Monday, June 29, 2009

Cushing's: Bleaching is alive and well in sunny Jamaica


Monday, June 29, 2009

THE phenomenon of skin bleaching is alive and well in Jamaica. The recent seizure by customs of goods containing a selection of bleaching creams only proves the point.


Bleaching is the application of chemicals to the skin to obtain a fairer colour. It may also be referred to as toning.


Usually the chemicals used contain hydroxyquinone or cortisone, eg Bethamethasone, R Triamcinilone, Clobetasol or Mercury. Usually the chemicals are obtained by illicit means and as that customs bust proved, not even the government is able to collect tax revenues on these drugs.


So much can be said for government's control of these chemicals. Every wholesale in Kingston has these drugs for sale. At every street corner in downtown Kingston these drugs are available. Men are bleaching, women are bleaching, boys and girls are bleaching. At every Passa Passa fete you will see a lot of girls who are bleaching, or just take a drive into the ghetto and you will see girls, their faces covered with a white cream busily bleaching.


The question naturally arises, what can be done? We need a new educational policy. Last year we had a drive that was put on by the pharmacy board at the Ministry of Health, where we went to the schools and to the libraries and spoke to the kids. I believe that it was successful but it was discontinued. We need to get back to the drawing board and get a new strategy to deal with this problem.


We approve of the ad shown on national TV showing a lady saying that she would never bleach her skin, but the usual response from our patients is, "She nuh know nuttin, she a eediat", completely dismissing the message that bleaching will damage their skin.


The preparations containing mercury are illegal because mercury is a toxic chemical which accumulates in the body and leads to some serious problems like liver disease. Mercury products are therefore banned worldwide but still find themselves unto our streets.


Hydroxyquinine products are used in medicine by dermatologist and by doctors. They should not be used carelessly as they may have 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.

Cortisione preparations are used again by dermatologists and in medicine but these preparations should be obtainable only with a doctor's prescription. They should only be used for a week or at the most two weeks before their use is assessed by a doctor to ensure that they are not causing any harm.
If these products are used for a long time they can cause the appearance of stretch marks.

Thinning of the skin, a severe form of acne called steroid acne and the appearance of a lump of fat at the back of the neck called cushings syndrome are also results. The face can also become round and moon like and there can also be wasting of the limbs.

If enough of the steroid is absorbed we can get high blood pressure and diabetes and if the creams are used around the eyes we can develop glaucoma. In fact we expect to see more cancers of the skin as the melanin is removed by the bleaching and the skin is exposed to the harmful effects of the sun.


Despite all of this our people continue to bleach and the sales of these creams continue to flourish. As soon as we crack down on one product it resurfaces under another name and in a different packaging.


It is hard to believe that in the 21st Century in Jamaica the country which is the heart of black pride - a country which gave the world Garvey and Marley and Rastafari - is still bleaching.