Dr Alfred Dawes | Make me whiter than snow
“Dem a bleach, dem a bleach out dem skin, dem a bleach fi look like a brownin” was Nardo Ranks’ observation in the years following Buju’s controversial ‘Browning’.
Bleaching has been around for some time now but there has been a rapid increase in its popularity in recent years. Bleachers use individually or a combination of creams, pills and even injections to whiten dark skin, oftentimes to appear “more attractive” and in an attempt to further their career or enter relationships. For others, it is simply a fashion statement.
Let’s face it, skin bleaching is socially acceptable for males and females in Jamaica and in many countries with darker skinned peoples. In fact, I have to incorporate it into the list of questions I ask patients about medication use.
Credit must be given to Vybz Kartel, who was quite open about his skin being “pretty like a coloring book” and his advocacy of cake soap to lighten skin. Bleaching is as much a part of the dancehall culture as is skimpy clothes and new dance moves every weekend.
In 2017, the skin bleaching industry was worth US$4.8 billion worldwide and is projected to reach US$8.9 billion by 2027.
Skin bleaching is not just a practice of Blacks. According to one study, up to 40 per cent of Chinese women used skin lightening creams and the highest growth regions are in the Asia-Pacific region.
Our own bleaching issues stem from cultural appropriation combined with the socio-cultural effects of colonialism on the predominantly Black Jamaican population.
…Bleaching is a Public Health Emergency
But bleaching is to be of greater interest than just a talking piece for Afrocentrism and debates about self identity and colonialism.
Bleaching is a Public Health Emergency.
Jamaican ports are notoriously porous and each year tons of contraband enter the country through the combined efforts of criminal importers and their “links at the wharf”.
Unsurprisingly, many of the bleaching drugs are not vetted by the Ministry of Health before they find their way on the streets and in wholesalers’ inventories. Many of these products contain chemicals such as mercury, hydroquinone, and steroids. These chemicals are dangerous and are heavily regulated due to the health concerns. Yet they find their way into the bleaching products, often in dangerous levels.
In one study, the concentration of mercury in Caribbean born Blacks and Dominicans was up to twice as high as that in Whites and other ethnic groups. Bleaching was thought to be the major contributing factor in this observation.
Mercury is a highly toxic heavy metal. Poisoning can even come from inhaling it, much less rubbing it on the skin daily. It affects the nervous system, gastrointestinal system and kidneys primarily.
The Food and Drug Administration limits the amount of mercury in most cosmetic products to one part per million. Compare that to the finding of 10,000 parts per million found in forty-five per cent of the 549 skin lightening products tested by one group. We simply do not know what are the mercury levels in our bleaching products because we have not been looking into this from a public health perspective.
Steroid use thins the skin, causes acne, dermatitis, and ochronosis - damage to the skin leading to intense darkening. I have seen patients with chemical burns requiring treatment because of home-made concoctions of bleaching creams used on the skin. High doses of steroids applied to the skin can be absorbed and result in depressing the production of steroids made by the body for its needs.
I have had to take the stance that I would not perform elective surgery on active bleachers because of the complications with wound healing that I have observed in that population.
… We cannot continue to ignore the potential health hazards
Colleagues in Obstetrics have observed an increased risk of complications during pregnancy among bleachers. And then there is the potential increased susceptibility to skin cancer due to our tropical location. Hydroquinone may damage our DNA, one of the initial steps in cancer development. But all these observations are either personal observation or armchair logic. More research is needed.
Unfortunately, the conversation has focused on why people bleach, rather than the dangers associated with the practice. Anthropological research is welcomed, especially if we are to craft a Public Health policy to address the dangerous practice, but that is not enough.
Persons are being harmed by this growing practice and we don’t know how exactly so. What we can all see clearly is that it is addictive. And like any other addiction, there are psychological and social consequences. We need to know the long term effects of bleaching and not just wait for other countries to provide the data when the horse has already bolted.
Already, some governments are taking action to address the growing trend. In Nigeria where 78 per cent of women bleach their skin on a regular basis, the government has banned products with high amounts of hydroquinone and mercury. South Africa and Kenya have followed suit.
As these governments are being proactive, so have the major manufacturers of these products. Celebrity endorsements and huge advertising budgets guarantee that sales will continue to rise despite the pushbacks.
We cannot continue to ignore the potential health hazards that a significant number of Jamaican males and females are exposed to with this new cultural norm.
The debate needs to move from discussing Blackness in beauty pageants to properly investigating the products available locally for harmful chemicals and taking steps to curb their unregulated importation. This is not just about Garveyism, Dr. Kenneth Standard is also turning in his grave.
- Dr Alfred Dawes is a general, laparoscopic and weight-loss surgeon; fellow of the American College of Surgeons; senior medical officer of the Savanna-La-Mar Public General Hospital; and former president of the Jamaica Medical Doctors' Association. Email: firstname.lastname@example.org; email@example.com.