skin bleaching literature review

The Skin Bleaching Syndrome

Skin Bleaching Syndrome

A Review of the Literature

Rose Bachan-

Research Methodologies

Tutor: Karl Anderson

University of Technology

November 3, 2009


The Skin Bleaching Syndrome A Review of the Literature

Over the past 35 years, researchers have attempted to determine the causes, effects,

symptoms and treatments of skin bleaching otherwise known as skin whitening. Skin bleaching

as discussed by Wade TJ. (1996) in the Journal of Black Psychology tilted “The relationship

between Skin color and self-perceived global, physical, and sexual attractiveness, and self-

esteem for African Americans” identifies skin bleaching as a controversial topic linked with the

detrimental effects of health, identity, self image, racial supremacy and colonial mentality.

Skin bleaching in Jamaica has become a very controversial issue and is the major concern

of people living in Kingston and St. Andrew as this sub-culture is rapidly developing especially

with students between the ages 16-20. To determine a definite conclusion as to what factors are

attributed to the behavior of these students is implicated by minor discrimination factors as skin

bleaching expands beyond boundaries of habits and cultural practices to accepted norms.

Researchers have generally agreed on most conclusive statements in regards to the effects of skin

bleaching, but some have attempted to highlight more precise answers towards the following

questions:

1. What is skin bleaching?

2. What are the disadvantages of skin bleaching?

3. What are the different categories and/or symptoms of skin bleaching?

4. What is the relationship between bleaching and the various sub-cultures?

5. Why is skin bleaching such a prevalent tendency amongst students between the

age group 16-25?


This review of the literature on The Skin Bleaching Syndrome focuses on these five questions.

What is Skin Bleaching?

According to the Canadian Encyclopedia of Dermatology skin bleaching is defined as

“The excessive use of skin lightening chemicals to alter, discolor, destroy or infect the skin with

the aim of achieving a lighter complexion” (Pirouzi, 2009). Pirouzi highlighted that skin

bleaching may be used for more than just its negative attributes; skin bleaching agents may be

used to clear dark spots such as moles, birthmarks and vitiligo which is death of the cells

responsible for skin pigmentation. The use of these creams as argued by Pirouzi can achieve a

uniformed skin toned but is describe as skin bleaching when the chemical is actually overused.

Conversely in the article “Bleaching is alive and well in sunny Jamaica” (Persadsingh,

2009) the writer argues that bleaching is the application of chemicals to the skin to obtain a fairer

color this he said may also be referred to as toning. Persadsingh identifies ingredients that are

used outside of original content such as Mercury which he said is a toxic chemical and

Hydroquinone which is used in medicine by dermatologist and doctors but should not be used

carelessly due to the harmful side effects of these chemicals (Persadsingh, 2009).

To complement the works of Persadsingh and Pirouzi, Dr. Malangu Ntambwe did a

highly topical research along with a team from the National School of Public Health at Medunsa,

where he aimed at highlighting to the public some of the major reasons for skin lightening. In is

research titled “Mirror Mirror on the wall, who is the fairest of them all?” Dr. Ntambwe defines

skin bleaching as the quest for 'fairness' in skin color through the use of skin lighteners which is

based on many 'unfair' problems and in the long term has very unfair and unhealthy results

(Ntambwe, 2004). In a forethought Dr. Ntambwe’s research was skewed towards determining


not just definitive reasons as to what is skin bleaching in its practical sense but defined skin

bleaching from the point of view of the “Bleacher” as oppose to the cynics.

Perhaps the best definition of what is skin bleaching can be derived from a previous

research done by world leading dermatologist Dr. Amina Mire in her article, “Skin bleaching:

Poison, Beauty, Power and the Politics of the Color Line” (Mire, 2001). Mire defines skin

bleaching as a practice whereby women and some men use various chemical agents on their skin

to achieve a lighter skin tone, or even appear to be white if possible. Skin-bleaching she argues is

linked to the ways in which whiteness historically has come to be viewed as the paradigm, the

standard, the universal human body, while blackness is seen as deviant, degenerate and ugly

(Mire, 2001). She also argues that in defining skin bleaching attention must be paid to not just

the effects but also the major influences such as culture and the social environment. She states

that “skin bleaching is a particular, albeit very destructive, attempt to gain respectability and

social mobility within the white supremacist capitalist social and political order (Mire, 2001).

