Skin Lightening: Heart of the Matter According to Dermatologists

In early February 2020, India’s government made the long-overdue decision to crack down on its’ multibillion-dollar skin whitening industry. Companies were selling false and misleading products. While this is a grand strike against the companies’ long-run of selling fairness creams on the market, there is a consequence behind the legislation. As more companies deceitful products are exposed, there becomes a higher demand for complex skin whitening treatments. These treatments can only be administered by a particular medical professional — a dermatologist.

Invasive procedures such as skin bleaching, laser treatments, chemical peels, and “whitening” pills have all become increasingly accessible across India. Dermatologists are put in a problematic position whether or not to grant patients’ wishes. While dermatology may not strike us as plagued by dilemmas, much of a dermatologist’s work conflicts with a patients’ vanity. It leads to an ethically uncertain territory. 

Dangerous Doses of Drugs

What has been labeled as the “wonder drug” of skin lightening, glutathione is a more direct form of treatment offered by some dermatologists. An antioxidant naturally found in our bodies, glutathione can protect the skin from UV rays. However, when it injects in veins, glutathione deactivates tyrosinase, the enzyme in our bodies that helps produce melanin. These anti-melanogenic properties of glutathione injections enter the blood and skin to provide a more fast-tracked skin lightening result compared to any topical cream or pill, making it one of the most in-demand treatments from dermatologists. 

Professional Reality

Hyderabad and Mumbai-based celebrity dermatologist, Dr. Rashmi Shetty, founded Reva Health & Skin in Hyderabad, and Ra Skin and Aesthetics in Mumbai. Bouncing between these two highly successful clinics, Rashmi has worked with thousands of patients. Ranging from ordinary citizens of India to some of Bollywood’s most famous actors, many of which come to her seeking skin lightening treatments.

“Often I have a lot of younger girls — or parents who bring their children to me — saying they want their skin to be fairer. This is almost always for matrimonial or career reasons,” says Rashmi.

Come across any matrimonial advertisement in India, and you’ll find the first and highest preference listed is for the girl to have fair skin. It echoes experiences of colorism – the process that privileges light-skinned people over dark in areas such as marriage, income, and education. Some of Bollywood’s most highest-grossing actors have endorsed and appeared on advertisements for whitening creams, further perpetuating the harmful message that you need fair skin to have a real career in Bollywood.

[Read related: A Deeper Look into India’s Fair Skin Obsessed Beauty Standards]

Earning her title as the ‘beauty doctor of Bollywood,’ Rashmi says she would only ever administer skin lightening treatments to someone who is well-informed and wants the treatment purely for a healthy glow, rather than fairer skin. “I need to see that the person wants to have glowing skin for personal and not societal reasons. If they believe having this treatment will make them feel more confident, then I don’t see a problem with it.”

Rashmi tells me she does offer glutathione injections to patients. “When the injections are administered regularly, and with a high dosage, there is a greater chance of seeing the skin turn a few shades lighter.” Rashmi uses the ordinary task of straightening naturally curly hair as an example.

“If you want your hair to stay straighter for longer, then you need to regularly straighten and maintain it with good products so it will stay that way. Likewise, if you want your skin to be a few shades lighter, then you must continuously maintain the skin with treatments to achieve this result,” she stated.

skin lightening cream
Getty Images/iStockphoto

Dr. Sujata Chandrappafounder of Bangalore-based clinic, R3 Clinic — is one of India’s most eminent practitioners of aesthetic medicine who also offers these injections. “From a medical perspective, it is not possible to permanently lighten the skin. But, with regular glutathione injections, along with a strict skincare regime, you can maintain light skin,” says Sujata. 

While research has revealed topical and oral glutathione is safe for skin lightening, there is limited information on the long-term side effects of glutathione injections. Dermatologists must try to navigate these grey areas in their industry. 

Side Effects

Both Sujata and Rashmi say they have never witnessed any side effects of glutathione injections. “In the last 20 years of my practice, glutathione only came into use five to six years ago. But throughout that entire time, I have never seen any side effects of it,” says Rashmi.

