This article originally appeared on Tonic.
In her quest to have the skin of a porcelain doll, Mach Mong, a 27-year-old administrative assistant in Cambodia's capital Phnom Penh, went online and purchased a small tub of whitening cream from Thailand. The jar had no information about the cream's ingredients, but Mong says she applied the solution liberally without investigating whether it was safe.
"A friend recommended this cream, and I wanted my skin to be whiter," Mong explains. "I only used it for one month, but then my skin got so bad." Today, Mong uses makeup to cover the bright red patches of acne and scar tissue caused by the cream. "Sometimes I don't go out because of [my skin]," she says.
In Cambodia, where popular beauty standards favor people with light skin over the tanner tones most Cambodians have naturally, people are poisoning themselves in the name of beauty, and often disfiguring their faces. In 2010, a young woman even died after having a bad reaction to a skin-whitening product. She had rubbed the cream all over her body in preparation for her wedding.
In response, Cambodia's Prime Minister ordered the Ministry of Health to monitor the use of whitening products. But no official ban of whitening products has been put in place, and the desire for lighter skin—and this is a fairly relentless global phenomenon—often trumps health concerns. Skin whitening treatments in the Kingdom range from injections people get at local markets to serums, powders, pills, abrasive skin peels, and an untold number of creams, both brand name and counterfeit.
Pharmacies and markets in Cambodia are piled high with whitening solutions, and it's even difficult to find deodorant that doesn't promise to make your underarm "extra white." Many of the treatments are inexpensive, making them accessible to even the poorest members of society.
But research demonstrates that many creams and treatments contain heavy metals such as mercury, lead, cadmium, and arsenic. Mercury, which inhibits the melanin that causes skin pigmentation, is one of the top ten chemicals of public health concern. A 2015 study conducted by a group of researchers from Cambodia and the United States found that 41 percent of the skin whitening cream tested contained high levels of toxic compounds such as mercury. The treatments also contained arsenic and lead, which can damage the nervous system and cause swelling in the liver and brain. None of the product labels revealed that mercury had been added.
Regardless of the negative health impacts, skin whitening continues to be a $10 billion global industry. Ing Sovanly, director of the Neary Khmer Association for Health and Vocational Training in Cambodia's capital Phnom Penh, says she estimates that around 90 percent of Cambodian women use whitening cream regularly.
"White skin is popular among Khmer people and in most ASEAN [Association of South East Asian Nations] countries," Sovanly explains. "People think whiter skin is more beautiful and more attractive than dark skin, especially because white skin means you are wealthy, it shows you aren't working on a farm."
In a country where almost 70 percent of the population toils in fields under the blistering sun, white skin is seen as a status symbol afforded by the wealthy. Ouch Lina, 23, purchased a whitening cream from a friend who mixes and sells her own cream at home. "If you are dark, people think you are from the countryside," Lina says. "I saw my friend had white skin, so I thought I would use this cream and be beautiful too. The aunt of the girl who sold me the cream works in a pharmacy, so I trusted her."
Lina says she suspects the cream contained steroids. After a month of using it, her skin broke out in pimples and dark spots. To date, she has spent over $1,000 visiting doctors and clinics in an attempt to heal the scars on her face caused by the cream.
"Most of the women end up with sensitive, dry, or itchy skin, like sunburn," Sovanly says. "I've seen women who have dark spots on their face and body, and with acne or wrinkles."
And it's not only women who are opting to bleach their skin in Cambodia—men are also using these treatments to feel more attractive. Kuoy Londy, 25, says he broke out in terrible acne after his friend gave him an unnamed whitening cream to use. "I wanted my skin to look nice like my friend's—so smooth and white," says Londy, who has a deep olive complexion. "So I decided to use what he used, which was a mixture of creams and powders from Thailand."
Shortly thereafter, his face broke out with large red pimples and cavernous pockmarks. Frightened that his face would be permanently scarred, he went to the doctor. "I was so concerned about my face," Londy says. "It's not nice to have scars." Today, Londy's face is healing. But he recommends that others don't use creams that are sold online.
In Cambodia, patients frequently buy medicine from pharmacists and traditional healers without asking questions about what they are consuming. Solutions, whether for health or beauty, are seen as the purview of professionals. That makes it less likely that consumers will ask serious questions about the ingredients in the cream they use on their face.
Meanwhile, counterfeit whitening solutions like the one used by Lina and Londy are sold everywhere, from independent beauty shops to open markets, and even in people's homes. Between March and May this year, Phnom Penh's police began cracking down on supplies of counterfeit cosmetics, stockpiles of which contained a variety of skin whitening products. They confiscated at over 70 tons of counterfeit cosmetics destined for independent beauty shops and markets around the capital.
Many women, however, buy whitening creams directly through Facebook, which is the country's main source of media. There are a plethora of Cambodian Facebook profiles that offer creams and tinctures to make your skin whiter. These are hard to crack down on because they aren't technically illegal.
Lina and her friends have grown concerned about the safety of some of the creams sold online because so many people they know have had bad reactions. "A lot of my friends, they look good when they first start using the cream," Lina says. "But then their skin starts to get red."