Different researchers have identified their individual definitions of what is skin

bleaching, this therefore obscures an attempt to classify or quantify a single definition for the

question “What is Skin Bleaching?” However we can generally characterize the activity of

making changes to tones of one skin as skin bleaching which subsequently has both negative and

positive results which is heavily dependent on the extent of the usage of skin creams which

contain heavy chemicals.


What are the Disadvantages of Skin Bleaching?

Despite the many different positive uses of skin lightening products such as; getting rid of

your hyper pigmentation, melasma, freckles, uneven skin tone, dark skin discolorations, acne

scars, dark underarms, elbows, knees or inner thighs. There are major disadvantages of overusing

this chemical which has led to a safety issue been raised over the availability of harmful skin

lighteners or whiteners in the market.

Of the different disadvantages covered by previous research articles, harmful health

effects such as the damage done to the skin is considered the most deadly. (Hauet, 2006) describe

the many symptoms which result from the damage done to the skin by skin lightening products.

In the article written in the American Academy of Dermatology Journal (Hauet, 2006) attempts

states: “Albeit skin lightening products have their normal medical uses, considerations must be

taken for the disadvantage of using such products which is eventual destruction of the skin….”

The writer clearly emphasizes the missing consideration being paid to the major disadvantage of

bleaching the skin.

In comparison to another source which portrays the disadvantages of using bleaching

creams, skin bleaching is responsible for the highest percentage of skin damages recorded

throughout the year at the Canadian Dermatology Center (Pirouzi, 2009). This therefore

solidifies the argument made by (Hauet, 2006) that skin bleaching major disadvantage is the

effect it has on human health.


There is considerable evidence that skin bleaching has its other disadvantages such as;

� It promotes a detrimental sub-culture

� It is addictive

� Give rise to discrimination

One of our most controversial examples involves the depiction of class bias and the classification

of skin bleaching as one of the newly emerging sub-cultures in Jamaica especially among

teenagers (Hope, 2006). Hope theorized that coupled with major descriptive factors such as “The

Inner-City”, “Dancehall Music” and “Poverty” the epidemic of bleaching which is positively

related to the factors named has become a habitual practice which has led to the rise of this

subculture (p. 42). The detriment of this sub-culture then is implied as any increase in the

practice/promotion of any of the descriptive factors will eventually lead to the practice of this

sub-culture which subsequently contributes significantly to the major disadvantage “Damage to

the skin”.

Another disadvantage which is also easily explained is the un-ethical practice of

discrimination within the black racial class. Bleachers often find themselves in a delicate

situation as quite often their decision to use bleaching cream to create an uneven skin tone is not

a socially accepted moral in Jamaica. Students, teens, and even elder people face major

discrimination situations (Hope, 2006). They are discriminated in the areas of employment,

sports, social preferences, income, education, housing, and the marriage market. Other examples

also justify discrimination as a major disadvantage of skin bleaching, as due to the color complex

which is also exported around the globe, in part through US media images, what results is a

situation which helps to sustain the multibillion-dollar skin bleaching and cosmetic surgery


industries, this evidently fosters the growth of the sub-culture and evidently leads to

discrimination (Hunter, 2007).

The works of Hunter and Hope definitely discuss the minor disadvantages of skin

bleaching however not to be outdone is the scenario of a domino effect which leads from

discrimination to stigmatization. The frequency of particular behaviors has created a certain

stigma around people who bleach their skin. Varying of the economic class, bleachers are often

stereo-typed as people with deviant and anti-social behavior (Mire, 2001). Therefore skin

bleaching not only damages the skin, but put people who are so called victims of the epidemic in

various unacceptable social situations. To underscore the fact that skin bleaching has its diverse

or plethora of reasons to be used by humans is a great but pyrrhic act of ingenuity, as the

opposing disadvantages have way more luculent effects on an individual than the advantages.


What are the different categories and/or symptoms of skin bleaching?

Skin bleaching can be categorize into two separate groups these are internal and external.

Different categories are associated with various symptoms and might be determined or classified

based on the type of effect it has on the skin. External symptoms are those symptoms displayed

on the outer layer of the skin, whilst internal symptoms are those which affect the skin from

within. The external symptoms of skin bleaching are those which can be easily identified as quite

natural they are visible to the human eye.