Sujata says while she has not witnessed side effects herself, she has heard of other clinics having reported incidences of hypersensitivity reactions to these injections. She thinks because they were administered in doses far too large at a faster rate than what is recommended. Sujata says that it is very dangerous.

Rashmi describes her process of administering glutathione injections as extremely judicious. “We do not give it to every patient that walks in the door asking for it. I am very particular about the patients I administer too and choose them carefully based on their reasoning for wanting it and the state of their health,” she says.

Despite both taking precautions, Sujata and Rashmi say there have been occasions where they have had no choice but to say no to patients who demand injections in much higher doses. 

“I never encourage a patient’s request for lighter skin if I feel they do not need it,” says Sujata. “I have turned away patients in the past because I don’t want to put myself in a position where I have to compromise myself morally and ethically,” she says. “It is so important to work with integrity in this industry, regardless of how much patients demand treatment. It is a moral and ethical obligation for the practitioner to educate the patient of every possible adverse effect that could potentially happen.”

Rejection and Desperation

A patient’s health is always a priority and dermatologists have the authority to turn them away. Still, the rejection may lead a patient to seek treatment from a private, often inexperienced clinic.

“There are some patients who want to be fair so badly that if you tell them no, they may end up going to unsafe places,” says Rashmi. “You need to do a thorough background check into any clinic you’re going to. Otherwise, you put yourself in an inherent danger of letting someone who may not be experienced enough to inject an unregulated fluid into their veins.” Rashmi says she would rather not push any patient to do this, emphasizing the challenges dermatologists face when turning away a patient and not knowing how they will react.

[Read related: Colorism in Bollywood and Hollywood]

The current clinical evidence landscape of glutathione injections is limited to just one study with an apparently flawed analysis of results. This casts doubt on the drug’s overall safeness and leaves many questions unanswered. However — in a report for the British Medical Journaldermatologist, Dr. Opheilia Dadzie reported potential side effects of the injections included toxicity to the nervous system, kidney and liver failure, and headaches. A handful of aesthetic clinics claim that glutathione injections ‘detoxify’ the liver and body, but with such scarce evidence to support this. It can only realize that clinics are making up their protocols. As a result of this lack of long-term safety data, the Food and Drug Administration (FDA) in both the US and Philippines have publicly condemned the use of glutathione injections and issued advisory warnings against its use. However, it seems no such measures have implemented in India.

The Root of the Problem

Many of the reasons people undergo glutathione injections in India can almost always be linked back to colonialism. The age-old narrative of lighter skin leading to greater chances of matrimony, more career prospects, and higher social status is no new phenomenon in India. It is worrying about acknowledging some people remain in the tight grasp of Eurocentricity. A system that will go to great lengths to reap the social and personal rewards of fair skin. 

One thing all experts can agree on is that if you want to undergo glutathione injections, you must not only do your research, but you need to ask yourself if it’s worth it. Based on history and analysis, people who agree likely want to escape day-to-day discrimination and prejudice. To many, being injected with glutathione is a glimmer of hope, it’s the beginning of something new to them — a new person. 

As experienced dermatologists, Sujata and Rashmi have been navigating the challenging landscape of skin lightening for a long time. Every day, they receive a visit from a patient — who in their eyes — is already naturally beautiful. Yet, they face challenges with the patient’s hunger and desire for lighter skin—the decision to offer such treatment or say no and cause them to seek unofficial treatment. Ultimately, the decision lies in the patients’ hands and dermatologists can only encourage them to reject beauty standards.

