Treating a bleached skin

As a teenager, Sarah Nantege was agitated by the pimples on her face. She began using a cream mixed for her by a lady in Gaza land plaza.

 “She told me to use it once only at night, probably to delay its effects. By the time I realised my skin was bleaching, it was too late. When I returned to her shop, it was closed!” she says. 

But Nantege was brave enough to stop and with time, the horrible withdrawal effects disappeared.

Bleaching has for a long time been part and parcel of the African cosmetic regimen, but when it gets to that point where it has caused irreversible damage, what do you do?

According to Dr Lucy Nakibuuka, a dermatologist at Unity Skin Clinic, the three main components that lighten the skin are steroids, hydroquinone and mercury. These, once introduced to the skin, gravely damage it. 

“They destroy melanocytes, the cells responsible for producing melanin in the skin,” she says. 

Melanin helps shield the skin from the harsh effects of the sun. It also prevents early wrinkling and generally preserves the skin. 

To destroy its factory is to leave your skin prone to skin cancer and premature wrinkling.

Nakibuuka points out the two most commonly used agents on the Ugandan market.

Steroids

These are usually mixed in face creams. “Initially, steroids smoothen the skin in as little as two days, then the lightening begins,” Nakibuuka explains.  

The skin soon develops multiple pigmentations, unevenly spread light and dark patches. 

The cycle of steroids is that when usage is stopped, the skin breaks out into a bad rash and then you need to apply them to clear it. 

“Some people get them from pharmacies and what began as a simple treatment for a rash turns, into a never-ending nightmare of recurring skin rash and acne. The problem with steroid-induced acne is that it is stubborn to treat,” Nakibuuka notes.

Hydroquinone

Even with doses as low as 2%, this substance, when exposed to the skin, destroys the melanocytes. 

It is so strong that it permeates the second layer of the skin, the dermis and binds itself permanently to the collagen, causing an irreversible condition called Onchronosis. 

“It is at that point that dark circles appear around the cheeks, neck and forearms,” Nakibuuka explains.

Daily, Nakibuuka receives at least three patients with bleached skin. 

“Majority are in their 20s and 30s. At this stage, a young woman is looking for a partner, dating, courting or getting married and at the height of her beauty,” Nakibuuka explains. 

They come in confused and distraught especially those who bleach unintentionally. 

“Those tend to seek help immediately they realise that they are beginning to lighten or when the dark circles are just beginning to develop,” she reveals. 

At that point, the situation can still be contained and the skin can heal.

Psychologist says:

According to Eva Busingye, a psychologist, bleaching is not restricted to a single class of people. A housemaid and a highly placed woman will both bleach.  

“Bleaching is an indicator of low self -esteem, especially when done intentionally. Those ladies believe that those with fairer skin are better looking, have better opportunities in life and have a higher social status so when they bleach they feel they fit in,” she says.

There is however another group of those who bleach inadvertently. These are especially teenagers or unsuspecting women looking to clear their skins of acne and blemishes. 

However, they get trapped in the cycle when they cannot undo the damage.

When they realise they have bleached permanently, it is also a problem because they do not fit in. 

“Since they are not naturally fair-skinned, they look strange, especially around the knuckles which remain dark. 

“That is why many try to conceal it by wearing henna for instance,“ Busingye says.

This affects someone psychologically because they can neither go back to their original complexion nor fit in with those who are naturally light-skinned.

What do you do?

The first step is to immediately discontinue use if you realise your skin is lightening. 

“There will be a rebound effect which can even last till a month but they eventually clear as the skin heals especially if you stop early,” says Nakibuuka.

Stick to trusted, authentic brands, and desist from exploring with cosmetics. Worldwide brands are safer, though more costly. 

The greatest victims are young women, who have just started earning and want to experiment with every type of cosmetic. 

They fall victim to quack “beauticians”, who stealthily mix steroids and hydroquinone in the creams they sell them. 

“That is why suddenly a horrible skin turns silky smooth within a few days of usage,” Nakibuuka illustrates.

The treatment offered depends on the damage to the skin. In some cases, antibiotics and creams are used to reduce inflammation and clear the rash. Derma rolling and derma pigmentation are also options used.

If upon examination it is discovered that the damage is irreversible, the best thing is to discontinue usage to prevent further damage to the skin.

Of course, no patient wants to hear from their doctor that their situation cannot be salvaged. 

“If they are adversely affected by the news, we recommend a psychologist or psychiatrist though that is rare,” she says.