A City Press in­ves­ti­ga­tion shows that a grow­ing num­ber of black and In­dian women want to be fair-skinned. Why? Skin-light­en­ing creams con­tain banned sub­stances

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Dark-skinned black and In­dian women in South Africa are lit­er­ally risk­ing their lives to be­come the fairest of them all.

De­spite a real risk of skin can­cer and other ef­fects such as ir­re­versible skin thin­ning, dark­en­ing and acne, an in­creas­ing num­ber of women and a few men are us­ing skin-light­en­ing prod­ucts – bought mostly from street ven­dors – that con­tain harm­ful and banned sub­stances such as mer­cury, steroids and hy­dro­quinone.

Pro­fes­sor Ncoza Dlova, chief spe­cial­ist and head of the der­ma­tol­ogy depart­ment at the Univer­sity of KwaZu­luNatal, says the trend – com­mon in the 1960s and 1970s, when peo­ple be­lieved be­ing white was beau­ti­ful – is now on the rise again.

This, she says, has given rise to ir­re­versible skin dam­age and ochrono­sis, and has ac­cel­er­ated the age­ing process. Skin can­cer is an­other fright­en­ing threat that has been re­ported with in­creas­ing fre­quency among those who use skin light­en­ers.

Dlova says skin-light­en­ing prod­ucts sold by street ven­dors or over the counter in phar­ma­cies are wreak­ing havoc on the coun­try’s al­ready over­stretched health sys­tem.

“We are see­ing an in­creas­ing num­ber of peo­ple pre­sent­ing with skin com­pli­ca­tions in clin­ics and hospi­tals be­cause of th­ese prod­ucts. Some of the cases are so se­vere that the dam­age can­not be re­versed and, in oth­ers, the state spends a for­tune treat­ing them,” says Dlova.

A study pub­lished in the Bri­tish Jour­nal of Der­ma­tol­ogy in July last year found that one in three women in Dur­ban were us­ing skin light­en­ers con­tain­ing harm­ful and banned sub­stances. The study sam­pled 571 black women (African, In­dian and coloured) be­tween the ages of 20 and 50.

A third of those who con­fessed to us­ing skin light­en­ers re­ported that they were us­ing them to brighten their com­plex­ion. The re­main­ing 67% were us­ing it to treat skin prob­lems, in­clud­ing postin­flam­ma­tory hy­per­pig­men­ta­tion, melasma – a chronic skin dis­or­der char­ac­terised by sym­met­ri­cal, patchy brown­ish fa­cial pig­men­ta­tion – and acne.

The study con­ducted by Dlova also found that th­ese prod­ucts, which of­ten con­tain the harm­ful and banned sub­stances mer­cury, phenol, resorcinol, steroids and hy­dro­quinone, were eas­ily ac­ces­si­ble. Some were sold by street ven­dors for as lit­tle as R10 a tube.

Dlova, the study’s prin­ci­pal in­ves­ti­ga­tor, says she was not sur­prised by the find­ings, con­sid­er­ing the num­ber of peo­ple pre­sent­ing with skin com­pli­ca­tions in health­care fa­cil­i­ties.

But what was dis­turb­ing, she says, “was that 34% of women re­ported that their skin had been dam­aged by the use of skin-light­en­ing prod­ucts, but 90% were still happy with the re­sult of a lighter skin tone”.

“This shows that peo­ple are not com­fort­able in their own skins. They be­lieve that be­ing fair in com­plex­ion makes them more at­trac­tive and opens up more op­por­tu­ni­ties for them,” she says.

“In cer­tain In­dian com­mu­ni­ties, for in­stance, it is be­lieved that the prospects of mar­riage are en­hanced by fair skin.”

Al­though there are no pop­u­la­tion stud­ies doc­u­ment­ing the preva­lence of the use and abuse of skin-light­en­ing creams among In­dian women liv­ing in South Africa, Dlova says the study “showed that 27% of In­dian women in Dur­ban use skin light­en­ers”.

Dlova says it is im­por­tant to spread the word about how dan­ger­ous th­ese prod­ucts are.

