To bleach or not to bleach…Is skin lightening worth the risk?

WINDHOEK - Health Focus this week looks into skin bleaching and whether it is advisable to use skin lightening products.

Dr Taka Chinyoka, a general practitioner and aesthetic physician based at the new Soweto Medical Centre in Katutura, says some bleaching products are safe if they are guided by a doctor. 

“People should not buy bleaching products from the street; that’s very dangerous,” advised Dr Chinyoka.
This is because these products need to be approved for safety and the molecules in the products need to be in the correct amount, Chinyoka explains. Initially, it may look as if bleaching products are working, however, their prolonged use, especially when not prescribed by a physician, can result in conditions such as exogenous ochronosis, Chinyoka says. Exogenous ochronosis is defined as a cutaneous disorder characterised by blue-black pigmentation resulting as a complication of long-term application of skin-lightening creams containing hydroquinone but may also occur due to topical contact with phenol or resorcinol in dark-skinned individuals.   “It’s difficult to successfully treat the condition,” Chinyoka adds. 

Health Focus recently spoke to vendors at the Okuryangava open market who sell skin brightening products, ranging from soaps, creams and tablets. Most vendors were reluctant to speak to this reporter; however, two women from the Republic of Congo (Brazzaville), who also use the products, said they procure the stock from Zambia and Angola.
The products are popular among Namibians and foreigners alike, the two women insisted.

The most common creams used, they shared, include Betasol, which sells for N$35 for 30ml container, Cocopulp, which sells for N$60, N$120 and N$150 for 150 ml, 300 ml and 500 ml respectively. Clairmen (for men) sells for N$35 and N$60 for 120 ml and 300 ml, respectively.

Bioclaire is also very popular, the women explained and it sells for N$40 and N$80 depending on the size.
Olivera cream is sold for N$50 for 125 ml. The women explained that it takes up to two weeks before the skin lightening creams start to show results. However, it also depends on the person’s skin.
One of the women said there are no side effects to using skin brightening products.

“I was about 19 years old when I started using skin lightening creams. I have been using it for 20 years now but nothing has happened to me,” the woman told New Era.

She also explained that some people do not use the products correctly and they end up with red skin. “If you apply the lightening creams during the day you should not expose yourself to the sun because it will damage your skin. Those who are exposed to the sun you can see their skin turning red and others get spots,” said the woman.  The woman said the lightening creams and soaps can also be used for women who want to get rid of spots and pigmentation. But what if it’s discontinued? What are the effects? I asked. “It depends on the skin of the person. If the person has an oily skin they will still have pimples and eventually dark spots,” explained the woman.

“It’s better to use it at night when you go to sleep,” she added. Asked on why she bleaches her skin, the woman who dominantly spoke during our interview said: “I don’t feel I’m okay if I’m like this if I’m white I’m beautiful.
“Like this, I’m not feeling okay because I’m black” (sic).

A quick google search on skin lightening products in Namibia revealed their popularity, everything ranging from pills, supplements, injectables and soap. The prices vary, depending on the products.

Skin-bleaching practices, such as using skin-lightening creams and soaps to achieve a lighter skin tone or to “whiten” skin, are common among non-White populations throughout the world, triggered by deep historical, economic, socio-cultural, and psychosocial roots, according to a 2016 study titled “Skin Bleaching and Dermatologic Health of African and Afro-Caribbean Populations in the US: New Directions for Methodologically Rigorous, Multidisciplinary, and Culturally Sensitive Research”. The same study revealed that skin bleaching has been associated with a variety of known adverse health effects ranging from dermatitis (a medical condition in which the skin becomes red, swollen, and sore, sometimes with small blisters, resulting from direct irritation of the skin by an external agent or an allergic reaction to it) to exogenous ochronosis, steroid acne, and nephrotic syndrome (kidney disease), which are linked to ingredients such as hydroquinone and corticosteroids.  

Due to health concerns, some of these chemicals are regulated. However, studies have found products containing the aforementioned ingredients with the above legal limits, including products from the US and European Union, where regulations are stricter and better implemented, according to the study. 

The Namibian government, through the Ministry of Health and Social Services and the police, has tried to regulate skin lightening products by confiscating them from the vendors mostly at the open markets. This is due to the danger and side effects that come with skin lightening products.

Chinyoka emphasized the dangers of purchasing skin lightening products from the streets. Some of these products may not be safe to use because of a high concentration of molecules and some contain steroids, Chinyoka explained.
Additionally, medical products may only be prescribed and sold by doctors, the doctor explained.   Commenting on why some people preferred to brighten their skin colour, Chinyoka said there was a belief that light is beautiful and good looking. But there is a safer way to bleach and ‘beautify’ the skin, Chinyoka added.