Women physicians call out colorism in South Africa, help skin-bleaching victims heal
Dark-skinned people in South Africa see skin lightening as a way to secure jobs, conform to beauty standards, and combat discrimination. Many people grapple with body dysmorphia based on skin color. When patients arrive at the clinic, they often appear desperate, ashamed, and in severe pain.
- 4 months ago
July 20, 2024
Dr. Ziyanda Ndebele and her sister Dr. Khanyisile combat colorism in South Africa by offering care to skin bleaching victims and empowering global health through education. | Photo courtesy of Health Life Aesthetics
JOHANNESBURG, South Africa — As dermatologists, my sister and I witnessed many distressing cases related to skin health in South Africa. A recent case, however, deeply affected me. A girl arrived at the clinic with her face wrapped in a scarf, revealing only her eyes. When I asked her to remove it, she burst into tears.
As she cried, the young woman explained that she resorted to skin bleaching because she believed it was the only way she could achieve her dream job. After attending countless job interviews, she observed a pattern. Lighter-skinned candidates succeeded in the corporate world she aspired to join.
Frustrated and desperate, she decided to alter her appearance to fit social standards. Standing in the clinic, severe burns covered her cheeks. I recoiled in shock. Silence overtook the office in the moments before she began to speak.
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Sisters aid skin-bleaching victims who grapple with prejudice
As medical doctors in South Africa, my sister and I run a clinic specializing in skin procedures and aesthetic treatments related to acute and chronic health issues. Our patients arrive in the aftermath of attempting to lighten their skin.
Often these alternative or even homemade treatments produce distressing outcomes. They age skin, making its texture like marble and extremely thin. Sometimes they develop green veins on the chest, bright red spots, and welts. Still others end up with extreme acne, blisters, blackheads, or Ochronosis – an accumulation of acid that darkens the skin.
It doesn’t end there. Patients who use steroid creams face accelerated hair growth and stretch marks, while others develop kidney problems, diabetes, hypertension, liver failure, and even cancer. Working with patients, we come to understand their reasons for skin lightening.
Dark-skinned people in South Africa see skin lightening as a way to secure jobs, conform to beauty standards, and combat discrimination. Many people grapple with body dysmorphia based on skin color. When patients arrive at the clinic, they often appear desperate, ashamed, and in severe pain.
When the young woman in the scarf arrived at the clinic, it was a typical day, but her story left me horrified. She told me she heard that lighter skin is more beautiful and socially acceptable; that it attracts customers and sales. Trusting internet reviews and recommendations, she purchased over-the-counter creams and applied them. At first, her skin appeared clearer but unbeknownst to her, the creams caused serious harm. Behind the facade of beauty, her skin began to silently cry out for help. In time, the burns developed.
Harmful creams, pills, and injections pose severe health risks to pregnant women and children
In the first few sessions, my patient writhed in pain, but we slowly reversed and healed the lesions on her cheeks. Eventually, she obtained that dream job and, in her own words, said she felt like she finally “fit in.” Risking her health to lighten her skin and secure employment highlighted the harsh reality of colorism in South Africa, especially in the workplace. The woman’s case felt eye-opening, and I saw firsthand how stereotypes profoundly impact people’s lives.
When it comes to skin bleaching, we see a dangerous cycle. Often after stopping the products, people’s skin reverts back to its natural color. This prompts them to return to the same harmful substance again and again. Traditionally, mostly older generations use the creams. The new generation prefers pills and injections. Young women in particular, favor injectable liquids that promise faster, more uniform results.
Throughout my work, I have encountered pregnant women who opted to use bleaching treatments to try and give their babies lighter skin. Mothers have applied homemade creams to their children, causing irreversible wounds that lead to desperate hospital visits. Sadly, the long-term consequences remain uncertain. Affluent consumers can afford tested products, but those with limited means often buy items containing hazardous ingredients that inhibit melanin synthesis.
These substances contain mercury, hydroquinone (a banned glucuronide derivative in the European Union), steroids, and lead. Excessive use of such products causes blisters and burns. They harm vital organs like the kidneys, pancreas, and liver, leading to diabetes, hypertension, and even skin cancer. Shockingly, some of these liquids cost just over $40. Online, discreet Facebook pages promise bone-marrow-deep whitening.
Skin lightening practices: from social pressure to personal harm
I still remember the day twin rappers visited our clinic seeking further skin lightening. Despite their naturally fair complexions, they believed even whiter skin would boost their music industry success. Like many others, they resorted to skin bleaching without medical guidance and obtained products from the black market.
Their friend, who bleached his skin for years, recommended certain products he thought worked well. Unfortunately, these products caused severe side effects, including acne breakouts due to steroids in the products. Initially, when they came to me, their deep scars took me aback. I typically expect tall, dark-skinned artists in the hip-hop industry, but these rappers defied that norm by seeking lighter skin. Their scars ran deep, and we faced the challenge of repairing the damage.
The desire to conform to social expectations drives many to bleach their skin. One fair-skinned patient arrived at the clinic with a distorted self-image that led to body dysmorphia. She dreamed of fitting into a more affluent social circle and longed to appear, “clean, pure, and luxurious.” Despite her already pale complexion, she craved more.
The situation caused severe depression and she sought out psychiatric treatment. Nevertheless, she opted to bleach her skin before her wedding. She hoped to look radiant, but instead, she faced disastrous results. So focused on meeting society’s expectations, she found herself unable to embrace her own beauty and to accept herself.
Skin bleaching serves as a symbol of power and wealth in Africa
Two months before her wedding, this young woman visited a salon and underwent an unauthorized skin whitening treatment using cream. After a week, she noticed discoloration on her face. Desperate to achieve the desired effect, she applied more of the product, and the breakout transformed into dark spots.
Only later did she discover the bleaching cream from the salon was an unauthorized beauty product. Despite a year of treatment to reverse the effects, the scars from the harmful cream remain visible on her neck. Some African companies falsely label their products as organic to reassure consumers, concealing the true, harmful ingredients within.
Many people bleach their skin in pursuit of the power and privilege associated with lighter skin tones in Africa. They seek to project more value, believing it comes through skin color. In Africa, light skin signifies wealth and is associated with office jobs and roles shielded from sun exposure. The African market continues to experience growing demand for skin whitening. Today, millions of people risk their health in pursuit of lighter skin, perpetuating harmful stereotypes and endangering themselves.
Skin whitening is not the problem; misinformation and lack of education are
Most of the patients I see now include young men and women, but I recently encountered a new trend: older women using home bleaching to appear younger or address insecurities after divorce. I believe desiring lighter skin is not inherently wrong. Choosing to lighten one’s skin remains a personal and respectable decision, and everyone has the right to express themselves as they wish. The key lies in doing it safetly.
Lack of information and education about processes and products contributes to the problem. Skin bleaching remains a taboo subject, which leads to misinformation. Exacerbating the situation, in South Africa, advertisers, filmmakers, and billboards typically fail to feature dark-skinned people. Many dark-skinned celebrities gain greater popularity after bleaching their skin or seeking work abroad. This contributes to the perception that dark skin is less valuable or less beautiful than light skin.
As a result, the term “bleaching” carries a negative connotation that does not support those who choose this path. People hide their bleaching products from family and friends due to fear of judgement. As a healthcare provider, part of my role is to educate and care for each person who arrives at my clinic seeking guidance. While we cannot prevent someone from bleaching their skin, we can guide them toward safe practices and accompany them on their journey.
