Rooted in colourism and perpetuated by popular culture, the growing market for skin bleaching products is spawning a public health crisis across Africa, with women the most affected.
Skin bleaching is a significant public health problem across Africa, with usage reaching 66% in Congo-Brazzaville and 77% in Nigeria. Photo: Tim Johnson
Beatrice Kunda started using skin lightening creams when she was 16 years old. By 27, says the resident of Lusaka, Zambia, she had the face of a 50-year-old. “The creams peeled away the top layer of my skin, which was left unprotected from the sun, turning my complexion a horrible reddish hue,” Kunda says. “It also became dry and scaly as my skin could no longer absorb moisturisers.”
So began her quest to not only heal her prematurely ageing skin but also help other women dealing with the deleterious after-effects of skin lightening and bleaching products. “I empathised with women who were struggling with their bleached skin. I wanted to help,” Kunda says. “I realised there was a gap in the market for this problem, so I decided to use the knowledge gained from my own experience to fill the gap.”
Kunda has set up a beauty clinic in Lusaka where she daily attends to over 10 women with varying degrees of skin damage due to lightening products. She also launched a herbal skin cream line that promises to not only promote good skin care but also restore lost pigmentation “as much as possible” over a period of time. “It’s not easy because some skin is really damaged,” Kunda says.
Kunda, like many spa and beauty clinic owners in Zambia, does not have any formal training in making skin creams and says she uses traditional knowledge of herbs to guide her. She also does not perform any invasive procedures that require a trained dermatologist. “I start by counselling women about the dangers of skin bleaching, giving myself as an example, and then we begin the treatment,” Kunda says.
Skin bleaching—also known as skin lightening, skin toning and skin whitening—is a cosmetic procedure to achieve a lighter skin tone. It is a significant public health problem across Africa. Usage varies widely across regions—from 25% in Mali to 31% in Zimbabwe, 32% in South Africa, 39% in Ghana, 50% in Senegal, 66% in Congo-Brazzaville, and 77% in Nigeria.
South African dermatologist Dr Ncoza Dlova, who is president of the African Women’s Dermatology Society, dean and head of the Nelson Mandela Medical School, and head of dermatology at the University of KwaZulu Natal, says 30% of her patients request skin lightening treatments—but she does not offer skin bleaching. For this, Dlova says, “patients either go to unscrupulous doctors or buy steroid creams from unscrupulous pharmacies without a prescription.”
Skin bleaching attempts are rooted in colourism—the entrenched preference for lighter skin over darker skin. A recent Zimbabwean study found that the main reason women gave for using skin bleaching was a desire for smooth and healthy skin, as well as increasing their chances of getting married and finding a good job.
“The desire to have light skin outweighs worries over the potential risks, which I believe most people are aware of.”
Princess Nyoni-Kachambwa, a co-author of the study, is a PhD fellow at HEARD, which conducts research on socioeconomic aspects of public health. She says the preference for lighter skin is perpetuated by the continued use of lighter-skinned models and television presenters in mainstream media, as well as on social media.
“Most television personalities, especially women, are light-skinned. Social media tends to mock dark-skinned individuals,” she says. “For instance, a recent reel (short video) on Facebook shows how a man who blocked a dark-skinned girl [from his social media account] some years ago is filled with regret now that the girl has lighter skin.”
So pervasive is the bias towards light skin that many women appear willing to take their chances on bleaching products and other potentially hazardous procedures. “The desire to have light skin outweighs worries over the potential risks, which I believe most people are aware of,” Nyoni-Kachambwa says.
Tracing the root causes of colourism
Tanzanian youth activist Isla Ibrahim agrees that society treats light-skinned people differently. They are perceived to look better in public-facing careers, while dark skin is often associated with poverty, low social class, and poor education. Indeed, many African celebrities publicly endorse skin bleaching practices as a means to achieving beauty and success, and the majority of successful black celebrities have fair complexions.
Ibrahim, who is 22 and has naturally light skin, says she has seen firsthand how she was favoured over her dark-skinned peers in school and university. “It’s the veneration of white skin, which is portrayed as smooth and fair, while dark skin is projected as dry, hard and wrinkled,” she says.
In South Africa, as in other parts of the world colonised by European powers, the politics of skin colour has been shaped by the history of white hegemony and institutions of racial slavery, colonialism, and segregation.
As Lynn M Thomas, a professor of history at the University of Washington who is specialising in the history of politics and gender in twentieth century Africa, wrote in a recent article, “During the era of the trans-Atlantic slave trade, skin colour and associated physical differences were used to distinguish enslaved people from free, and to justify the former’s oppression. Colonisers cast melanin-rich hues as the embodiment of ugliness and inferiority. Within this racist political order, some sought to lighten their complexions.”
The role of hazardous ingredients
Yet racism alone is not enough to explain the hankering for skin lightening treatments. Changing beauty ideals and a billion-dollar cosmetic industry that fuels colourism by producing skin bleaching products must share some of the blame. And all of this comes at a cost—the health hazards posed by the ingredients contained in many skin bleaching products.
