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Skin-bleaching on the increase in Sierra Leone

27 December 2020 at 19:06 | 1435 views

Skin-bleaching on the increase in Sierra Leone: Will skin cancer be avoided?

By Teddy Foday-Musa, Freetown, Sierra Leone

This article was first published in 2008 to serve as a deterrent to skin-bleaching in Sierra Leone. But after more than a decade, the act of skin-bleaching seems to resurface and continues to appeal to our young teenage girls and adult women in the country. It is against this background that an edited version of the article is prepared for publication to serve as a reminder to victims of skin-bleaching. The article explores the medical complication of skin-bleaching. It clearly articulates the importance of the three-layers of our dark skin and their preventive attributes in protecting us from skin cancer and other related skin diseases.

Teenage girls and adult women apply cosmetic ointments and gels on their body, in order to transform the colour of their skin to a lighter or brighter outlook. The process is commonly known as “bleaching” but medically recognized as “skin-bleaching”. According to them, skin-bleaching is an added value to their beauty. However, public opinion about them is that - they are using skin-bleaching to capture the attention of men for sexual and material gains. They also use skin-bleaching in preparation of their body for activities like wedding ceremonies to render them a flamboyant look on the occasion.

The act of skin-bleaching
Skin-bleaching is not only an insult to our true African identity, but comes with a terrible price of medical complication prone to skin cancer. It has been scientifically proven that the dark colour of our Sub-Saharan African skin, and our curly-black hair, are preventive attributes naturally bestowed on us to withstand the harsh climatic conditions of our tropical environment. Our dark-coloured African skin plays a vital and leading preventive role.

Our dark colour skin – a protective mechanism
The Dark African skin is made up of three layers - the outside (top), the middle and the lower. The outside layer is also referred to as the epidermis layer. This epidermis layer contains a certain thickness of elasticity that serves as a protective layer over our skin against natural reactions like the severe ray of our hot- burning tropical sun. It also serves as a protective layer over the middle skin layer which contains our blood vessels, nerves and courteous layers with fat for our healthy existence and survival. The normal operational functions of our blood vessels and nerves within the middle skin layer are enhanced by the strong elasticity and thickness of the top skin layer or the epidermis. Therefore, it is advisable that we prevent our top skin (epidermis layer) from undergoing any skin lightening process which will reduce its thickness and handicap its protective role as a barrier to infections, irritants and even skin cancer.

Today, in Sierra Leonean, the protective epidermis skin layer of most teenage girls and women has been damaged and destroyed by the use of tropical steroids. This exercise is commonly known as “Bleaching”. Victims are frequently utilizing potent creams, ointments and gels like, skin-light, all of which falls under the category of tropical steroids. These tropical steroids contain high content of HYDROCORTISONE and HYDROQUIOLONE which speedily helps in damaging the upper layer skin (epidermis) by making the upper skin layer lighter, thus making their blood vessels and nerves prone to skin cancer the killer diseases.

Medically, you are only advised to apply these tropical steroids with a mild percentage content of 1% hydrocortisone. Our top skin layer or the epidermis contains the protective melanin which is what albinos. lack and as a result get the skin burn reaction on their skin with small hyper pigmented, pedunculated papules on their faces and all over their bodies. Therefore, it is no surprise when victims of skin-bleaching produce reactions on their skins like striae (breeding mark) which are due to loss of dermal collagen and are likely to be permanent even after discontinuation.

Skin-bleaching a possibility for skin cancer
Skin-bleaching is accomplished with enormous medical complication prone to skin cancer the old-age killer disease. There is also the medical complication of not being able to undergo a surgical operation in order to save your life. Speaking to one surgical doctor at Connaught Hospital in Freetown, he told me that stitching the skin of patients who do skin-bleaching has always proved difficult or even not possible, which normally leads to loss of lives. He also told me that those who survived the stitching of their extra lighter skin are faced with the problem of skin healing after the exercise. And in most cases, the surgical wound easily becomes bacteria infected and stays with them longer than expected.

It is also medically stated that the use of tropical steroids with more than 1% of hydrocortisone more so on the face, will result in Perioral dermatitis. Perioral dermatitis is a rash around the mouth, made up of small papules and vesicles, which spares the area immediately around the lips.

Photo: Perioral dermatitis
The only treatment for it is to stop or discontinue the use of the tropical steroid. The rash will then resolve but it may take several months. Oral tetracycline 250mgbd (on an empty stomach) for six weeks may speed up its resolution.

Telangiectasia is also another medical complication manifested by the use of tropical steroids. This telangiectasia appears on the cheek of our face like hyper pigmented, pedunculated papules. This happens when tropical steroid stronger than 1% hydrocortisone is applied to the face of adults over the age of 30 years.

The application of this potent steroid will lead to telangiectasia, and later tearing of the skin and scarring.

A word for the wise
I would like to call on my fellow compatriots to kindly abandon this act of skin bleaching and help in preparing their skin to return to the usual healthy medical state of condition. However, if at all you find it difficult to stay away from skin-bleaching, I will recommend that you always contact a dermatologist (Skin Doctor) who will provide you the necessary medical advice and ascertain the content rate of hydroquinone in your chosen tropical steroid before application on your skin.

A Prosperous 2021 to all.

Teddy Foday-Musa is is a lecturer at Fourah Bay College, University of Sierra Leone