Skin bleaching at the expense of health in Senegal: ‘It’s like a drug. They can’t break the habit, even while knowing the risks’

Maïmouna is from Léona, a village in the Louga region of Senegal, in the north of the country. In her twenties, she began regularly bleaching her skin, shortly before marrying the first man she shared her life with. “I bleached my skin for my wedding, but it was to please myself,” she explains. However, she then admits that it was really because her husband liked it. In fact, he was the one who gave her the money to buy the products.

Approaching 50 — and despite having a grayish complexion, visible marks on her body and occasional skin reactions — Maïmouna has no intention of abandoning her beauty ritual. She continues to ignore health warnings: “When I have skin problems, I take a break. I let [my skin] rest… and then I start again.” She didn’t even stop the practice of xeesal – the word used in the Wolof language to describe facial bleaching – during her pregnancies. “I wanted to look beautiful for the day of the birth and the christening.”

According to the village midwife, voluntary depigmentation during pregnancy is quite common. This is despite the potential obstetric complications for both mother and newborn, such as developmental delays, low birth weight, lower plasma cortisol levels, or a smaller placenta.

“Xeesal isn’t a good thing. And the Muslim religion (Islam) doesn’t like it, either. God wants us to be as we were born. So, every day, when I pray at night, I ask for forgiveness,” Maïmouna says, her eyes filled with sorrow.

Dakar, the capital and largest city of Senegal, is a four-hour drive away from the village. This is where the Dermatology Department at the Institute of Social Hygiene is based. Behind a discreet door lies the headquarters of AIIDA: the International Association for Information on Artificial Depigmentation. Since 2002, AIIDA has provided refuge for those undergoing this procedure. Most of the patients are women.

Skin-bleaching is widespread in Senegalese society, despite the health risks associated with this practice. According to a 2023 analysis by the World Health Organization (WHO), the prevalence of voluntary skin depigmentation was 50% in the country. And, according to social worker and dermatologist Astou Diouf – the president of AIIDA – this practice has reached alarming proportions in Senegal over the last 10 years.

“Look around you,” Nyamae Aminata Touré gestures. She’s the coordinator of AIIDA’s social work team. “You’ll see nothing but damaged skin,” she sighs, pointing to a crowded waiting room. “Here, more than half of the women who make an appointment with the dermatologist have at least one complication due to [voluntary] depigmentation. Sometimes, [they have] two, three, or even more.”

Dermatologist Fatimata Ly is a researcher and the founder of AIIDA. She’s a leading figure in the fight against depigmentation in Senegal. She emphasizes the impact and widespread toxicity of this practice on the entire body. “No organ is spared the consequences of voluntary depigmentation,” she affirms.

The heavy burden of ‘xeesal’

Artificial depigmentation typically begins as just another beauty ritual: a woman applies soap, oil, cream, or a whole range of products on her skin, hoping to lighten her complexion and feel more beautiful. These cosmetics promise a lighter or even whiter complexion in just seven days. Their use often intensifies before important celebrations, such as weddings, baptisms, or religious festivals. However, what worries specialists most is the constant application of these products over the course of several years, because the most serious effects can begin to appear 15 years after starting regular use. These effects include diabetes, acne and stretch marks. There are even documented cases of cancer associated with the use of these products.

Twice a week, before praying and going to bed, Maïmouna applies her products. She mixes creams and oils, sometimes diluting them with a little water to adjust the texture and desired intensity. She’s convinced that the more expensive products are less harmful and can even “repair the skin.” Hence, she invests in products that cost 20,000 CFA francs (about $30). This is a lot of money in Senegal, where the minimum wage is just over $100 a month. However, for this mother, her bleaching routine remains a priority investment. Her current partner also believes that the xeesal makes her more attractive. “Here in Louga, it’s something many men like,” she maintains.

The main motivation of the girls and women who do this is “to look more beautiful.” But, in reality, they’ll end up “not being able to look at themselves in the mirror,” laments Nyamae Aminata Touré. “There are appalling cases. Over the years, the skin becomes so damaged – the stretch marks and burns so extreme – that one woman confessed she no longer dared to show herself naked to her husband. Much of the time, they’re horrified by their own reflection.”

“I used to be beautiful. I was married and I was very pretty,” says Bintou, a resident of the Dalifort suburb, southeast of Dakar. The first spots appeared in 2013, which is when she reduced her use of these products… but it didn’t help. Today, in her sixties, her skin is irreversibly scarred: her face is covered with dark sores that form a kind of mask around her eyes. The uneven tone of her hands shows years of exposure to bleaching products. “We have to tell young people: don’t do xeesal, it’s bad. I didn’t pay much attention to [the warnings]… but now, you just have to look at my skin. If young women saw it, words wouldn’t be necessary.”

Most of these products contain excessively high doses of corticosteroids. These potent substances – derived from cortisone — have many side effects, such as skin bruising, mood swings, weight gain and stomach irritation. They also often contain chemicals such as hydroquinone — which has been banned in EU nations as an ingredient in over-the-counter cosmetics since the year 2000 – or even heavy metals, like mercury.