“We are see­ing an in­crease in the num­ber of pa­tients in pub­lic clin­ics and pri­vate prac­tices pre­sent­ing with skin com­pli­ca­tions from us­ing skin-light­en­ing creams. Many of the par­tic­i­pants in our study were not aware of the dan­gers of the skin-light­en­ing prod­ucts they pur­chased over the counter and had no idea they con­tained harm­ful and banned sub­stances that come with ad­verse ef­fects,” she says.

“Th­ese creams cause ir­re­versible thin­ning of the skin, se­vere stretch marks, rapid age­ing, skin in­fec­tions, steroids-in­duced acne, per­ma­nent dark marks and skin can­cer. Sadly, man­u­fac­tur­ers and dis­trib­u­tors do not de­clare this in­for­ma­tion on the pack­ages.”

Clin­i­cians from Groote Schuur Hos­pi­tal in Cape Town and academics from the Univer­sity of Cape Town re­cently con­ducted a study in­ves­ti­gat­ing the ac­tive in­gre­di­ents and coun­tries of ori­gin of pop­u­lar skin­light­en­ing prod­ucts avail­able in Cape Town.

Out of the 29 prod­ucts tested, 80% con­tained one or more il­le­gal or banned in­gre­di­ents (par­tic­u­larly hy­dro­quinone, steroids and mer­cury). This is de­spite the fact that South Africa banned the in­clu­sion of th­ese ac­tive in­gre­di­ents in over-the-counter cos­metic prod­ucts in 1992.

Ac­cord­ing to the World Health Or­gan­i­sa­tion, mer­cury in skin-light­en­ing prod­ucts causes skin rashes, dis­coloura­tion and scar­ring, and a low­er­ing of re­sis­tance to skin in­fec­tions. It could also cause anx­i­ety, de­pres­sion and nerve dam­age.

Hy­dro­quinone can cause se­vere al­ler­gic skin re­ac­tions, as well as blis­ters and per­ma­nent blue-black patches on the skin. Steroids can cause skin thin­ning and acne.

The re­searchers found that the la­bels on most of the prod­ucts did not in­di­cate that they con­tained th­ese harm­ful in­gre­di­ents, a point Dlova says is the big­gest pit­fall in the fight against the use of over-the-counter skin light­en­ers.

“Peo­ple re­ceive rec­om­men­da­tions from friends and rel­a­tives that th­ese prod­ucts clear pim­ples and pig­men­ta­tion, and they use them with­out know­ing what the ac­tive in­gre­di­ents are, due to the lack of proper warn­ing la­belling. Yes, at first they look beau­ti­ful and their com­plex­ions brighten up, but this is the false sense of con­fi­dence most users ex­pe­ri­ence within the first few months of us­ing the prod­ucts – but it is later fol­lowed by a re­bound phe­nom­e­non and side-ef­fects,” warns Dlova.

Dr Noori Moti-Joosub, a der­ma­tol­o­gist at the pri­vate Laser­derm clinic in Jo­han­nes­burg, agrees: “The overuse of cer­tain prod­ucts can lead to ochrono­sis, which is a de­po­si­tion of black pig­ment un­der the skin and thus the side-ef­fects of th­ese prod­ucts nul­lify their re­sult.”

Dlova has urged govern­ment to take ac­tion against the man­u­fac­tur­ers of th­ese skin-light­en­ing prod­ucts, but also to raise aware­ness about the dan­gers of us­ing them.

“We can only win this war if we ed­u­cate peo­ple at a young age to be proud of their nat­u­ral skin, and we ap­peal to the govern­ment to en­force strict reg­u­la­tions when it comes to th­ese bleach­ing creams.”


Ru­mour has it that Kelly Khu­malo uses skin-light­en­ing prod­ucts Nonhlanhla Ntuli has earlystage skin dam­age



RE FO BE From th­ese be­fore-and-af­ter pho­tos, it is clear that No­ma­sonto ‘Mshoza’ Maswanganyi (above) and US rap­per Nicki Mi­naj have been us­ing prod­ucts to lighten their skin

Pro­fes­sor Ncoza Dlova

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