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Journal of Pakistan Association of Dermatologists 2007; 17: 100-104.Review ArticleFair skin in South Asia: an obsession?  ...
Journal of Pakistan Association of Dermatologists 2007; 17: 100-104.Generally speaking, a preference for fair             ...
Journal of Pakistan Association of Dermatologists 2007; 17: 100-104.Adverse effects        of   skin    lightening        ...
Journal of Pakistan Association of Dermatologists 2007; 17: 100-104.dermatologists have an important role to              ...
Journal of Pakistan Association of Dermatologists 2007; 17: 100-104.                                                      ...
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7. review article fair skin in south asia


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7. review article fair skin in south asia

  1. 1. Journal of Pakistan Association of Dermatologists 2007; 17: 100-104.Review ArticleFair skin in South Asia: an obsession? P. Ravi Shankar, P. Subish Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal.A large part of South Asia was governed by Dravidians has been stressed in history,the British for around two centuries. The though recently some historians have cast‘white’ race was the ruler and the ’dark’ or doubts on the theory. There were later‘black’ natives were the ruled. The colonial invasions of other fair skinned races like thelegacy in South Asia may be one of the Moghuls and the Europeans.1 The Hinducontributory factors for the belief that White caste system with the ‘fairer’ higher castesis powerful and White is beautiful. and ‘darker’ lower castes in general, may have given another impetus to the notion ofThe British and American influence the superiority of fairness.The British left South Asia by the middle of Fairness and South Asian societythe twentieth century. Large parts of Asiaand Africa gained independence in the In South Asia, pale skin is considered as1950s and the 1960s and the Sun was finally social markers of aristocratic lineage andbeginning to set on the British Empire. The class allegiance. Dark skin is associated withdecline of the British was followed by the labour and field work in the Sun.1 ‘White’rise of their transatlantic cousins, the skin has a colonial notion of power andAmericans. The American empire in superiority.2 According to many authors, thecontrast to the British was mainly an preference for ‘white’ is also reflected in theeconomic one. The American dream and the South Asian film industry. The heroines ofidea of America as an El dorado caught the films are usually fair and beautiful, theimagination of the masses. Hollywood, heroes are fair and handsome and theAmerican television and the entertainment villains are dark and swarthy. There haveindustry exerted a powerful influence on been exceptions to this rule of course. InSouth Asia. recent times, beauty pageants have become common in certain regions of South AsiaThe invaders and South Asian women have done well in international beauty contests. In India,South Asia, a heterogeneous region has been beauty contest winners are extraordinarilya melting pot of cultures since antiquity. The tall, breathtakingly slim and have a lightfair Aryans subjugating the darker honey-colored skin.3 Matrimonial columns and web sites reveal the influence of a Address for correspondence Dr. P. Ravi Shankar young woman’s skin colour on her Department of Pharmacology marketability to marriage partners.3 Manipal College of Medical Sciences P.O.Box 155, Deep Heights, Pokhara, Nepal. Phone: 00977-61-440600 Fax: 00977-61-440160 E-mail: 101
  2. 2. Journal of Pakistan Association of Dermatologists 2007; 17: 100-104.Generally speaking, a preference for fair professional and the personal sphere. Thewomen is universal and has been known to natural anxiety of men and women regardingexist in nearly every society including skin colour has been heightened. Whiteningancient India, Egypt, Crete and Japan.1 has been represented as an active processFairness of skin was considered as a effected through lightening.2 Fairnessyardstick of purity and innocence. creams portray fair skin as an object of desire in countries where a large proportionFairness creams of the population is dark. Fair skin is said to heighten attractiveness towards the oppositeThis widespread preference for fair skin has sex. The advertisement for a male fairnessbeen exploited by the manufacturers of cream shows a dark-skinned college boyfairness creams. A consumer goods giant being ignored by girls. On using the productlaunched the mother of all fairness creams in his complexion lightens and girls flock tothe subcontinent in 1976. Today, the product him like moths to a marketed in over 38 countries and hasbecome the largest selling skin lightening Melanocytes, melanin and skin colourcream in the world. Today a number of othercompanies have also jumped on the The melanocytes in the epidermis are‘Fairness creams’ bandwagon. The craze for responsible for the intensity of skin colour.fairness creams has emerged in the last fifty The number of melanocytes is the same inyears. Skin whitening and fairness creams both fair and dark skinned people. Thehave spread to other regions with dark- amount of melanin produced by theskinned people like Malaysia, Egypt, melanocytes is partly determined byNigeria and other African countries.4,5 genetics and partly by the environment.8Recently a fairness cream has been launched People living near the tropics have moreexclusively for men. Initial surveys show melanin to protect them from the harsherthat an increasing number of Indian men are rays of the Sun. In the 1800s white skin wasalready using or are in favour of using the deemed desirable by many people ofcream.6 Recently the male fairness cream European descent.8 Women even ate arsenicwas also launched in Nepal and other South to make their skin pale. However, during theAsian countries. twentieth century, the pendulum swung in the opposite direction and a tanned skinThe power of advertising became a fashion trendsetter among Caucasians.8 Fairness creams halt the naturalThe natural preference for a fair skin has production of melanin to bring about anbeen fanned by the manufacturers of fairness artificially-enhanced and genetically- 2creams. Advertisements in the media aim to unnatural whiteness. A study states thatproduce a hierarchy of values based on the there is marketing of a hybrid creature, anotion that fairness is an object of desire.7 dream-doll with Asian features andCertain advertisements had tried to project a Caucasian skin.2notion that a fair skin is a necessaryprerequisite for success in both the 102