A classification of the external symptoms can be derived from various researchers who

answers range from social and medical to psychological and physiological symptoms (Anderson,

2003). According to (Anderson, 2003) forms of external symptoms are; Stretch Marks, Acne,

Thinning of the Skin, Increased bruising also known as stripping and increased sensitivity to the

sun. More recent studies of external symptoms added additional contributions such as; discolored

palms and fingernails, sores, skin deterioration, scars, blemishes (Persadsingh, 2009).

Research conducted in Africa also identifies the effect of causing onchynerosis in which

there is the development of ugly dark spots on the skin caused by the deposition of melanin - the

pigment of the skin deep in the second layer of the skin. Onchynerosis is called “Festus” or

“Duppy Mark” in Jamaica and is a very consistent symptom among skin bleachers (Persadsingh,

2009).

Another external symptom of major discussion is the result of using mercury a harmful

toxic chemical used to bleach skin. Scientific study conducted for seven years by Dr. S. Allen

Counter who is a professor of neurophysiology and neurology at Harvard Medical School. The

results of the scientific studies done displayed similar tendencies of mercury poisoning which


was found in urine samples of patients (Counter, 2003). Mercury poisoning is known to cause

neurological and kidney damage and may also lead to psychiatric disorders (pg. 9). The

abundance of external symptoms is therefore understated by (Anderson et. al) as seemingly

researchers have found more traumatic effects of skin bleaching. More recent studies have shown

reports on patients who have developed hormone disorders and the inability to conceive

(Stevenson, 2008). The dermatologist stated someone would have to use huge quantities of these

creams for them to be absorbed into the body and cause these symptoms. According to

(Wayengera, 2009) bleaching the skin can be identified if there is any form of skin discoloration

where the skin has become multi-colored from bleaching. This will result in red skin, yellow skin

and dark skin. The skin on the knees, toes and finger joints will fail to lighten and will remain

black due to the hardness of those areas. Those in the medical profession explain that this

condition occurs from allergic dermatitis or irritant dermatitis (abnormal, extensive and often

local inflammation of the skin). The skin of the people using these bleaching products get

inflamed, turns red, enlarges and begins to lose function as the cells fail to produce melanin

(Hauet, 2006).

In later studies the forming of categories of symptoms seemed necessary as coupled with

the external symptoms are internal symptoms such as skin infections, destruction of melanin,

damage to other skin cells, liver damage, kidney damage and the increased likelihood of skin

cancer (Smith, Thomas et al., 2003, pp. 256-258). Research studies have definitely brought much

light to the bleaching syndrome and patients, doctors and health officials are no more aware of

how to find evidence of skin bleaching. The suggestions made by dermatologist to categorize the

symptoms of skin bleaching definitely highlights the difference in the effects of skin bleaching as


the internal effects often carry a larger impact on the individual’s health as compared to the

external symptoms (Forrester, 2005).

The effect of the internal symptoms is therefore an area which is in need of more

thorough research. The articles reviewed definitely provide the public with general data in

regards to the effects, but vaguely describes the causes and what chemicals from the different

creams can be attributed to a specific internal symptom.


What is the relationship between bleaching and the various Jamaican sub-cultures?

In sociology, anthropology and cultural studies, a subculture is a group of people with a

culture (whether distinct or hidden) which differentiates them from the larger culture to which

they belong (Jefferson, 1993). In modern Jamaica there are various sub-cultures, these may

appear in the form of;

� Dancehall Music

� Rude Bwoy/Shotta/Hot Head

� Ska

� Bling Bling or Hype

� Uptown

� Ghetto/Inner City

� Anti-Social Behavior

Jefferson’s definition of a sub-culture directly describes the above mentioned sub-cultures found

in Jamaica. In his 1979 book Subculture the Meaning of Style, Dick Hebdige argued that a

subculture is a sub-version to normalcy. He wrote that subcultures can be perceived as negative

due to their nature of criticism to the dominant societal standard. Hebdige argued that

subcultures bring together like-minded individuals who feel neglected by societal standards and

allow them to develop a sense of identity (Hebdige, 1979). On this basis the sub-cultures

identified are directly associated with negative criticism which further brings validity and

luculent of Jefferson’s language is his definition.

