Prapti, 16, had come to me in tears because her social life was at a standstill. Asha, 28 found herself ‘rejected’ at the matrimony forums she was on. Paresh, 41 was convinced he was not getting ahead in his career, because of his ‘savla’ (brownish dark) face. Beena, 58 wanted not to look ‘so’ dark at her daughter’s wedding, at the behest of her family.
I treated all these people. Before that, I counselled them about focusing on skin health rather than skin colour, but, treated them anyway. And while I consoled myself that I was restoring self-esteem, providing a weapon to fight social ostracism, career glitches and aiding people to find happiness in life, I was insidiously promoting colourism, racism and casteism in a country that runs rampant with all three.
I’m a dermatologist and have been working for more than 20 years as an expert in aesthetic medicine. I have learnt, and trained countless young doctors on the adage ‘Do not judge’ as being the most important one for this speciality apart from the Hippocratic norm of ‘Do no harm.’ It is not our right to question why someone wants a sharper nose, fuller lips, or higher cheekbones. We evaluate the possibilities, outline the risks, counsel the psychological aspects and after obtaining full informed consent, proceed to provide the medical services and products that can do so.
I have outlined the possibilities of skin lightening treatments, provided those seeking the same with whatever certified and safe services or products that would work for them. I have helped create ‘breakthrough’ skin glow treatments. I have treated countless cases of pigmentation, provided tips to reduce tanning of the skin, discussed how to improve ‘brightness’ of the skin and talked about services like peels and lasers that can lighten the skin, by reducing the melanin.
The desire to get ‘perfect’ skin—the most common term used for skin lightening—is almost universal in India and other Asian countries like China, Korea, and Japan. Skin brightening, white perfect, glow, evenness of skin, toning and de-tanning are all the various pseudonyms under which skin lightening and products related to lightening masquerade.
Some papers show a similar trend in other parts of the world too, namely African geographies and even select populations in the western world, where there is overt and covert messaging that elevates light coloured skin to the most aspirational beauty attribute.
Once too often, I have been a part of discussions that equate lightening treatments to weight loss treatments, anti-ageing injectables or minimally invasive surgery. What is wrong, who are we to judge, as long as its medically safe, etc. But there is a fundamental difference when it comes to skin colour.
Providing these other services does not contribute to covert and tacit acceptance of racism, colonialism and casteism. It does not promote and perpetuate the notion that human beings are unequal based on the differences in 5g of melanin and it is a notion that has historically led to slavery, civil wars and oppression of countless individuals.
The notion that beauty is linked to the whiteness of skin is rooted in race, class and caste distinctions which prevail through almost all societal transactions and interactions in India. Casual conversations, matrimonial columns, Bollywood stereotypes and song lyrics all equate fairness with beauty. It is ubiquitous and so encoded in our psyche that most of us do not even react to it. However, as doctors who have the power to influence individuals and societies, I ask myself that if not now, then when will we acknowledge our subtle and insidious contribution to this monster that continues to plague generation after generation of Indians?
Yes, all discrimination is bad and must be avoided. Ageism promotes the rush for anti-ageing products, cookie-cutter, media-led standards of impossible beauty drive people to seek that perfection that is being promoted. While there may be intellectual discussions on why people seek these services, there can and must be no two ways in looking at lightening skin colour. It is fundamentally heinous discrimination and if we don’t distance ourselves from this now, the time will never come.
One of my dermatologist friends, during our conversation on this topic, asked me if we should stop treating hyper-pigmentary conditions like melasma, lentigines, post-inflammatory scars etc. Indeed, the notion is ridiculous. However, we need to know and realise that research has shown that attitude change to divisiveness based on the colour of the skin will also stem from not having access to products and services that encourage the seeking of this lightening trend. As long as someone provides ‘fairness’ treatments and products, the notion of seeking its superiority and the edge that it supposedly gives people who possess it will never die down.
Should then we be discussing guidelines for the same? Of course not. Social responsibility is individual and innate to every one of us and cannot be mandated. I watched an episode of Hasan Minhaj’s show, where he made a valid point about walking the talk on racism, not just admiring those who have beaten the odds to ascend high. It is not enough to just admire the achievements of Michael Jordan, Maya Angelou, and so on, it is time to do our bit and stop participating in the business of skin lightening. What services we do for our patients and what we refuse to do, will always be a function of the lines we draw for ourselves. But, ultimately to establish ‘fairness’ in beauty as in life, the spectre of achieving fairness in skin colour must be done away with and we as dermatologists need to say “Stop!”
Dr Aparna Santhanam is a dermatologist, cosmetologist and hair expert working in the field of beauty, health and wellness for more than 20 years.
