The Complexion Conundrum
is the scribed dialogue between me and Style.comarabia’s
senior editor Sofia Guellaty, exploring the controversial skin lightening trend in the Middle
East.
You can read the Style.comarabia's fnal version here:
Let's Be Fair
What do they say? Grass is always greener on the other side
of the pond. People in the West are baking their bodies under the sun to attain
a bronzed/tanned complexion even at the risk of getting skin cancer. Meanwhile,
people on our side of the pond (Middle East) are looking for skin lightening
solutions to ditch their perfect caramel/chocolate complexions in favor of a
pale ghost-white complexion – idiosyncrasies of human nature go figure.
Skin Whitening
Let me start by clarifying one thing, the term skin
whitening is misleading, I prefer to address complexion blending as skin
lightening or depigmenting.
You can lighten your skin tone (a shade or two) by getting rid
of tan acquired through careless or planned sun exposures, and you can also blend
dark patches on your skin (due to hormones, acne or other skin predispositions)
to attain a more uniform complexion, but you can’t whiten your skin, at least
not without causing serious damage to your skin’s vital structures.
Skin Lightening
Treatments
Skin lightening products - also known as bleaching creams,
whiteners, skin brighteners, or fade creams - work by reducing a pigment called
melanin in the skin. Most people who use lighteners do so to treat skin problems
such as age spots, acne scars, or discoloration related to hormones. It is also
a technique used to lighten naturally dark skin.
Understanding Skin
Color
Skin color is determined by the amount of melanin in the
skin. Melanin is a pigment produced by specialized cells called melanocytes.
People with dark skin have more melanin.
How much melanin your skin has is mainly a matter of your
genetic makeup. Sunlight exposure, hormones, skin damage, and exposure to
certain chemicals can also affect melanin production.
Changes in skin color often resolve themselves. For
instance, tans fade when the amount of direct exposure to sunlight is reduced.
But over time, certain discolorations, such as "age" spots or
"liver" spots, become more or less permanent.
What Is Skin
Bleaching?
Skin bleaching is a cosmetic treatment to reduce the
prominence of skin discolorations and even out the color of the skin. You can
buy bleaching creams over the counter or by prescription through a
dermatologist.
How Do Skin Lighteners
Work?
Skin lighteners contain an active ingredient or a
combination of ingredients that reduces the amount of melanin production in the
skin where it is applied.
The most widely used ingredient in skin lighteners sold around
the world used to be hydroquinone. Recently it has been banned in
Europe because of its serious side effects over long-term usage. In U.S. the
FDA regulates the use of hydroquinone (over-the-counter skin lighteners can
contain up to 2% hydroquinone. Dermatologists can write prescription for
lighteners that contain up to 4-6% hydroquinone). In Middle East its use is
still uncontrolled and different percentages are available through over the
counter sales.
Other skin lighteners use drugs such as steroids and retinoic acid (vitamin A) as active
ingredients.
Newer and safer skin lighteners use natural ingredients such
as ascorbic
acid (vitamin C), kojic acid (a compound that comes from a specific
type of fungus) and arbutin (a compound found in various plants).
Answers To Style.comarabia’s
Ms. Sofia Guellaty’s Questions:
Is quest for fair
complexion a post-colonial trend?
Margaret Hunter an expert on skin of color issues explains the
desire to be lighter complexioned quiet eloquently for me. According to her,
colorism is the process of discrimination that privileges light-skinned people
of color over their dark skin counterparts (This definition of colorism places
the phenomenon solely among non-Whites, but colorism also occurs among Whites, but
that is another discussion for yet another day :).
The contemporary colorism has its roots in the European
colonization of Africa, Asia-Pacific, the Middle East, and the Americas. The
complexion consensus empowers light-skinned people with more opportunities,
status, and prestige in nearly all these societies. Thus, the values and norms
of the complexion consensus influence many people to bleach their skin.
Furthermore, in the Middle East fair people, especially
women, are considered prettier and most men prefer to marry a fair woman. In a
culture where status and wealth is typically acquired through marriage,
physical beauty and complexion translate into a fast track ticket to a life of
privilege. This creates a much desired and easy connection between a girl’s social
problems and the tone of her skin, explaining the particular prevalence of skin
bleaching desire in young females belonging to the middle classes.
Why does Chanel only
sell skin lightening products in Asia and Middle-East etc.
Beauty trends and unique regional market demands are the driving
forces behind product sales. To run a successful business companies hone in and
focus on those criteria.
In Asia like the Middle-East lighter skin tones are
considered desirable and affiliated with high status symbol. A huge number of
men and women use skin brighteners on regular basis as part of their daily skincare
routine. Hence, both these regions are big markets for skin lightening
products.
US is a melting pot of ethnicities, there’s an enormous demand
for skin brighteners among ethnic communities in US too.
In Europe only people with uneven skin tone are interested
in skin lightening products which doesn’t translate into big numbers, hence companies
don’t find it a lucrative business strategy to focus on skin bleaching
products. As per demand cosmetic companies focus more on tanners and bronzer in
those markets.
Do you see a lot of
patients that want to whiten their skin?
Of course I do and by Rolls-and-Bentley-loads if I may say
so. Arab and Middle Eastern skin is more prone to pigmentation disorders.
Actually the skin classification has been revised over time and “Pigmented”
is the latest addition to Skin Type Charts. It pertains to skin types; which
produces abnormal levels of melanin in response to friction, sun, hormones and
inflammation or injuries resulting in uneven complexion.
