Skin Bleaching Is Poisoning Women — But Business Is Booming

Inna Samson was 15 when she finally gave in to the pressure to take pills to lighten her skin tone. “It’s definitely the biggest regret I have from high school,” she says. She’s been teased for most of her life for her medium complexion, and it wasn’t just coming from kids at school; her cousins, sister, and aunts all joined in, calling her names like “monkey” or making underhanded comments that still sting today.

“I was always called beautiful, but...,” Samson, now 24, recalls. “Beautiful, but dark. Beautiful, but short. There was always a ‘but.’” Samson grew up in Manila, the capital of the Philippines, where it’s estimated that nearly half of the population actively uses skin-lightening products. In high school, she joined this growing percentage by experimenting with whitening creams and soaps, then finally starting taking glutathione pills, a rarely studied skin-lightening ingredient that’s gaining popularity around the globe.

For Samson, it felt like an easy fix for the one thing she felt was holding her back. “I just thought, Maybe if I were fairer, I'd be a little more attractive to boys, my parents could show me off more, or I'd be seen as smarter or more responsible,” she says. “That fair girl in my head is someone that's a little better than me.”

Samson's story isn’t unique to the Philippines; countries like Nigeria, Jamaica, China, Malaysia, South Korea, and India are all grappling with dangerous skin-bleaching epidemics, with rates of use as high as 77% in Nigeria. Around the globe, skin-lightening procedures and products — many of which are experimental, unregulated, and extremely dangerous — are becoming popular among women hoping to gain an upward trajectory in cultures that prize lighter complexions.

Skin bleaching is a rapidly growing industry that’s estimated to reach a valuation of $24 billion USD in the next decade, but it’s rife with controversy. For one, there are many potential and proven health risks associated with the practice, from poisoning to organ failure. Beyond that, many argue that the skin-lightening industry is fuelling discrimination based on the shade of your skin, called colourism or shadism. By perpetuating the idea that a lighter complexion will make you more desirable, Western beauty standards continue to feed a global market that profits off women’s insecurities.

We travelled to Manila, which has one of the highest rates of skin-bleaching use in the world, to learn exactly why women are risking their lives for a shot at being a few shades lighter.

Skin lightening goes by many names, including bleaching, lightening, and whitening. They’re often used interchangeably, but the purpose is universal: using products or undergoing procedures to reduce the amount of melanin, or pigment, in the skin. This can include lasers, peels, creams, soaps, injectables, pills, and more.

Experts believe that the root of why many strive to lighten their complexions is more complicated than disliking what they see in the mirror. “The idea is that your skin tone is directly correlated with some economic value or some social or political value,” explains Joanne Rondilla, professor of ethnic studies at UC Berkeley and author of Is Lighter Better? Skin-Tone Discrimination Among Asian Americans. “The lighter you are, the more economic value you have, the better jobs are available to you, the more money you'll make, the better education opportunities are, the better your dating and marriage opportunities are. Skin tone isn't just about skin; it’s about class.” We spoke to women in Manila and they agreed. Many said that lighter complexions have long been preferred by employers across industries.

Rondilla says that in her research, she’s found that most individuals who whiten don’t want to look like they’re a different race, but just be a lighter version of themselves. “Historically that's what they perceive as not only beautiful, but as powerful,” Rondilla says, adding that having light skin meant you were less likely to be doing lower level work, like field labour in the sun, or were related to powerful Western invaders. In other words, colourism existed long before the modern skin-care industry.

It’s a stereotype deeply ingrained in cultures that were colonized, including the Philippines, Rondilla says. The island nation was ruled by Spain for 333 years before it was briefly occupied by Japan and then the U.S. before gaining independence in 1946.

Vicki Belo, MD, is one of the most in-demand dermatologists in the Philippines, and has built an empire from whitening alone. “Everybody wants to be fairer so they can be admired,” she says, noting that it’s mostly women in their 20s and 30s undergoing procedures in her practice. “Patients feel that it increases their chances of finding a good mate,” she says.

Dr. Belo estimates that whitening constitutes up to 60% of the work done at her 13 clinics across the Philippines, where she offers the most cutting-edge procedures, from lasers to IV drips to in-office exfoliation. It’s made her a celebrity across Asia: She has nearly 2 million followers on Instagram and has her own cosmetic makeover TV show called Belo Beauty 101, currently in its 12th season. Even her four-year-old daughter Scarlett has more than three million followers on Instagram.

