.”

If you experience any adverse effects in response to a product, stop using it right away, thoroughly wash the affected area with a gentle cleanser, then apply a petroleum-based moisturizer, such as Vaseline, to form a protective seal over the skin, he says.

4. Professional anal bleaching can be pricey — but worthwhile, if you must.

Some spas, salons, and plastic surgeons offer the service for about $125 per session, according to Cindy Barshop, CEO and founder of VSpot Medi-Spa in New York City. Others, like the Unisex Intimate Bleaching Peel, offered at Svendsen’s office, cost up to $1,000 for three 30-minute treatments scheduled two weeks apart. You could see results after one session, but it will likely take several sessions to get the skin color you want, and you often need to apply lightening products at home between sessions. Like DIY bleaching, the results can last up to six months, Svendsen says.

Because professionals typically use more potent lightening products that deliver faster results than DIY options, according to Svendsen, exposure to professional-grade products could increase your chance of post-treatment irritation, Zeichner says.

The biggest benefit of going pro is peace of mind, since products are applied by technicians who can see what they’re doing, Dr. De Latour says.

5. You need to forgo sex during anal bleaching treatments.

To prevent skin infections, Svendsen recommends skipping sexual activities for three to five days post-treatment, even if the treated area isn’t irritated. And if the skin in the anal area is open or raw any time after treatment, you should continue to abstain, Zeichner says.

Because heat and friction can irritate your skin and cause hyperpigmentation that makes it harder to maintain anal bleaching results, either you should avoid waxing and laser hair removal, plus activities such as hot yoga, running, bathing, wearing a thong, and soaking in a hot tub — or exercise caution.

6. If you don’t want beauty products all up in your butt, there’s a laser bleaching alternative.

The treatment breaks down dark skin pigment into small particles that are later carried away by white blood cells. Although it can cause a hot, prickling sensation, in the area that’s treated, a prophylactic non-steroidal anti-inflammatory drug like ibuprofen can help, as can a topical numbing agent applied by your practitioner. The treatments can cost upwards of $375 per 20-minute session, like at Sherrill’s Los Angeles office. Expect to see results about a week after the first treatment, although you may need up to three sessions for optimal results, with touch ups every six to 12 months, Sherrill says.

7. Laser treatments have some uncomfortable side effects, too.

Afterward, the skin might swell and feel sunburned for a few days. In rare cases, it could irritate the anal canal lining and cause burns, which can result in permanent scarring, Dr. De Latour says.

8. Anal bleaching could cause anal strictures, which make pooping difficult.

Any of the bleaching treatments outlined above can lead to scarring (a.k.a. anal strictures), which could prevent the anus from properly stretching during bowel movements, and ultimately lead to constipation and pain while evacuating your bowels, according to Dr. De Latour. “This is a very sensitive area of the body, and there are no studies that show what the real risks of anal bleaching are,” she says.

It’s why, if you spring for pro anal bleaching, it’s extra important to choose a provider with a dermatologist or gynecologist on staff to oversee the procedure, Dr. De Latour says. Alternatively, Dr. Zeichner suggests consulting a dermatologist about DIY products before using them.

The Bottom Line: Ultimately, any approach to anal bleaching can endanger your health for a temporary benefit: “With time the pigment producing cells come back. “If one of my patients told me they were considering doing this,” Dr. De Latour says, “I’d warn them that the cosmetic benefit does not outweigh the health risks.”