By Angelica Silva

Angelica is a journalism and sociology graduate from Brisbane, Australia. With parents from Singapore and grandparents from South India, she … Read more ›

Culture Series Part 3: Remembering Indentureship Through art in Suriname, Guyana and Trinidad

Featured Photo Credit Kevita Junior | Left to Right: Tu hiya ka kare he, Tu kaha bate, Tu hamar ke bate 

Thundering waves clawed on the body of the vessel as the sea swallowed the voices of terrified passengers. They clung to the shreds of the Eagle Speed as each hour submerged the ship deeper within the kala pani (dark waters). Steamer ships were sent for rescue, finding two children alone, clenching to the remains of the mast. The unscathed captain and crew fled in boats, leaving the lives of coolies (indentured laborers) to the fate of the dark waters. The Eagle Speed set sail on August 19th, 1865 from Calcutta to Demerara. This tragedy took the lives of over 300 hundred indentured laborers. The coolies onboard were not just casualties of the kala pani, but a larger system of British colonialism.

The crossing of these tumultuous seas was forbidden for Hindus, as it meant the severance of reincarnation and the unraveling of caste. Yet more than 2 million Indians were taken across the kala pani. The forbidden water carried stories along its transatlantic waves, bearing witness to history lost against its tides. The restraints of caste drowned along the voyages as surnames and relations were cast across the seas. They became Singhs (lions) and Maharaj’s (great kings), Brahmins by boat instead of birth.

[Read Related: The Culture Series Part 1: Descendants of Indentured Diaspora a Look at Fijian Representation]

These indentured workers were mainly taken from regions of Bihar and Uttar Pradesh to different corners of the globe, with some of the largest to the Caribbean. Guyana experienced around 238,909 workers, Trinidad 143,939 and Suriname 34,304. With 399 Indians, the Lalla Rookh docked on June 5, 1873, at Nieuw Amsterdam in Suriname, later becoming known as the coolie depot. As workers poured out of ships and onto plantations, they experienced violence and oppression at alarming rates, especially against women.

Coolie Belle

They were nameless and barefooted with gold jhumkas and bangles adorning their bodies. As tourism increased in the Caribbean’s, photographing indentured women on postcards became part of its selling point. These women became subjects to appease the white colonizer gaze and fetishized exotic ‘Coolie belles.’ A bulk of these postcards were shot in Trinidad and sold in local shops to visiting tourists. Yet these postcards failed to translate the hierarchy of power between the photographed and those behind the camera. The white European men who carried out these photoshoots chose backdrops that masked the real conditions of sugar cane fields and living quarters. Who were these women? What were their names? The women were juxtaposed with the term ‘Coolie,’ a slur for laborer and ‘Belle,’ the French word for beautiful. They were coined as laborers of beauty, yet their eyes tell a story of fear of pain.

Suriname

Tu hamár ke bate? (Who are you to me?) Tu hiyá ká kare he? (What are you doing here?) Tu kahá báte? (Where are you?) Artist Nazrina Rodjan posits these questions that rummage through the minds of many Indo Caribbean descendants. Who were my ancestors? What did they experience? Rodjan aims to explore the experiences of indentured women through her oil painting series “Kala Pani.” In this series, she reimagines the postcards of indentured women alike the depictions of European nobility. In conversation with Rodjan she mentions,

 I’ve thought long and hard about whether it would be ethical to reproduce these staged images of women who might have felt scared and uncomfortable being brought into these studios to be photographed by men. I will never know their true experiences and how they might have felt knowing a stranger in the future will decide to paint them in the same positions they were put in for the original photograph.

Rodjan’s art series started as a way to commemorate 150 years since the first indentured workers arrived in Suriname and expanded to include regions like Guyana, Trinidad and Jamaica. 

Wanting to reclaim these images comes from feelings of injustice whenever I see these postcards. They were made from a dehumanizing perspective. Reclaiming these images becomes necessary knowing how the violence Indo-Caribbean women still face today is just a continuation of the violence brought onto indentured Indian women then. To me, creating this piece, symbolized the acceptance of questions remaining unanswered, stories being lost forever, and realizing that after a history full of trauma, there’s a treasure in the women that are still here to tell their stories.

The ratio of men to women arriving on these ships left little to no autonomy for women. Experiences of violence on ships and plantations were common throughout the Caribbean. Despite this, indentured women became trailblazers and pioneers in uprisings against poor working conditions. 

