BLEACHING is still rife in Jamaica and many young women are bleaching for reasons they can't explain. Some believe that their prospects in life will improve with a lighter complexion, but many, when asked, don't even know why they are bleaching, or will give vague and unconvincing responses.
Some young women will claim that they're bleaching because the men only want 'brownings'; others claim they cannot compete with the other women out there. Others blame slavery, claiming that fairer slaves got better treatment; still others blame white people. But needless to say, despite many, many medical warnings, the bleachers are out in their numbers.
Bleaching is defined as the application of chemicals and steroid creams to the skin to obtain a fairer or whiter colour. In medicine we treat many diseases with steroid creams. One of the side effects of these is hypopigmentation — that is for the skin to turn white. People are deliberately using these creams to bleach. These include Betnovate, Dermovate, Neoprosone, Omnic gel, Pro Betasone, Prosone gel, Lemon gel, Top gel, Plustop gel, Fair and White and Whitening gel.
By law, these creams are supposed to be sold in pharmacies under a prescription from a doctor, where they should only be used for a short time — no more than seven days and in exceptional cases, 10 to 14 days.
This is because steroid creams can both harm the skin and the rest of the body. The effects on the skin are more common and include steroid acne, which is a challenge to treat. What happens is that the cream will control the acne for a short time, and the face looks good. Then the acne returns, and more cream is used or a stronger cream is used. Eventually the cream stops working and then the person will need expert advice to get the acne bumps under control.
There is also a problem with thinning of the skin. This is very common on the epidermis, that is the top-most layer of the skin. It becomes very thin and very fragile and sometimes atrophic. Small new vessels might grow in the skin — called telangiectasia. The face will eventually look like a grater, permanently disfigured from skin damage due to the bleaching cream. Some patients go on to develop stretch marks and these can be very difficult to treat.
Steroid creams can also mask or hide fungus infection. The steroid cream can change the appearance of the fungus disease so that the right diagnosis is difficult to make. This is called tinea incognito.
Steroid creams on the face can also give rise to a rash around the mouth. In medicine, this diagnosis is called Perioral dermatitis.
For the body there are other side effects. These include high blood pressure and diabetes. There will be weakness in the muscles and wasting away. Libido may go down and sexual performance may suffer. Menstrual problems may arise. The application of steroid cream around the eyes may cause glaucoma. This may need treatment for life and may lead to blindness.
In all, steroid creams should only be used under medical supervision and should only be prescribed by doctors. If by chance you have been using one of these creams, please go and see the dermatologist as soon as possible. And please stop the bleaching!
Dr Persadsingh, MBBS, Dip Derm FAAD is a dermatologist. He is the author of the book Acne in Black Women and operates from Nutall Medical Centre.