Hae Shin Chung, Adjunct Professor of Dermatology at the Yonsei University College of Medicine in Seoul, South Korea, explains that although primarily a common practice among women, the desire for lighter skin exists among men as well, and has increased in recent years ( Tan, 2012). SL products have shown dramatic growth during the past several decades ( Ashikari, 2005), with estimates that 40% of South Koreans routinely use SL agents ( Tan, 2012). (2008), advertisements in four Asian countries demonstrated that good skin was portrayed as smooth and white, whereas bad skin was dry and dark with wrinkles. In East-Asian culture, the fair-skinned ideal of beauty is illustrated in the proverb “a white complexion is powerful enough to hide seven faults” ( Li et al., 2008). Because patients acquire these creams without the counsel of a physician, they are often unaware of the potential side effects and if aware, stop its use only if they personally experience such effects ( Yusuf et al., 2019). Despite these restrictions, patients are still able to obtain products from street vendors and cosmetic shops, avoiding bans or regulatory constraints ( Dadzie and Petit, 2009, Dlova et al., 2015). South Africa became the first country in the world to ban skin bleaching products and was recently joined by Rwanda, Cote d’Ivoire, Tanzania, Kenya, and Ghana ( Thomas, 2012). In the 1970s, the government began regulating active lightening ingredients and in 1990 prohibited the use of hydroquinone in cosmetic and over-the-counter (OTC) products. South Africa has a lower rate of SL than other African countries, likely owing to the anti-SL messages broadcasted on television for decades ( Lartey et al., 2017). Underlying Motivation of Patients Seeking Skin Lightening Treatment. Similarly, in regions of East Africa, 52% of patients use SL products for pigmentary disorders, 38.7% prefer a lighter skin color, and 9.7% report both reasons ( Yusuf et al., 2019). Of the South-African patients using SL creams, 67% are treating postinflammatory hyperpigmentation (PIH), melasma, and acne, whereas 33% use the creams with the primary goal of lightening skin ( Fig. Ncoza Dlova, current president of the African Women’s Dermatology Society and Chief of the Dermatology Department at the University of KwaZulu Natal in South Africa, explains that 30% of her patients request SL treatments. Consequently, individuals claim that lighter skin makes them attractive and increases their career opportunities ( Dlova et al., 2015, Yusuf et al., 2019).ĭr. Up to 75% of women in Nigeria ( Dadzie and Petit, 2009, Dlova et al., 2015), 60% in Senegal ( Blay, 2011), 50% in Mali ( Baxter, 2000), and 30% in Ghana are estimated to use bleaching creams regularly, with similar rates in other African countries ( Lartey et al., 2017, Mckinley, 2001).Throughout the continent, both men and women are frequently targeted with marketing campaigns showing public figures who bleach their skin ( Owusu-Agyei et al., 2020). Skin bleaching became a popular cosmetic practice in many African countries in the 1950s ( Sagoe et al., 2019).
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