Skin bleaching is on an all-time rise in Nigeria. The local market for skin brightening/lightening products is booming. Many Nigerians use bleaching products extensively regardless of age, gender, educational, marital or socio-economic status. These products are reportedly the fourth most commonly used household products after soap, milk and tea. Some people are so reckless, applying bleaching products even during pregnancy, lactation and on children under several hardly reasonable guises. In spite of its widespread popularity however, it is difficult to unequivocally attribute this trend to any socio-cultural, psychological or financial factors, at least not on this occasion.
The commonest pharmacological compounds found in bleaching products are hydroquinone, corticosteroids, retinoids, mercurials and other heavy metals. These agents have been demonstrated to either induce or aggravate certain health challenges. There is strong scientific evidence linking the abuse of these agents to several cutaneous and systemic health complications such as dermatitis, ochronosis (which can potentially result in loss of skin elasticity and impaired wound healing), skin atrophy, thinning and breaking of skin giving rise to acneform eruptions, paradoxical increase in skin pigmentation, hypertrichosis as well as other devastating and irreversible skin damage. Other complications that may arise includefungal/bacterial infections, unusual presentation of scabies, skin cancer, obesity, diabetes mellitus, hypertension, renal and liver damage, thyroid disorders amongst others.Some studies have linked these agents with teratogenicity, mutagenicity and neurotoxicity in rats. Mercury toxicity may give rise to psychiatric and neurological problems, darken skin and nails, thereby posing significant risks both aesthetically and physiologically, even after discontinuing. The widespread misuse and overuse of these agents clearly is a bothersome phenomenon.
The use of bleaching products is not exclusively for ‘beautification’; there are certain skin/medical conditions such as vitiligo and localized skin discoloration that might necessitate the prescription of skin-lightening products/agents. However, most bleaching products used in Nigeria are not obtained by a medical prescription. Like many other potentially toxic products, skin bleaching products are not effectively regulated in Nigeria. Although regulatory authorities like NAFDAC have placed ceremonious bans on products containing some of these agents, enforcement is very poor and these products continue to be available on the market. Pharmacies, cosmetic stores, roadside and online vendors indiscriminately sell these products packaged in different forms as soaps, creams, ointments and concoctions many of which are not properly labelled as to their actual ingredients. Some herbal preparations contain totally unregulated mixtures of ingredients many of which have not been properly identified and characterized but are potentially toxic or at least have questionable safety profiles.
The sale and use of some of these agents have been effectively banned in some advanced countries, while many others have restricted their use. For instance, hydroquinone is a prescription only ingredient in some countries (including all member states of the European Union under directive 76/768/EEC:1976). According to the US Food and Drug Administration, hydroquinone cannot be ruled out as a potential carcinogen and in 2006, rescinded its approval and proposed a ban on all over the counter preparations.
There are some alternatives whose active agents are botanicals such as papaya and arbutin, which are being marketed as safe. This appears to be indeed true, however, there is no rigorous scientific evidence to prove that these claims are not merely anecdotal. It is also impossible at this point to ascertain the safety profiles of other ingredients,their mechanism of skin brightening as well as the full degree of the side effects of many of them.
Data correlating death or complications to abuse of skin bleaching products is nonexistent in Nigeria. Statistics available in other regions of the world however indicate higher perceived risks in African women. I believe that most people are not fully aware of the potential grave consequences of using bleaching products. It is necessary that Nigerians be enlightened regarding the possible health complications that the abuse of bleaching agents may induce. The Federal Ministry of health has the obligation to sponsor campaigns and enlightenment programs to inform the general public of the likely deleterious effects of some of the commercially available topical products. Other key players that could effect change include public health practitioners, medical doctors as well as relevant Non- Governmental Organizations. It is very important to understand the root cause of the skin-bleaching obsession that has taken Nigeria hostage. Sociologists, psychologists, psychiatrists and other experts need to investigate this problem. It will be very helpful if relevant public and private institutions will invest in this type of research. It is also desirable that the research output be made available for public consumption. More importantly, Nigerian citizens should be made to understand that the skin is pigmented for a reason and any attempt to interfere with the instituted barrier should be done cautiously.
Oluwadara is a writer as well as an academic researcher. She is currently a PhD student at the Department of Food Science, University of Campinas