Skin lightening is a big thing in Africa. In Nigeria 77 percent of women use lightening products, but it's also a regular part of beauty regimens in Togo, South Africa, Senegal, and Mali, where 59, 35, 27, and 25 percent of women use them, respectively.
Yet despite their popularity, many of these skin-lightening creams contain stuff that can kill you. That in mind, yesterday Ivory Coast banned creams containing cortisone, hydroquinone (in concentrations over 2 percent), mercury, or vitamin A and its derivate. According to Ivory Coast authorities, the health risks associated with the creams can include increased risk of diabetes, hypertension, and skin cancer, which, given their popularity, could transform a beauty trend into a public health crisis.
"The number of people with side effects caused by these medicines is really high," local pharmaceutical authority Christian Doudouko told the Guardian.
Skin lightening products are also hugely popular in Asia, with the largest global market being in India, where over 60 percent of women (and a growing number of men) consumed 233 metric tons of the products, including vaginal bleaching washes, in 2012. That year, the $400 million-plus market outsold fucking Coca-Cola. And the trend is growing worldwide—at a rate of 20 percent per year in India, but by similar rates in other countries.
In Asia, the preference for light skin and use of whitening products dates back hundreds to thousands of years, and is most often attributed to the connection between fairness and wealth and luxury (allowing one to stay out of the sun). In Africa, however, if the practice has ancient roots they are largely unknown or unrecognized popularly. Local psychologists describe the trend as an expression of self-hatred and inferiority stemming from colonial racial attitudes, reinforced by local and global media stereotypes and aggressive modern cosmetics industry ad campaigns associating wealth and status with light-to-white skin.
"Black people are seen as dangerous," Jackson Marcelle, a Congolese hair stylist living in South Africa who regularly uses skin lightening creams, told the BBC of these stereotypes in 2013. "That's why I don't like being black. People treat me better now because I look like I'm white."
Most skin whitening products produced by major global corporations, if used in moderation, appear to be safe. These creams use well-tested compounds like arbutoin, kojic acid, niacinamide, retinoic (derived from vitamins or things like bearberry or licorice) to either inhibit melanin production or slough off top layers of darkened tissue, revealing lighter natural skin.
But many cheaper products made by smaller companies (and common knock-offs of major firms' cosmetics) use the ingredients banned by Ivory Coast as they tend to be cheap and effective, despite the fact that they are all well-linked to major health problems. Cortisone and similar steroids can thin skin, prolong the healing time for wounds, cause hypertension, create or exacerbate blood sugar issues, lead to stretch marks, or suppress natural steroid production. Hydroquinone, although it can be used in high concentrations to treat eczema, psoriasis, and vitiligo, can lead to anything from redness and irritation to permanent skin color change or skin cancer when used without doctor supervision. Mercury, an especially common melanin-blocker, is especially easily absorbed through the skin, leading to brain damage, organ failure, or a variety of cancers if used for prolonged periods of time. And a new product not banned in Ivory Coast but increasingly popular in India, glutathione (usually used to help patients in chemotherapy), is associated with thyroid and kidney disorders and skin necrosis, among other health conditions.
Due to a lack of research on skin whitening product usage, and the extreme variability in the cosmetics themselves, it's hard to make definitive statements about the scale of the risks these products pose. However we do know that in India, a 2014 study by the local Center for Science and Environment found that at least 44 percent of the products on local shelves contained harmful materials (32 of them contained toxic levels of mercury). A 2002 poisoning scare in Hong Kong revealed that some of these products contain 9,000 to 65,000 times the acceptable dosages of mercury. And a 2000 BBC interview with dermatologists found that some believed up to half of their patients suffered from problems related to skin lightening creams, of which they used between one and two bottles per day over the majority of their bodies. It's also telling that the British Skin Foundation recently found that 16 percent of the UK's dermatologists believe that skin whitening products are never safe, and 80 percent believe they should only be used with doctor supervision.
Other nations have banned skin lightening creams in the past, including Gambia, Ghana, Kenya, and South Africa. In 2006, the US Food and Drug Administration tried (but failed) to institute a blanket ban on all over-the-counter whitening products, even those with safe ingredients.
Yet these bans have never been especially effective. In Africa, black markets keep a steady supply of dangerous skin whitening products flowing into local markets on the cheap to satiate continued demand against unwitting or unconcerned consumers. And even in America, the scale of poorly labeled cosmetics imports overwhelms inspectors—in 2010, the Chicago Tribune launched an investigation of 50 over-the-counter skin creams found near their offices or ordered online which revealed that over 10 percent contained unacceptable levels of mercury.
This precedent suggests that mere bans like that promoted by Ivory Coast this week will not be enough to overcome the health risks of skin lightening products. Instead, nations will have to find ways to cut back on the massive levels of demand that incentivize the creation and importation (slash inundation) of cheap and dangerous cosmetics. There are signs that such measures are coming into effect in India, where a major Bollywood actress launched a highly visible Dark Is Beautiful campaign in 2013 and where the self-regulated Advertising Standards Council of India decided to ban ads depicting dark skin as negative or inferior to light skin in 2014. Yet whether these measures will manage to take a cut out of that nation's massive skin lightening market and then prove exportable to other nations like Ivory Coast remains to be seen.
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