MONICA KAYOMBO, Lusaka
ACCORDING to Healthline.com, skin bleaching refers to the use of products to lighten dark areas of the skin or achieve an overall lighter complexion.
These products include bleaching creams, soaps, and pills, as well as professional treatments like chemical peels and laser therapy. For those with a liking for skin bleaching, the major reason is enhanced beauty. But they usually turn a blind eye to the negative effects of lightening creams and lotions. Malan Malumani, a lecturer in dermatology and venereology at Mulungushi University, School of Medicine, said in an interview that skin bleaching is a sensitive matter as it borders on bread and butter. He stated that the best option to avoid skin cancers caused by mercury and hydroquinone is to completely quit using bleaching products. Dr Malumani said skin bleaching can cause other complications such as skin cancer, kidney, heart and liver problems. “In some cases, skin bleaching causes dementia,” he said. Dr Malumani believes skin bleaching is mainly a psychological issue. He said if the practice has to be completely done away with in Zambia, medical experts need the support of Government, Zambia Bureau of Standards and all other stakeholders. “Going forward, we plan to have a dermatology department at all health facilities so that we can effectively deal with this problem,” he said. He said he finds it hard to recommend alternative lightening products and insists that quitting bleaching is the best solution. Dr Malumani said most people who face skin problems due to bleaching rarely visit health facilities, but that they seek alternative products at cosmetic spurs. He also pointed out that suturing bleached skin can be hard as the skin becomes too light. The World Health Organisation (WHO) says mercury-containing skin lightening products are hazardous to health and, as a result, have been banned in many countries. Even in some countries where such products have been banned, they are still advertised and available to consumers via the Internet and other means. On the other hand, a harm reduction concept started some 30 years ago, whose goal is to reduce lifestyle diseases burden. Recently, IntergraAfrica held a Harm Reduction Exchange (HRE) virtual meeting under the theme “Harm reduction a winning strategy in Africa”, and the six panellists touched on a number of topics anchoring on harm reduction for all sectors. One of the topics covered was skin bleaching, a global health problem that has become difficult to control despite the users of these skin lightening creams knowing the consequences. Moussa Diallo, a renowned dermatologist from Senegal, explained that scientists in his field are thinking of having a new approach on harm reduction in bleaching. “People are reluctant to change their behaviours for many reasons. This is where harm reduction strategy comes in,” Professor Diallo said. He said many dermatologists dealing with addicts of skin bleaching have started recommending alternative bleaching products that are mild and don’t contain hydroquinone. Prof Diallo said skin bleaching is not an African problem, but one that is faced in many parts of the globe. He said in Africa, the prevalence rate of bleaching stands at 51 percent and it is done by people from different professions and backgrounds. “It is more widely aped among women between the ages of 20-40 years of age in urban areas,” he said. Bleaching is done for several reasons, and Prof Diallo cited beauty and imitation of influential artists.
He said many women that have sought treatment from him have admitted that they decided to bleach because they felt they were missing out on something. “Just like a smoker would rush into smoking instead of eating, it is a general addiction,” he said. He said bleaching blocks the melamine process and this, over a period of time, results in skin cancer and infections, including fungi. Apart from causing cancer, the use of bleaching creams can result in high blood pressure. In the hard reduction strategic measures, dermatologists have continued to discourage the use of the products through enhanced sensitisation to the general public. In Senegal, for instance, to discourage bleaching, the government has increased tax on all bleaching products, and importation has also been restricted. But even then, people still manage to sneak in the bleaching products, and his question was, what do you do? He said the solution on this matter is harm reduction through continued sensitisation and recommendation of alternative products that are less harmful. “But we still insist that quitting bleaching is the best option,” he said. Prof Diallo said in an effort to bring the bleaching problem to a complete halt, scientists are considering a disciplinary-based strategy and enhanced psychological support to users of lightening creams.
He said over the years, harm reduction has been implemented in malaria through the use of treated mosquito nets, HIV through the use of life-prolonging anti-retroviral drugs, cancer through the use of vaccines, and now COVID-19 through vaccination and following the five golden rules for preventing the spread of the virus. Moroccan specialist in drug addiction and behaviour, and president of the Moroccan Association for Addictive Medicine and Associated Pathologies, Imane Kendili, said it is important to communicate to masses harm reduction strategies and policies effectively.
“There is a need to adopt a public policy based on harm reduction,” she said. Dr Kendili said Africa has a key role to play in harm reduction.
She is optimistic that the forthcoming observatory conference on harm reduction in Africa will offer many solutions to the current problems.
Another major problem is smoking, and Kgosi Letlape, an ophthalmologist from South Africa, said the major challenge in many lifestyle diseases today is lack of knowledge and misinformation. Giving an example of cigarettes, Dr Letlape said combustion in cigarettes could be avoided by the use of modified risk tobacco products (MRTPs) that have been approved by the Food and Drug Administration (FDA). Late last year, FDA director Mitch Zeller said data submitted by Philip Morris Company on tobacco heating system products shows that the products might help addicted adult smokers transition away from combusted cigarettes and reduce their exposure to harmful chemicals, but only if they completely switch. “We need to look at what alternatives technology can offer,” Dr Letlape said. French oncologist and professor of oncology at Pierre and Marie Curie University and adjunct professor at the MD Anderson Cancer Center in Houston, Texas, David Khayat, and Joseph Magero, the chairman of Campaign for Safer Alternatives (CASA) were other resource persons that contributed on the discussion on lifestyle diseases and how the reduction strategy could be applied. The meeting was coordinated by Dr Tendai Mizha, a leadership expert in the fields of general management, marketing, branding and market research.