Everything about these women seems to be a question we can never answer, but I decided to give them titles in Hindustani that are questions they might have for me as the painter who looks at them and sees both a stranger and a loved one. Tu hamár ke báte? Who are you to me?

Living in the Netherlands, Rodjan talks about her experiences tracing her ancestry and honoring this history:

 Unfortunately, in the Netherlands learning about the history of Dutch colonization only meant memorizing all the different spices they brought in and listening to teachers talking proudly about the Dutch East India Company in elementary school. Tracing back my ancestors has so far only led to a picture of my parnani and a few more names in the family tree.

Guyana

On May 5, 1838, Anat Ram stepped foot on the rich grounds of Berbice, becoming the first Indian laborer in Guyana. The Whitby and Hesperus departed from Calcutta on January 13 and arrived in Berbice first then West Demerara. Over the course of 79 years, approximately 259 ships voyaged from India to Guyana. While the experiences of these ancestors may remain unknown, artists like Suchitra Mattai aims to revitalize the voices of our indentured ancestors.

[Read Related: The Culture Series Part 2: Exploring the Indo Jamaican Identity ]

Suchitra Mattai is an Indo Guyanese multi-disciplinary artist. Through her work, she uses the experience of her family’s migration and the history of indentureship to rewrite and expand our notions of history. In her piece, Life-line, a rope of saris pours out of a tilted boat, mirroring the experiences of her ancestor’s journey across the transatlantic. The saris serve as both water and a connection to two lands, India and Guyana. Mattai further explores indentureship in the piece “Coolie Woman,” depicting a woman seated with a sari, embellished with jewelry and flowers. 

I wanted to reimagine the photo to give her agency. I also wanted to address the desire for people of the diaspora to connect to their homelands and ancestral pasts. The painted wallpaper drips and fades to parallel the way my memory of Guyana ebbs and flows, Mattai says.

Trinidad

Anchoring at the Port of Spain on April 22, 1917, the last ship to ever carry indentured Indians made its final stop. A system that bound Indians to an unknown land finally ended after 79 years. 

To invoke conversation and pay homage to their memory, artist Gabrielle Francis creatively analyzes indentureship. Gabrielle Francis is an Indo Trinidadian queer interdisciplinary artist, writer and organizer from Queens, New York. In her piece “206:21 Queer Altar Mixed Media Performance,” Francis pays homage to her indentured ancestors with a focus on queer identities. The title 206:21 reflects the ratio of men to women that journeyed on the Fatel Razack, the first ship from India to Trinidad. A mirror is decorated with the colors of Trinidad’s flag along with six candles embodying the pride flag and vibrant red carnations. Written across the mirror is, “I wonder how many of you were queer?” A question that allows for openness and conversation around potential queer ancestors. Written records around indentureship were translated and produced by European men, leaving little to no room for women or queer folks. Francis’s work aims to transform and challenge Eurocentric narratives surrounding indentured history.

 {insert photo} 206:21 Queer Altar Mixed-Media Performance, 2021

As descendants of indentureship, it becomes difficult to sit with questions that may never have answers. Visiting National Archives or exploring digital databases can help connect descendants to learn about their own history. As we unravel difficult experiences of the past it’s important to ask, how do we carry the legacies of our ancestors? How do we honor their sacrifices?

As they were stripped of their identities and reduced to passenger numbers, they fostered new relations—jahaji bhai and jahaji bhain (ship brother and sister). From shipmates to family, to present-day melodies of chutney music to the stew of pepper pot on Christmas morning, these bonds of community have evolved and are seen across the diaspora today.