Available in various formats and concentrations, these cosmetics — produced mainly in West Africa and Asia — are sold everywhere: in small shops, pharmacies, supermarkets, online, on social media platforms like Snapchat, or even by street vendors who deliver them directly to homes.

“There’s nothing written on the bottle,” Dr. Astou Diouf explains. “It just shows an attractive, depigmented woman. [Consumers] buy it for the image, because they think, ‘I want to be like her,’” she adds. “So they wait a week, it works… and they’re hooked. They talk about it with their friends, they [share] the bottles. Sales skyrocket.”

Nyamae Aminata Touré insists that the women who undergo xeesal are aware of its potential harmful effects. “There’s no need to bring in a dermatologist to warn them. Every woman who does xeesal has a mother, an aunt, [or] a sister who has suffered. But it’s like a drug. They can’t break the habit, even while knowing the risks.”

Stopping artificial depigmentation is complex. If the process is interrupted, the skin’s natural pigment returns. This relapse often causes distress. As a result, many women continue to lighten their skin, sometimes secretly, even hiding it from their doctors.

This behavior is partly explained by social pressure. Sometimes, those closest to the women who use these products are a negative influence on them as they try to stop the practice. “As soon as their skin darkens a little, their husband might say, ‘What’s wrong with you? How come [you look] like this?’ And then the neighbor says, ‘Are you sick? Don’t you have money for treatment?’” the social worker explains. “And that’s when they relapse.”

With a devastated look, Dr. Astou Diouf adds: “Most people only stop when they have no other options, if the lesions are severe. In the worst cases, [these products] lead to cancer.”

“If you don’t use xeesal, you don’t have friends and boys don’t like you”

For many years now, with the aim of addressing the lack of medical assistance and coverage – and in an attempt to gain widespread recognition of the seriousness of this phenomenon – AIIDA has been appealing to policymakers to take action. One of the association’s major victories was the 2017 approval of Article 112 of the Press Code, which prohibits the advertisement of skin-lightening products on television channels and radio stations in Senegal.

A welcome, albeit bittersweet, victory: despite the National Council for Audiovisual Regulation’s (CNRA) oversight of advertisements, most television presenters still sport light complexions. The normative beauty ideals that underpin skin-lightening remain deeply ingrained in popular culture, and these are much harder to regulate.

These standards are reinforced by popular music videos and TV series, which are constantly played in homes, restaurants and beauty salons. This content features actresses who show clear signs of skin-bleaching. Furthermore, dark-skinned people are rarely seen in advertisements.

“These products represent a considerable source of revenue. If our laws aren’t strong enough, it’s for economic reasons,” Dr. Ly laments. She denounces this lack of political will. “In Mauritania, they have a law that prohibits the import of depigmentation products and blocks their entry at customs. Furthermore, they’ve launched a national plan to combat voluntary skin lightening,” she adds.

However, the researcher is hopeful that changes will occur with the new political landscape. “We’ll see if things change with the current government,” she notes, referring to the administration of President Bassirou Diomaye Faye, who was sworn in 18 months ago.

Meanwhile, AIIDA’s work continues on other fronts. They organize awareness campaigns in schools to help young women rediscover pride in their skin color. This is a monumental task, given the scale and normalization of skin-lightening.

In the village of Léona, for example, teenage girls begin these practices as young as 10. “I started using my mother’s [cosmetic] products because I thought she looked prettier,” 17-year-old Seynabou explains shyly. She’s Maïmouna’s youngest daughter. She and her friends already live in an environment where skin-lightening has become a social norm. They all acknowledge that it’s “fashionable.” Practically every girl at their school does it.

“If you don’t do xeesal, you don’t have any friends. You’re left alone; boys don’t like you,” another young woman whispers. “To be seen, to be looked at – to find a husband and be the first wife – you have to be djongoma (‘attractive’),” another girl says, amidst the group’s laughter.

The girls know that the products aren’t good quality, especially when they use creams that cost less than 1,000 CFA francs (about $1.75), but they admit that they continue applying them every day. “We’ll stop when we’re djongoma enough,” the friends conclude. All of them have already found lesions on their bodies.

“When you see a really beautiful girl, you think: ‘Why can’t I look like her? She’ll surely find a husband right away,’” says Marie, 20, Maïmouna’s eldest daughter. Despite this, she has decided not to follow in her mother’s footsteps: she doesn’t want to be anyone’s first wife, nor does she want to use skin-lightening agents. “I’m Black and I’m proud of my ebony skin,” she declares. “You can be beautiful and still be natural. There are plenty of men who don’t like xeesal.”

Marie says she doesn’t feel pressured by either her mother or her younger sister. “It’s more like I’m the one who tells them things. I insist that [bleaching] is wrong and that they’re ruining their skin. But they tell me to mind my own business.” She shrugs and concludes: “Ultimately, everyone is free to decide whether or not to do xeesal.”

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