Most of my patients come to me with complaints of hormone
and sun related pigmentation problems in addition to a unique complaint of dark
elbows and knees very indigenous to Middle East and Indian Subcontinent. Najadi Boys know about this
pigmentation Achilles heel and tease girls on the subject all the time. I
believe dark knees and elbows haunting females are even part of folklore tales
originating from the Middle Eastern region.
Where do they (patients)
come from?
As I practice in Saudi Arabia, most of my patients seeking skin-lightening
treatments are Saudis, some hail from the neighboring Arab Middle Eastern and
African countries too.
What is their
motivation?
Every region has its indigenous beauty icons. In Middle East
mostly the Lebanese, Syrian or Egyptian (music or T.V) celebs are given goddess
of beauty and attraction status. As, most of these celebs set high on the
glamour pedestal are light skinned, all our girls next door want to bleach
their hides to match their silver screen diva’s skin color.
I also believe that the growing preference for white skin is
not merely one of choice or aesthetics, but it seems to grow also from
self-doubt and the lingering confusions of identity and acceptance. Spousal
pressure and acceptance are also quoted as the main reasons by some of my
patients seeking skin-lightening treatments.
What are the risks of
whitening?
When our skin is exposed to the sun, cells called
melanocytes produce pigment to make a shield around the nucleus of the cells to
protect it from carcinogenic mutations caused by the UVA & UVB rays. This
pigment acts as a barrier shield protecting our skin from cancer and photo-aging.
Long-term use of skin lightening products can increase the
risk of skin cancer with sun exposure.
As with any new product, skin lightening products do come
with some risks. It’s important to read the label and know the facts before you
buy and apply a skin lightener.
Various bleaching agents, including natural ingredients, can
cause skin irritation or skin allergies e.g AHA’s (alpha hydroxy acids), high
concentration of ascorbic acid (vit. C), tretinoin (vitamin A) etc.
Mercury Warning: Some
people apply skin lightener to their entire body to change their complexion, and
this can be very risky. Regional ministry of health’s have reported the active
ingredient in some skin lighteners (originating from Africa and Asia) can be
mercury, using these products can lead to mercury poisoning.
Mercury is a toxic agent that can cause serious psychiatric,
neurological, and kidney problems. Pregnant women who use a skin lightener with
mercury can pass the mercury to their unborn child.
The use of mercury as an ingredient in skin lighteners is
banned in Saudi Arabia, UAE, U.S and Europe. However, some skin lighteners
produced outside these regions may still contain mercury.
I always warn my patients to make sure there is no mercury
in the skin lightening products they use. Mercury is sometimes listed under
other names, such as calomel, mercuric, mercurous, or mercurio.
Steroid Warning: Some
skin lighteners contain steroids. Using steroid laced products can lead to
increase risk for skin infections, skin thinning, acne, and poor wound healing.
Applying steroids to large areas of skin can put you at risk
for health problems related to steroid being absorbed by the body.
Hydroquinone Warning:
Long term use of Hydroquinone has been linked with unwanted and untreatable
skin discoloration called ochronosis.
Is whitening more
dangerous than tanning?
I don’t think whitening is more dangerous than tanning if
tried under proper medical guidance. Over the years tanning has been clearly
linked with skin cancer.
Dermatologists world around are busy rallying and campaigning to warn
against and stop the skin tanning trends.
Skin color (melanin) acts as a shield against skin cancer
that’s why we don’t see too many reported cases of cancer in darker skin types.
Lighter skin is more prone to getting skin cancer and anybody using skin-lightening
creams must remember that by loosing skin color they are loosing their
protection shield against harmful UVA and UVB rays. Hence, they must use
sunscreen diligently and religiously.
Which products do you
recommend?
I don’t advocate mindless skin bleaching. I usually tell my
patients no matter what your skin color it’s the quality and health of your
skin that makes you look beautiful. In my opinion a little color in the skin actually
adds to a person’s attractiveness.
Product choice-wise, I prefer products that are hydroquinone
or cortisone free.
I recommend products containing vitamin C, niacinamide,
arbutin, licorice extract, kojic acid, tretinoin, and azelaic acid.
I also strongly advocate use of sunscreen on daily basis,
even on cloudy days.
Could you share some
whitening stories with us?
When I moved to Saudi back in 2004 I used to get like 5-10
patients walking in specifically with skin bleaching/whitening requests on
daily basis. They were always looking for a miracle cure to change their skin
color completely. “Doctor do you have any pills or injections that can change my
skin color permanently”, was the most common question rolling off of every
patient’s tongue.
When I explained to them it is practically impossible to
change your skin color completely without seriously damaging your skin, as complexion
is a genetically determined trait. “How did Michael Jackson magically changed
his skin color permanently” was the counter query thrown at me. I had to
explain over and over again - There is a disease called Vitiligo in which some
parts of the skin lose their color producing cells (melanocytes). Michael
Jackson had Vitiligo and he opted to destroy all his pigment producing cells to
blend his dark skin with the diseased colorless patches and that’s how he
became the poster child for skin whitening. During his last days he was seen using
face-mask, umbrella and gloves on regular basis because his doctors warned him
he was at serious risk of getting skin cancer.
With years of education, constant reiteration and advice
most people now understand that skin color is a genetic trait and can’t be
tampered with without serious consequences. Now a days I am mostly seeing
people with complaints of melasma, dark patches post acne, dark elbows and
knees coming over for complexion blending, which I am happy to cater to.
Photo Credits: Sølve Sundsbø & Lily Cole