By Anjali Seegobin

Anjali Seegobin is an undergraduate student at the City College of New York, majoring in political science and anthropology. She … Read more ›

‘The Black Rose’: British Asian Shweta Aggarwal Voices her Truth Against Colourism and the Battle to end her Skin Whitening Cream Addiction

Black Rose

I was a mere 14-year old on the fateful night of 22 April 1993. The night that witnessed black teenager Stephen Lawrence brutally murdered in a racially motivated attack as he waited for a bus. The night that cemented my fear, that the colour of my skin does matter. The same night that confirmed my indifference as a British Asian in the United Kingdom — were we really united? Fast forward to May 25 2020, the murder of African-American George Floyd by a white policeman was the turning point for British Asian author and my lovely friend, Shweta Aggarwal to finally break her silence and narrate her story of colourism, in her new book, “The Black Rose.” 

Aggarwal’s gripping memoir emits so many emotions; that of an awakening, a voice that has been suppressed for years, filled with anger, mistrust and guilt. But most importantly, “The Black Rose” successfully disrupts the narrative that consistently allows society to box someone as indifferent based on a visibility factor. For Shweta, this factor was the colour of her skin. The injustices she consistently endured via some family members and fellow South Asian peers throughout her life, was as a result of her skin tone failing to qualify as ‘acceptable’, or as she often quotes in her book, not ranking high enough on the ‘fairometer.’ Whether she was in India, Japan or London, the scale was never too far behind. 

[Read Related: Liam Neeson’s Week of Rage is Every Person of Colour’s Truth]

Within the first chapter, she recalls as a child in India, the distinct lack of subtlety displayed by certain family members through direct taunts of her duskier appearance in comparison to her parents. She realised that she wasn’t in complete isolation from this prejudice, as her maternal aunt and uncle were also harshly nicknamed on the basis of their skin colour — Kaali (black) and Savla (wheatish). Aggarwal was left mortified by what many South Asians sadly still continue to casually exercise. Echoing similar incidents within my social proximity, it’s infuriating witnessing the recipients of such remarks surrender to laughing at themselves too. 

Except it isn’t funny. Born into a culture where conversations on religion, caste and hierarchy in India are still so prominent, the comparison of Aggarwal’s skin colour being as dark as that of the domestic help (often from poorer families), prematurely planted seeds in her mind that she simply didn’t belong with her family, especially  when she was sent to boarding school. Her lack of self-worth coupled with these taunts, gave her a whole new vocabulary for the letter B, that grew in parallel with the ongoing prejudice and anxiety. B for blackie, beggar’s child, bedwetter! Not funny, but derogatory. Post her book launch that Brown Girl Magazine attended, she tells me,

I personally feel we are way behind when it comes to understanding the importance of mental health. Name-calling was normalised and if you objected, you were ridiculed further with remarks such as ‘So sensitive! Can’t you take a joke?’ Body and colour shaming can lead to a feeling of inadequacy in the victim, which can further lead to depression and much worse mental illnesses.

During the 1984 Hindu Sikh riots in India, where over 3000 Sikhs lost their lives, Aggarwal recollects the frightening moment when she and her classmates fled into hiding to escape the violence during a school trip. As a means to save all the students from harm, the Sikh boys were forced to remove their turbans and long hair — their visible identities stripped to keep them alive. Yet, ironically, even in this horrifying situation, Aggarwal felt least at risk, attributing this self-assurance to her darker appearance. 

The crux of her self-loathe was the love-hate relationship she formed with skin whitening creams. The birth of Fair and Lovely, India’s most renown brand (now known as Glow and Lovely following a backlash) was notorious for selling the damaging message that fairer skin equated to a happier and fulfilling life. For it was fairer skin women that would qualify for marriage — clearly their only sole purpose! 

Tactfully using famous fair-skinned Bollywood actresses in television ads and posters, their so-called perfection would scream out to vulnerable young girls. (Men were targeted much later on, but the importance seemed less). Akin to the wretched beach body posters plastered on every corner in January — because apparently bikinis only look good on a certain body type —  the damaging message remains the same. Social acceptance comes at a cost, and that cost is to look a certain way. 