Bleaching creams have four main ingredients—mercury, hydroquinone, lead, and steroids—that are harmful to health. Photo: Sora Shimazaki
Amira Adawe, executive director of the The Beautywell Project, a US-based non-profit centred on eliminating the use of skin lightening products and empowering women, says bleaching creams essentially have four ingredients—mercury, hydroquinone, lead, and steroids—all of which are harmful to health.
She says research shows that continuous use of steroids impairs the body’s ability to fight infections and causes the skin to become thin or weak with stretch marks and prone to easy bruising. There are also reports of families testing positive for mercury, which can potentially lead to lung and brain damage. “In some cases, even visitors to their home have tested positive because mercury vaporises and stays in the air,” Adawe says.
In the 1990s, South Africa became the first country to restrict the sale of skin lightening creams containing harmful ingredients. It was recently joined by Rwanda, Cote d’Ivoire, Tanzania, Kenya, and Ghana.
Hydroquinone causes blue-black discoloration from prolonged use, and wounds do not heal effectively as the skin is thinner than usual. Sun exposure of bleached skin is a risk factor for conditions such as melanoma.
The World Health Organization, too, warns that skin bleaching can cause liver and kidney damage, psychosis, brain damage in foetuses, and skin cancer.
In the 1990s, South Africa became the first country to restrict the sale of skin lightening creams containing harmful ingredients. It was recently joined by Rwanda, Cote d’Ivoire, Tanzania, Kenya, and Ghana.
Despite these restrictions, people are often able to obtain products from street vendors and cosmetic shops. Of particular concern is how the beauty industry has begun to use euphemisms for these products to bypass legislation.
Adawe says manufacturers often do not list all the ingredients used in their products. “They use words like ‘toning’, ‘clarifying’, ‘brightening’, and ‘polishing’—nothing about the use of mercury or steroids,” she says.
Beauty industry continues to adapt
Ugandan beautician Imogen Kawagwa says there is a new trend of wealthy women and celebrities opting for spa-based treatments like laser therapy, chemical peels, and glutathione—which are administered intravenously to suppress melanin formation for lighter skin.
“There has been a realisation that some skin lightening creams, lotions, and soaps are mass-produced cheaply and have harmful ingredients, so more discerning people opt for professional establishments and use products that are safer,” she says.
However, Adawe says these procedures do not reverse the damage done by over-the-counter skin lightening products. “There is no solution, except to allow the skin to heal naturally,” she says.
Plus, Adawe notes, the use of glutathione as a skin lightener has been banned in the US even as it continues to be used unregulated in Africa. Worryingly, skin care companies in Ghana and other African countries are increasingly using it to convince pregnant women to lighten baby skin in utero.
Adawe, who buys pigmentation altering products for testing, says the beauty industry is innovating and finding ways to keep growing. “Recently in Kenya, I discovered that shops are selling plastic trousers and shirts, which people wear to create a kind of steamer effect to enable the products to permeate their skin quicker,” she says.
The Beautywell Project recently scored a huge victory against tech giant Amazon—teaming up with the Sierra Club, it persuaded the e-commerce site to stop selling about 15 products containing toxic levels of mercury. This put a small but noteworthy dent in the global trade in skin lighteners, which is estimated to reach $31.2 billion this year.
There were other similar victories: in 2023, Botswana and Burkina Faso, on behalf of the Africa region, sought to amend the Minamata Convention on Mercury—a treaty to protect human health and the environment from the adverse effects of mercury—to ban the sale of cosmetics containing mercury.
In January, the Cosmetic, Toiletry and Fragrance Association of South Africa (CTFA), which represents 80% of cosmetic companies in South Africa, issued a condemnation against manufacturers and importers of illegal skin lightening products for making false claims and selling products containing prohibited substances such as mercury, phenol, and hydroquinone.
“These products do not comply with legislated industry standards and regulations, in respect of composition, claims being made and, most importantly, consumer safety in use; these products are entering the market illegally,” it said in a statement.
Balancing legislation with cultural change
While acknowledging the efforts being made to control the use and sale of skin lightening products, Dlova and Nyoni-Kachambwe say legislation should work in tandem with advocacy.
“The skin bleaching issue is deep-rooted in the culture of colourism, hence continuously advocating for a cultural change and policies that can help curb the practice could have an impact,” Nyoni-Kachambwe says. “I believe some laws can minimise the accessibility of these products—for example, high taxes on the products.”
“We need campaigns that celebrate dark skin and show that one can be successful and wealthy and all that without changing one’s pigmentation.”
For any legislation to work, there is a need for consistent and strong regulatory systems that can enforce the law, Awade says. Kunda, who runs the beauty clinic in Lusaka, says these regulatory systems must apply to the trade and the use of skin lighteners. “If I showed the government pictures of some of my clients, they would implement bans immediately,” she says.
Just as important is the need to educate people about their identity and being comfortable in their own skin, Dlova says. “There has been a systematic onslaught on dark skin, which needs to be reversed; there needs to be a cultural shift,” she says.
“We need campaigns that celebrate dark skin and show that one can be successful and wealthy and all that without changing one’s pigmentation.”