Open letter to the Natonal Assembly members of The Gambia

Sunday 19 July | Open Letter | Ahmed Manjang

SKIN BLEACHING, HEALTH, SOCIAL AND ECONOMIC COST

As the debate rages on over the merits and demerits of repealing the section of our constitution dealing with skin bleaching, as a concerned citizen, I felt obliged to write to you, the lawmakers of The Gambia to give specialist advice on this critical topic. I heard the Feminist proclaimed; here are a group of men again trying to legislate issues affecting women so they can exert more control over them. I beg to differ; I think skin bleaching is more than just women issue, it is more of a societal problem that carries with it host of problems including but not limited to health, social and economics. From a medical standpoint, there is no need or benefits to lighten the skin, but if one is considering skin

bleaching, it's essential to understand the risks.

Desire results are not guaranteed, and there are ample pieces of evidence that skin lightening can result in serious side effects and health complications. But the World Health

Organisation warns that skin bleaching can cause liver and kidney damage, psychosis, brain damage in fetuses and cancer (1) .

Skin bleaching or whitening is the act of brightening the skin complexion by using chemical substances that are applied to the skin or administered into the body by other means. These chemical products include bleaching creams, soaps, and pills, as well as professional treatments like chemical peels and laser therapy. The use of skin bleaching agents has its disadvantages in terms of causing harmful effects such as skin disorders like depigmentation, rashes, pimples, discolourations, kidney damaged, cancers, neurological and psychiatric complications depending on how the agents for the skin bleaching are used.

Skin bleaching used interchangeably with skin whitening, or skin lightening is the process of brightening the skin complexion using chemical substances, concoctions or physical treatments. People bleach their skins for aesthetic or cosmetic reasons to increase skin glow, radiance and vibrancy in addition to the lightening. The mechanism of skin lightening influences the amount of melanin in the skin to cause-effect. Melanin is a skin pigment produced within the skin to impart its colour as well as provide protection against ultraviolet (UV) rays of sunlight and other biological effects. Melanin is an omnipresent biological pigment, which is present in mammalian skin, hair, eyes, ears and the nervous system.

There are three main classes of melanin; eumelanin, pheomelanin and allomelanins. There is also neuromelanin, the melanin of the nervous system. Eumelanin is usually observed brownish to dark black colour of the skin and hair, while pheomelanin is reddish and yellowish. Many biological systems produce a combination of two types of melanin, red haired (ginger) people usually have pheomelanin predominantly in their hairs and skins. Many studies have shown that people with pheomelanin as the predominant pigment are susceptible to more photodamage than people with predominant eumelanin in their skin (1,2) .

Mechanism of skin bleaching

Skin bleaching slows down the production of melanin and reduces its concentration in the skin. Melanin is a dark pigment produced by cells called melanocytes. The level of melanin in one's skin is mostly determined by genetics, hormone, environmental factors, such as sunlight and certain chemicals also influence melanin production. When skin bleaching products such as hydroquinone are applied to the skin, it decreases the number of melanocytes; this can result in lighter skin and a more even appearance to the

surface.

Health effect of skin bleaching

Melanin from natural sources has been reported to possess a broad spectrum of biological activities, which include protection against UV radiation, enzymatic lysis, damage by oxidants, resistance to drugs by pathogens, protection of insects against bacteria and antiviral protection. Melanin natural ability to protect against UV rays has been utilised in the production of sunscreens in an attempt to imitate the natural role of these molecules in the skin. The protective effect of sunscreen is rated using the Sun Protection Factor (SPF) scale, and it is thought that a higher SPF value indicates a better protective capacity. All melanin lowering bleaching agents carry potential hazards by intervening in the protective activity of melanin. Mercury-containing skin bleaching agents have been scientifically proven to cause chronic kidney diseases and neurological damage and even psychiatric disorders.

Many countries across the world, including the Gambia, have put in place legislation to control sale, distribution and the use of skin bleaching products because of the dangers associated with them. I firmly believe common sense will prevail and this dangerous practice will remain banned in the Gambia. Many research had established that Skin bleaching has been associated with several adverse health effects, including but not limited to; syndrome mercury poisoning, dermatitis, kidney failure, steroid acne, whiteheads and

blackheads, and nephrotic (3,4) .

Mercury poisoning

Some skin bleaching creams made in countries with no proper regulatory mechanism have been associa