[Read Related: Dear Priyanka Chopra, Endorsing Colorism and Discrimination is not ok. It Never was and Never Will Be]

It’s an extension of the dated methods imposed on women from the womb, where mothers are lectured on drinking milk with saffron to ensure the baby is fair, traditional matrimonial sites asking women to specify skin colour, and women being told to stay out of the sun. These socially ingrained views are eventually developed into modern day methods in the form of cleverly marketed consumables. Aggarwal admits, 

Most people only use the cream on their face just as I did. At that time, I didn’t even think about the rest of the body. I felt that if the face becomes fairer, that will be enough for acceptance. My mum noticed the difference for sure and I was lighter by the time I met my husband, Amit. I must admit the addiction is a combination of three factors: the justification in your own head, the strong marketing message that ONLY fair is beautiful, and the ‘compliments’ from those around you. 

I admired Shweta’s honesty on admitting what essentially was a dangerous obsession that she remained faithful to throughout her teenage and adult life. A ritual that, whilst prompted gradual results in her appearance, was never going to eliminate the insecurities she felt within herself. Moments of joy with her husband and children on holidays abroad, would be broken up by the need to ‘fix’ any damage the sun may have inflicted i.e. reverse her tan. The booming tanning industry in U.K., her now home, and admiration of her ‘sun-kissed’ look by Brits initially surprised Aggarwal — as if her colour had now gained acceptance. 

But who are we seeking acceptance from? A society that is still deep rooted in patriarchy forcing women even now to adhere to dated rites of passage that holds no relevance? Or a society that seeks to point out one’s indifference because of how they look — their skin, their religious attire, their weight? Or a society that passes judgement on a woman’s self-worth, and continues to abuse that same woman behind closed doors under the eyes of Goddess Kali? Aggarwarl goes on to explain,

The more damaging perceptions of colourism, are that ‘fair is rich’, ‘fair is successful’ and ‘fair is better educated’. Essentially, ‘fair is supreme’ in every sense. And if that’s the case, where does that leave dark-skinned people? In Ukraine, for example black and brown people were discriminated against and  not given a fair chance to save their lives. Is it fair to be denied a basic human right — survival — based on your colour? 

I personally was curious to know from my family what the definition of prejudice in the Hindi vocabulary is and how it is/was applied to in India. “Pakshappat” (taking sides) or “poorva dhaarna”, were the closest pure Hindi definitions known to my cousin, yet rarely used. However, my dad stated that “hum bedh bhau nahin hai” was the common term used to state amongst family and friends when someone was not biased and believed in equality. Somehow, colourism never really came under that category. A sentiment echoed by some of my Chinese and black friends . Even in parts of China and Africa, the belief that darker skin is perceived as inferior, is accredited to stereotyping certain groups of people as manual labourers working under the sun, and therefore of a lower class or caste. Does Shweta believe we can change this attitude?  

A couple of my aunts are still reluctant to help me with my mission. One even said ‘it’s pointless fighting it’, while one said, ‘everyone has the right to define beauty for themselves and being fairer is what beauty is for some.’ The problem with this is that people then start to look down on people who aren’t. Colourism, casteism and classism divide people, creating more unrest in society. If we continue to aspire to be fairer, we’re still encouraging white skin privilege, and encouraging colonial values. The more we allow ourselves to succumb to these social constructs, the more enslaved we feel internally. Melanin is crucial for protecting our skin against the harmful radiation of the sun. Feel blessed that you have it and wear it with pride! 

I wonder how we can dare to walk shoulder to shoulder with our black friends in the Black Lives Matter movement, if we refuse to face up to our own biases against colour? We seek equality in the U.K., but deny our deep-rooted prejudice, whilst a white privileged man lectures the world on the difference between racism and unconscious bias (yes Prince Harry, I’m looking at you!). “The Black Rose” has paved a way for many more voices to speak out against the damaging impact of colourism, and in my view, rightly belongs under the definition of prejudice in the collective South Asian vocabulary.

“The Black Rose” is available to purchase on Amazon.

 

Photo Courtesy: Shweta Aggarwal

By Sejal Sehmi

Brown Girl Magazine’s U.K. Editor Sejal Sehmi is an IT consultant by day, whose passion for writing stemmed from challenging … Read more ›