Dr. Belo has been whitening her own skin for decades, but she says that when she first started her practice, her initial approach was to question why patients wanted to be whiter, especially if their skin was healthy and even in tone. “They would just turn around and go to another doctor,” she says. “I was losing patients that way. I said, Even if I think that they look better dark, if they want to look fairer, then as long as it's safe and it's not hurting them, I'll do it. I better stop lecturing them.”

Though Entrepreneur Philippines estimates Dr. Belo’s net worth to be in the millions, she’s not just appealing to wealthy Filipinas. If a client can’t afford a $190 USD double-strength Cinderella drip (a lightening mix of glutathione and vitamin C), there are dozens of products in her Belo Essentials line available at grocery and mass retailers across Asia and online. Her intensive whitening toner costs around $1.50 USD, and her face cream rings in at just under $5 USD. It’s reportedly the most lucrative part of Dr. Belo’s business, bringing in $14 million USD in revenue in 2006 alone.

But Dr. Belo has competition from global drugstore brands, many of which are from the same companies pushing skin-positive messages in their U.S. marketing. Olay, Ponds, Dove, and Nivea are just a few of the brands we spotted in Manila during our investigation, with product names like Natural White, White Beauty, Ultimate White, and Extra Whitening, respectively. Most contain similar ingredients to their formulas sold elsewhere, like vitamin C, just packaged with different marketing. L’Oréal’s version of a lightening cream, called White Perfect, features a trademarked ingredient called ‘Melanin-Vanish’. While the ingredients in these drugstore lines might be widely considered safe, they’re unlikely to noticeably whiten skin. It presents an ethical question for brands: Are multinational corporations simply preying on cultural pressures for profit?

In response, Ponds issued this statement: “This product is sold in Asia where products that control the dispersion of melanin and help fade or reduce dark patches and hyper-pigmentation are popular with many consumers.” Nivea’s parent company, Beiersdorf had a similar message: “Beiersdorf is a global company. Our affiliates carry a diverse portfolio of products that are aimed at addressing the broad range of skin-care wants of our consumers around the world.”

Dove had this to say about its whitening deodorant: "Dove is wholly dedicated to inspiring women to develop a positive relationship with their beauty in Asia and around the world. We conduct extensive research with women to provide solutions for everyday beauty concerns. Removing underarm hair can cause irritation, leading to the creation of dark marks and changing the colour of one’s natural skin tone. This is a concern for women, often causing anxiety and affecting self-confidence. Certain Dove Deodorant products in Asia are designed to reduce the appearance of dark marks and promote even skin tone over time."

L’Oréal writes, “The branding of this L’Oréal Paris product refers to the whitening and brightening effects that it creates.” Olay did not provide a statement at time of publication.

But it’s not just a message you see in grocery stores: Billboards, magazine ads, TV shows, and commercials inundate young women with the idea that lighter is better. “If you look at media in the Philippines, there's a complete erasure of dark-skinned or indigenous Filipinos,” Rondilla says. “This is what prompts many people to engage in skin-lightening practices.”

Social media is the next frontier for brands peddling skin-bleaching products — and is arguably one of the most influential. YouTubers and Instagrammers push glutathione pills and IV drips in videos and posts, the Filipino sponcon equivalent of hair gummies or diet teas. “I have some brand ambassadorships because I have fair skin. It’s an advantage in the modelling scene,” says Charlene Pega, 24, a Manila-based model, entrepreneur, and influencer with more than 200,000 followers on Instagram. “The mindset of Filipinos is that when you're fair, you're more beautiful.” She’s been using soaps, lotions, and pills for years and rarely misses a day. While Pega doesn’t find this phenomenon problematic, she does bring up a major concern: “I advise people who are going to use whitening products to make sure that they’re safe,” she says.

But is there such a thing as a “safe” whitening product? According to Annie Chiu, MD, board-certified cosmetic and general dermatologist in Los Angeles, the answer is no. She says that exfoliating to reveal brighter skin or spot treating discolouration on the face with a product recommended by a dermatologist is okay, but there’s no safe or effective way to lighten your entire body. “We currently do not have enough studies that establish either the safety or effectiveness for any treatments for generalized skin lightening for the entire body,” Dr. Chiu says.

