Fuelled by a multi-million dollar industry, the South Asian obsession with fair skin is a beauty myth that needs to be busted  By Smriti Daniel Why do so many of us find fair skin desirable? Perhaps it is a subtle socio-economic indicator of class – only the wealthy can afford to stay out of the [...]

The Sundaytimes Sri Lanka

The dark side of white


Fuelled by a multi-million dollar industry, the South Asian obsession with fair skin is a beauty myth that needs to be busted 

By Smriti Daniel

Why do so many of us find fair skin desirable? Perhaps it is a subtle socio-economic indicator of class – only the wealthy can afford to stay out of the sun. Perhaps it’s a colonial hangover, a lingering desire to identify with the dominant race. Arguments have been made for sexual selection favouring the fair, for mass media that have instigated a vicious cycle by associating beauty with fair skin, for cultural preferences so ingrained that the first question some couples are asked is if their new-born is fair. Whatever the cause, the pursuit of fairness is today one of the most profitable in the cosmetic industry. Amid all the promises and enticements, the real question is – can you become permanently fairer?

The genetic basis of fairness

“Actually speaking, we should consider ourselves lucky that we have this layer of melanin that protects us against the harmful ultraviolet rays emitted by the sun,” says Dr. Chalukya Gunasekera, a Consultant Dermatologist at the National Hospital in Colombo. Exposure to UVB radiation, a component in the sun’s rays, can burn the upper layers of your skin, but it is UVA radiation in sunshine that causes us to tan. These rays penetrate to the lower layers of the epidermis, where they trigger cells called melanocytes to produce melanin which protects the skin and prevents it from burning.

The number of melanocytes tends to be similar across all races, but exposure to the sun causes what we label tanning, where tighter bundles of melanin are formed and leave the skin temporarily darker. The colour of your skin itself is the result of racial differences. “There are six skin types, starting from Type 1 skin to Type 6 skin, where in Type 1 the skin is fair, the hair is fair and they can’t withstand the effect of the sun. At the other extreme, skin type 6 is found in the Negroid races. So we stand at somewhere around skin Type 5 or perhaps a few of us are of skin Type 4. Our hair and eyes also tend to be towards darker shades,” explains Dr. Gunasekera.

That fair skinned people are many times more likely to develop skin cancer is a well-known fact, supported by the much higher incidence of skin cancer in the west. However, the colour of your skin can also affect how well you age. A 70-year-old dark skinned Southeast Asian woman will have fewer wrinkles and clearer skin as compared to her fair skinned European counterpart.

Mercury and steroids: the magic ingredients 

Whitening treatments have been compared to women wearing red nail polish – simply a cosmetic fad. Now more than ever, dark skinned men and women in Asia and Africa are actively seeking out ways to become fairer, fuelling a multi-million dollar industry and generating a demand that cosmetic manufacturers are scrambling to meet. Unfortunately, what customers are paying for is at best a temporary fix, and at worst, a long term health hazard.

A WHO report published in 2012 warned of serious side effects of using fairness creams and products as they contained mercury or preservatives that could cause kidney damage, anxiety, depression, nerve damage and lower the skin’s resistance to infections. “Really speaking these lightening creams are not recommended on a long term basis. A lot of the cosmetic creams that are on the market, we don’t know what goes into it, unlike with medicated creams there are no laws that makes it imperative for manufacturers to list out the ingredients in the creams,” says Dr. Gunasekera explaining that part of the problem is that while a very low percentage of certain heavy metals such as mercury is considered acceptable their use is still not well regulated. Patients buying these products over the counter may use unhealthy amounts over inadvisably long periods of time. “The dangerous ingredients are supposed to be at safe level when these creams are manufactured but when they are not coming under proper testing we don’t know what strengths are used,” she adds.

Creams that use bleaching agents work only as long as the cream is being applied. Come off it and you’ll find not only that your skin goes back to its normal hue but that you might actually be worse off. Dr. Gunasekera has had her fair share of patients requesting lightening creams. When dealing with blemishes, dermatologists sometimes do prescribe such creams but their use is very carefully monitored, not only in terms of duration but in how the cream is applied. It is never meant to be rubbed onto the whole face but to be limited to the few affected areas.

Of particular concern are fairness creams that incorporate steroids. “When we prescribe steroid creams, we take into consideration the strength of the steroid, the age of the patient and the skin disease we are treating,” says Dr. Gunasekera. Off the shelf creams that use steroids can leave people suffering with many adverse effects such as thinning out of the skin and acne outbreaks. When it comes to high strength steroids, skin becomes dependent and just like oral steroids can get you hooked – any attempt to stop the cream has your skin reacting badly. If you really do want to become fairer, your healthiest option may be a good sunscreen.

When dark skin is a symptom of disease

However, darkened patches of skin are sometimes a symptom of a health issue. Patients with a skin condition known as melasma present with patchy brown, tan or blue-grey facial skin. Afflicting mostly women between the ages of 20 – 50, it is thought to be caused by exposure to the sun or hormonal issues triggered by some birth control pills or even the internal hormonal changes associated with pregnancy. When it is the latter it is dubbed choloasma or ‘the mask of pregnancy.’

Typically, hydroquinone creams are used to treat the condition and patients are advised to limit their exposure to the sun and to use a sunscreen as well. However, melasma has also been known to clear spontaneously without any treatment. People with insulin resistance also sometime develop dark, unsightly patches of thickened skin, particularly around the neck. The best cure in such cases involves lifestyle changes that include weight loss, exercise and adopting an improved diet.

Finding your way to more beautiful skin

As a dermatologist, Dr. Gunasekera has her own definition of what constitutes beautiful skin. “I don’t think the colour matters at all,” she says, “it is the texture of skin, which makes a difference and whether there are blemishes or acne.” A good dermatologist can help with the latter, but the former is accomplished easily enough with a little care. If your skin is dry, Dr. Gunasekera recommends you follow a good moisturising routine. Ensure as well that you do not use harsh soaps on your face, and while it’s important to wash, don’t overdo it or sensitive facial skin will react badly.

It’s worth noting that dermatological issues, particularly those related to facial skin can cause patients a great deal of concern and suffering. The effect of diseases on patients is sometimes assessed using a life quality index in which patients are asked questions and their responses are scored. “When they have done these life quality indices on dermatological patients they have found them to be very, very high as compared to those having diseases that affect their internal organs,” says Dr. Gunasekera. “Though people tend to dismiss skin problems as not being life threatening and therefore not so serious, for each person that is affected it can have an enormous impact.”

The issue with fairness then becomes one of health and emotional wellbeing. If caused by a health issue it must certainly be addressed, however, for purely cosmetic reasons the pursuit of fairness is one that dooms enthusiasts to disappointment and a deepening sense of inferiority. “The reality is, the skin tone you were born with cannot be changed significantly,” says Dr. Gunasekera. “You have to come to terms with it and learn to be comfortable with it.”

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