Further research statistically associated people who bleached their skin with the identified

sub-cultures due to the high frequency of individuals who are members of the named


subcultures. Dr. Persadsingh in his article “Bleaching is alive and well in sunny Jamaica” makes

reference to a popular weekly dance “Passa Passa” and suggest if you take a walk down into the

ghetto “you will see girls, their faces covered with a white cream busily bleaching” (Persadsingh,

2009). Dr. Persadsingh positively relates bleaching to a supreme sub-culture “The Ghetto”, this

is however contrasted by Dr. Arthur Williams who did a survey and reported the findings in his

book titled Uptown vs. Downtown, where he not only associated bleaching to another sub-

culture “Uptown”, but also stated that bleaching uptown is called toning (Williams, 2006).

One of the major associations between bleaching and sub-cultures can be derived from

the relationship between stigma, dancehall music and skin bleaching. Stigma as described by Dr.

Ann Beuf is the major factor behind determining ones identity in terms of who we are or who

could be (Beuf, 1979). Beuf discussed the effect of stigma and pointed out that "for those who

are socially stigmatized by race, religion or caste cultural myths of their own inferiority may be

internalized." This dates back to the days of slavery, where the black man thought of himself as

inferior to that of the lighter skinned male/female. This in its effect created an imbalance

between races; as people of darker complexion often associate opportunities as being attributed

to the white man, hence arise the situation of bleaching. This stigma clearly demonstrates that

black people psyche was destroyed from the days of slavery. Dancehall music today in its own

form illustrates narratives of the societal acceptable skin tone through the lyrics expressed by

popular artist (Persadsingh, 2009).

To further emphasize Persadsingh research, Dr. Hope who participated in the 1999 panel

discussion “Loving the skin you are in” relates social debates by panelist in her book “Inna di

dancehall”. The university was informed by male and female bleachers that bleaching was a


means of getting ahead in Jamaica (Hope, 2006). She further relates the idea of one woman who

was convinced that the lighter your complexion the more attention you get and a male who

professed that bleaching was a way out of the ghetto because people only see you when you are

brown (Hope, 2006). To authenticate this premise, in the 1990’s, popular deejay Buju Banton in

is song which states “Mi love me car mi love mi bike mi love me money and thing but most of

all mi love browning” evidently illustrates that the then accepted skin tone was browning.

Evaluating the above mentioned research done by the different Dermatologist, Doctors

and other researchers, all have made excellent contributions towards defining the relationship

between bleaching and the various sub-cultures. It is evident that due to the great quantity of

Jamaicans who are so called associated with a particular sub-culture, the relationship between

bleaching and sub-cultures is positively related meaning as one increases it is likely that other

will increase as well. However, the researcher’s failed to identify the fact that bleaching in

Jamaica is no commonly more of a trendy issue like slangs and other fashion statements made by

people of the above mentioned sub-cultures. This can be confirmed by looking at brown people

who bleach, what would be their reasons for bleaching? In this sense bleaching is nowadays

more commonly related to the bling-bling, hype, anti-social behavior and ghetto sub-culture.


Why is skin bleaching such a prevalent tendency amongst students between the age group 16-25

in Kingston and St. Andrew?

To determine why there is such a prevalent tendency of students in Kingston and St. Andrew

between the age group 16-20 who bleach their skin; one would have to take two separate point of

views; Psychological and Cultural.

According to Erik Erikson Psychosocial Development theory stage 5 (Identity vs. Role

Confusion) which is associated with the age group 16-25 states; during adolescence, children are

exploring their independence and developing a sense of self. Those who receive proper

encouragement and reinforcement through personal exploration will emerge from this stage with

a strong sense of self and a feeling of independence and control. Those who remain unsure of

their beliefs and desires will be insecure and confused about themselves and the future (Wade &

Travis, 2008).

This theory seeks to explain the prevalent tendencies of students between the age group

16-25 bleach their skin due to the fact identifying their role young adolescence attempt to

associate themselves with a particular social group or peer group. Erikson states that young

adolescents ask themselves the questions; who am I? And where am I going? The adolescent is

newly concerned with how he or she appears to others. Superego identity is the accrued

confidence that the outer sameness and continuity prepared in the future are matched by the

sameness and continuity of one's meaning for oneself, as evidenced in the promise of a career

(Erikson, 1968). It is therefore evident that from a social psychological point of view the

prediction of human development facilitates the opportunity of people practicing tendencies of

identifying themselves with a particular group and also confusing their role as to who they are.


