Mirror mirror on the wall, what’s the most dangerous cream of them all?
The answer, according to the International League of Dermatological Societies (ILDS), is the skin-bleaching products used by more than 30% of South African women in a bid to be fair, despite serious risks from burnt skin to cancer.
This week the ILDS again sounded the alarm on the illegal sale of creams laced with powerful corticosteroids from street vendors, spice shops and pharmacies, which experts say has reached “epidemic levels”.
The global skin-bleaching industry is projected to be worth about R275bn by 2032.
South Africa is one of the countries where, according to the World Health Organisation, about 35% of the population fall for the glowing promises of skin-lightening products.
“Skin-bleaching is a global phenomenon, reaching epidemic levels and, for the first time, cases of squamous cell carcinoma are being reported, which is a serious concern. The dermatology community must work together to address this problem, both through education and by tackling the psychosocio-political influences on this practice,” said Prof Ncoza Dlova, University of KwaZulu-Natal’s head of dermatology.
She said topical steroids now found in skin-lightening products are a group of prescription schedule 4 creams used specifically for medical conditions such as eczema, lupus or other skin conditions that cause skin inflammation.
“They require a doctor’s prescription and close monitoring to avoid complications and should not be easily available from pharmacies or street vendors without a doctor’s prescription. It is therefore illegal to sell steroids or steroid-containing creams without a doctor’s prescription.”
“Some of these creams are illegally imported through our porous borders, thus reaching the consumers in an unregulated way,” she said.
A UKZN study showed most people buy them illegally from street vendors, spice shops, hair and beauty salons and some healthcare professionals’ rooms without consulting a doctor.
“The typical profile of those using skin-bleaching products in South Africa includes Indians and Africans, both professionals and those with less formal education, rural and urban residents, young women, some men, and expatriates from other African countries,” said Dlova.
The ILDS updated position statement called for stricter regulation and enforcement of regulations that ban the sale of such creams without a prescription from an appropriately trained healthcare professional and increased education on the dangers of skin bleaching.
Durban-based aesthetic medical doctor Parushinee Naidoo every week manages patients who have severe post-inflammatory hyperpigmentation and chemical burns from using unsafe products in an attempt to bleach their skin.
It is.. illegal to sell steroids or steroid-containing creams without a doctor’s prescription.
— Prof Ncoza Dlova, University of KwaZulu-Natal’s head of dermatology.
“The fixation of viewing fair skin as synonymous with beauty is centuries old. In many communities... there is cultural and generational pressure to be lighter skinned. Darker-skinned individuals are ridiculed and often treated with prejudice. This is exacerbated by the unrealistic beauty standards set by social media.”
One woman who spoke to the Sunday Times said she was ashamed of using skin-bleaching products, which left her “disfigured”.
“I never wore makeup before but now I have to use foundation just to hide the dark scars on my face. I purchased the imported cream from a spice shop. Within weeks, my face turned darker than it was and my cheeks started to crack. I was too ashamed to go to the doctor because I feared being judged for using that cream. Now, every time I look in the mirror, I feel this deep regret. I hate myself for making that choice.”
Durban clinical psychologist Nazia Osman said that psychologically the desire to lighten one’s skin is often linked to self-esteem issues and the need for social acceptance.
“Some individuals experience body dysmorphia, a condition where they obsess over perceived flaws and take extreme measures to alter their appearance.
“Research shows a complex link between mental health and skin-lightening products. While some users may initially feel a boost in confidence, long-term use can lead to increased anxiety and depression. This paradox suggests that while skin lightening may provide temporary satisfaction, it often results in more profound psychological distress.”
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