  3. 3. Journal of Pakistan Association of Dermatologists 2007; 17: 100-104.Adverse effects of skin lightening high. For example, one of the commonlypreparations used fairness creams cost 45 Nepalese rupees (1US$=72.5 Nepalese rupees) for 45Certain advertisements portray the sun as an grams. One might need 45 grams for a weekenemy and harp on the theme that the skin making the monthly expenditure nearly 200should be protected using sunscreens and Nepalese rupees. Many times, the patientssun blocks. A demelanised skin would of go for a more costly preparation believingcourse be more vulnerable to damage by the that these will work better for them.sun. Many fairness creams may containskin-bleaching agents like hydroquinone, Promoting an ideal body imagesteroids, mercury salts, hydrogen peroxideand magnesium peroxide among others.1 Fairness creams project a particular bodyMercury derivatives may cause image as the preferred one and then sell aneurotoxicity, mercury-induced nephropathy product to help people attain the particularand immunotoxicity.9 Hydroquinone ideal. Thus it may meet the criteria forpreparations can cause ochronosis, disease mongering.7,12 Pharmaceuticalhyperchromic or hypochromic erythrocytes companies also manufacture demelanizingand neuropathy.9 It is reported that up to preparations. Controlled studies on the60% of those who practice skin lightening efficacy and safety of fairness creams aremay suffer from at least one complication. lacking. A particular advertisement had claimed that a particular product producesEconomic impact of fairness creams 60 per cent more fairness than any other cream. The advertisement does not mentionAdded to the adverse effects, the cost is which studies were conducted, where and onanother worrying fact associated with the whom.13use of fairness creams. In India, it was foundthat of the Rs. 3,000-crore cosmetics and Skin lightening beauty treatmentstoiletries market, the skincare segmentaccounts for Rs. 1,200 crore. Among these Skin lightening treatments are offered incosmetics products, fairness products many beauty saloons. These treatments relyaccount for a whopping Rs 700 crore of this on bleaching to give the skin a lightersegment. The annual growth rate is between appearance. Many preparations are10 and 15 per cent.10 One popular unregulated. Ayurvedic preparations containcosmeceutical company recently has natural skin-lightening agents like 1reported that the rural growth of their market Kumkumadi tailum. Studies on the safetyhad been phenomenal in the latter part of the and efficacy of these preparations andyear, 2006 from 1.7 per cent in the first treatments are lacking.quarter to 14 per cent in the last quarter.They also launched several newer products Fairness creams are a fact of life over muchin the latter part of the year, leading to an of South Asia. They are over the counteroverall 64 per cent market growth.11 In products and are available without ageneral, the cost of fairness creams is very prescription. Doctors and especially 103
  4. 4. Journal of Pakistan Association of Dermatologists 2007; 17: 100-104.dermatologists have an important role to 30932,68743,.shtml Posted on July 9,play. They should educate patients that 2001. Accessed on December 9, 2006. 6. Chadha M. Indian men go tall, fair andblack is also beautiful and skin colour is not handsome.the sole arbiter of beauty. The concept of an body image being propagated through /2/hi/south_asia/4396122.stm. Published 02/11/2005. Accessed onthe media should be countered. The December 7, 2006. (check not opening)mechanism of action of these creams can be 7. Shankar PR, Giri BR, Subish P.explained to patients and the public. Fairness creams in South Asia- a case of disease mongering? PLoS MedicineDermatologists as learned and respected 2006; 3: e315.members of society can lead a debate on the 8. Swerdlow JL. Unmasking skin.issue of fairness creams and skin whitening. National Geographic 2002;202(5):36- 63. 9. Ntambwe M. Mirror mirror on the wallReferences who is the FAIRSET of them all? march/skinlightening.htm. Accessed on 1. Islam KS, Ahmed HS, Karim E, Amin December 9, 2006. AM. Fair factor. The whiter the better. 10. Challapalli S. Alls fair in this market. Business line (Internet Edition), 006/05/02/cover.htm. Accessed on published on 5th September 2002 December 9, 2006. Available at 2. Goon P, Craven A. Whose debt? Globalisation and white facing in Asia? atalyst/2002/09/05/stories/20020905000 Intersections: gender, history and 40300.htm (Accessed on 17th culture in the Asian context. August December 2006) 2003, Issue 9. 11. Venkatraman L. Fairness creams to be htpp:// our growth drivers. Business line, ections/issue9/gooncraven.html. Published on 20th July 2006. Available Accessed on December 7, 2006. at 3. Lal P. Beauty queens and fairness creams. atalyst/2006/07/20/stories/20060720000 80300.htm (Accessed on 17th /031218.shtml. Posted January 2, 2004. December 2006) Accessed on December 7, 2006. 12. Shankar PR, Dubey AK. Disease 4. A question of colour. The Muslim mongering and medical doctors. BMJ News, No.598, August 8-14, 2002. South Asia edition 2006; 22:16. Accessed on 13. Sen S. Playing it fair. December 9, 2006. 5. Ngunjiri P. Search for white skin e/catalyst/2001/11/01/stories/1901o05f. darkens African women lives. htm Accessed on 7th December 2007. bin/selfnews/viewnews.cgi?newsid9948 104
  5. 5. Journal of Pakistan Association of Dermatologists 2007; 17: 100-104. 105