This can also be derived from the fact that most teens that practice skin bleaching are pressured

by their peer group.

Further development as however been conducted in the field of social psychology. The

Social comparison theory (Festinger, 1954) is the idea that there is a drive within individuals to

look to outside images in order to evaluate their own opinions and abilities. These images may

be a reference to physical reality or in comparison to other people. People look to the images

portrayed by others to be obtainable and realistic, and subsequently, make comparisons among

themselves, others and the idealized images (Festinger, 1954). This in it sense also contributes to

the high prevalence of skin bleaching among teenager students in Kingston and St. Andrew as

human beings especially young females are found to be very sensitive about beauty and

appearance to others. Festinger eliminates the options of other internal factors which are

associated with people taste and preferences.

The role of sub-culture and or tradition as definitely made major contributions towards

determining the reasons or factors that bring about this prevalence. Sub-Cultural situations can

be defined from the view point of understanding that students learn from their ancestors and if

this theory has been practiced in ancient Jamaica, then evidently the continuation of a culture

will be natural (Hope, 2006). Subsequently the relationship between bleaching and the various

sub-cultures also aligns the tendency of bleaching with a particular age group especially in

Kingston and St. Andrew. Looking at the positive relationship of the various sub-cultures and

skin bleaching, the age group 16-25 consists heavily of students who are inclined to associate

themselves to one of the above named sub-culture (Hunter, 2007). This therefore ascribes that it


is most natural for students to bleach when they reach a certain age group due the factors of peer

pressure, the hype crowd etc.

Although research studies continue to produce high levels of controversies, there is a

constant increase in the quantity of students between the age group 16-25 in Kingston and St.

Andrew who continue to bleach their skin. They seemed to be miss-informed or negligent

towards the possibility of the disadvantages. These disadvantages have resulted in a variety of

deadly symptoms such liver disease and have definitely been associated with particular sub-

cultures. The gap between the awareness of those who are bleaching and those who are not

bleaching is getting tightening and soon everyone should be aware of methods used by

dermatologist for beneficial purposes as oppose to informal methods which will in the long run

be of some detriment to the individual.


References

Anderson, C. (2003, July 23). The Bleaching Syndrome. Kingston, Jamaica.

Beuf, A. (1979). The Fact of Stigma. Kingston: Methuen & Co. Ltd.

Counter, S. A. (2003). Whitening skin can be deadly. London: The Boston Globe.

Erikson, E. (1968). Identity, Youth and Crisis. New York: Norton.

Festinger, L. (1954). A theory of social comparison theory Humans Relations. New York: Kluwer

Academic/Plenum Publishers. .

Forrester, W. (2005). Attack on the black skin. Sydney: Adventure Work Press.

Hauet, T. (2006). Skin lighthening-From the advantages to disadvantages. Journal of the American

Academy of Dermatology , 262-271.

Hebdige, D. (1979). Sub-Culture the meaning of style. London: Methuen & Co. Ltd.

Hope, D. P. (2006). Passa passa: Interrogating cultural hybridites in Jamaican dancehall . Kingston:

Mona, Jamaica University of the West Indies Press.

Hunter, M. (2007, Janurary 1). The Persistent Problem of Colorism: Skin Tone, Status, and Inequality.

InterScience , pp. 10-12.

Jefferson, T. (1993). Resistance Through Rituals: Youth Subcultures in Post-War Britain. New York:

Routeledge.

Mire, A. (2001). Skin Bleaching: Poison, Beauty, Power, and the Politics of the Colour Line. Gale .

Ntambwe, M. (2004). Mirror Mirror on the wall who is the fairest of them all. 1-4.

Persadsingh, N. (2009). Bleaching is alive and well in sunny Jamaica. Jamaica Observer.

Pirouzi, P. (2009). Canadian encyclopedia of Dermatology. Canadiana The National Library of Canda.

Smith, K. T. (2003). Internal effects of chemicals. The Journal of Pharmacology and Experimental

Therapeutics , 64-72.

Stevenson, O. (2008). Warning over illegal skin bleach. London: BBC.

Wade, C., & Travis, C. (2008). Invitation To Psychology. California: Prentice Hall .

Wayengera, M. (2009). Skin bleaching the dangers. Uganda: Uganda Press.

Williams, A. (2006). Uptown vs Downtown. Kingston: White Works.

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