Hydroquinone, which is still legal in the U.S. in products containing less than 2%, can cause rashes, redness, irritation, and even, paradoxically, skin darkening. Plus, researchers are still trying to determine if it causes cancer in humans. Some countries, including Ghana, Ivory Coast, and Rwanda, have recently joined the European Union, Japan, and Australia in banning skin-bleaching products with hydroquinone altogether.

Glutathione IV drips, which are solely approved for treating side effects of chemotherapy, are strongly discouraged for cosmetic use by the Filipino FDA. Dr. Chiu says that thyroid issues, kidney failure, and liver dysfunction have been reported from glutathione use and reiterates that there is a lack of long-term studies. “There is very little convincing evidence in favour of glutathione for skin lightening and physicians and dermatologists do not recommend it,” she says. Still, Dr. Belo claims that the intravenous glutathione she offers is safe, based on a six-month study her team performed. Dr. Belo and Dr. Chiu do agree on one thing though: Very serious complications can occur if glutathione injections are performed by unskilled technicians, in non-sanitary environments, or with tainted fluid.

However, there’s an entire other category of whitening outside of the care of a physician, and it’s by far the most accessible and dangerous: mercury. Those desperate for noticable, quick results have taken to mercury-laced bleaching creams, which do lighten the skin. But it can be poisonous when applied topically. “Long-term use of inorganic mercury in skin-lightening creams can result in kidney damage, skin discolouration, rashes, toxicity to the kidneys, peripheral neuropathy, and psychosocial issues such as anxiety, depression, and possibly psychosis,” Dr. Chiu explains.

Because of these dangers, mercury is illegal above trace amounts in most countries; one part per million is the max in both the U.S. and the Philippines. But it’s also incredibly cheap, so it has found its way into skin-bleaching products that are often counterfeit, mislabelled, or smuggled. It’s an epidemic in the Philippines, where products loaded with mercury are still commonly sold in grocery stores and outdoor markets.

Thony Dizon, chemical safety campaigner for environmental NGO EcoWaste Coalition, and his team have found them in stores all over metropolitan Manila. During our investigation, we accompanied one of his colleagues on an undercover buy. Not only did we find products quickly and easily, but after testing them at EcoWaste’s office, we also found that they had up to 41,000 times the legal limit of mercury, which could cause health issues with just one application.

“It's a serious concern,” Dizon says. Numerous reports in the local media have shown the women who use them suffering from skin lesions upon first application that require hospitalization. Some cases even involve children who were accidentally poisoned through normal contact.

But despite EcoWaste’s progress — they recently succeeded in a petition for the government to issue notices to stores selling them — it’s going to take a bigger shift to rid the country of these products. Lourdes Villamar, a customs official in the Philippines, says that border agents accept bribes to allow the toxic products to pass into the country. “Customs employees are in collusion with the smuggling,” she told us. “It's a culture in the bureau that it is immoral to let drugs and firearms slip through customs.” But when it comes to beauty products, she says some agents have the perception that they are helping Filipinas improve their appearance. There’s even a competitive going rate: “For a 20 by 40 foot container van, a customs official gets $150,000 pesos [about $2,800 USD] as a bribe to allow the release of these goods,” Villamar says.

Along with EcoWaste’s activism against the illegal sale of these toxic products in the Philippines, Dizon and his team are working on a campaign with a message that brown is beautiful to “encourage Filipinos to be proud of our beautiful, natural complexion.” The hashtag currently has over 50,000 posts on Instagram from individuals of all ages from all over the globe. It’s just one of many social movements encouraging people to stop whitening.

It’s what helped Samson brush off the bullying she received and feel confident in her own skin. She’s now the face of a Manila-based movement called Moreno Morena, a term used to describe Filipinos with darker complexions. “Being in the campaign feels like I am empowered,” Samson says. “I feel beautiful and there are no buts.”

She’s hopeful that this kind of social media exposure means the next generation won’t have to deal with such a narrow definition of beauty. But it was more than a campaign that changed Samson’s perspective: As a new mother, she’s never going back to whitening again. “I gave birth to a dark, beautiful, baby girl and I want her to feel that,” she says. “I want her to feel that I am super proud of her and her skin colour. I don't want her to feel like she has to change. No pill, or soap, or lotion could fix something that's not even broken.”