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By Christy Anyanwu
The skin is the largest organ of the human body. It plays very important roles in protecting the body against infections, aids in excretion of waste products of metabolism and temperature control. Over time, women have abused the skin by using cosmetics to tone it in the ill-conceived desire to achieve a fair complexion. Also, a very small, almost infinitesimal number of men have engaged in skin bleaching. At the recent Beauty West Africa Event, organised by Cerave Group, President of the Nigeria Association of Dermatologists and Senior Lecturer at Ahmadu Bello University, Zaria, Dr. Tahir Mohammed, who is a medical doctor, spoke with Sunday Sun on issues regarding the skin.
What is unique about dermatology and why did you specialize in it?
Essentially as a physician, you have to specialize in a field. I chose dermatology because the skin, which is the biggest organ in the body, needs to be taken care of and doing so will be more rewarding than taking care of other systems.
In the 80s when you were in the university, when it was not popular to be a dermatologist, did your colleagues make fun of your choice?
Not at all. There was nothing to make fun of. Everybody knew it’s a speciality where there are few people. In my class in the university we were above 70. Back then, admissions were controlled and the numbers were not as explosive as now.
Many doctors specialise in gynaecology and make money from the practice because women must give birth. Why didn’t you specialize in that?
Money isn’t everything. If you are trained to be a physician, you have already left all those things. As a physician, you have studied internal medicine and within internal medicine, you can choose a sub-speciality. So its like sub-specialization. Actually, from the moment I committed to study internal medicine, I left all the other ones you are mentioning. Internal medicine itself has sub-specialities like cardiology, respiratory medicine, endocrinology, neurology and all that.
Skin cancer appears to be quite common among Caucasians more than Africans. Did God give us special protection or what?
Yes, the pigments on our skin give us protection. So people who are not heavily pigmented and are exposed to the sun get skin damage. If nothing is done, the skin becomes scrawny and can then transcend to skin cancer. There are other cancers you can also have because of our attitude to healthcare. Maybe someone has skin ulcer that he doesn’t take care of for years. Ulcer is any break in continuity of the skin or any other surface in the body, for the instance the inner surface of the stomach of the duodenum. So, if you have a chronic wound in your body or some other places and it is not taken care of, and it is malignant, you could also have the cancer that people get from exposure to the sun.
What about the albinos?
Albinos don’t have those pigments. They have little or no pigments. So, through exposure to the sun they absorb ultraviolet (UV) radiation that damages their skin. Those of us that have good pigments we tend to reflect it but they don’t reflect them. They absorb UV radiation. That causes damaging the skin. So, initially it is simple damage to the skin, flacking, dryness, wrinkles and all that. But with chronic exposure, and lack of care of the initial lesions, they can become malignant. Most albinos do not protect themselves. They don’t wear the appropriate clothes, to cover their skins, so they are exposed to harmful UV radiation. When radiation damages the skin, and in the attempt to repair the cells, they can can become malignant.
As a dermatologist how do you feel about women or even men that bleach their skin?
Well, it is unfortunate but it is what they want. It’s like somebody who wants to eat pounded yam. Somebody who wants the complexion changed, that is just what the person wants. It is unfortunate. But then the bleaching and the type of substance they use for the bleaching ends up damaging the skin. Besides damaging the skin, some of the bleaching creams or substances are to toxic to the users. Some of these bleaching substances contain mercury, which not only damages the skin, it can also cause renal problems. So we have people developing renal disease that can lead to kidney failure. By altering the natural pigments, the person become like the albino too. The person’s skin is now easily damaged by the sun. That is why you see many of them having what we call “Coca-Cola faces” because of damage from the chemical ingredients, like hydroquinone, used to produce the bleaching substances.
But can the products that contain hydroquinone be used only at night, to prevent harmful effects sunlight?
It’s not a matter of using hydroquinone at night. Hydroquinone alters the skin pigmentation. Whether you use it at night or not, the pigment is removed. When you are exposed to the sun you can get the damaging effects of radiation from the sun.
Given your knowledge as a dermatologist, do you think that the government should ban the creams on health grounds?
Actually many of them are already banned but the implementation of the ban is a problem. Now, there are certain concentrations of those things they use that should not be sold in the open market, just like prescription drugs should not be sold in the open market. Like the powerful steroids, they are not supposed to be sold like that. But cosmetics are different. Some of the things they put in these creams they may not even list them on the packaging for the buyer to read and be properly informed. For instance, most of the bleaching creams significantly have mercury but none of the manufacturers would ever list mercury as one of ingredients on list of components. Again, the ones that we think are not dangerous like steroids, the fact is that when you absorb them into your body, they alter the skin, and you can develop diabetes, hypertension and obesity. When you see people with broken skin, the skin becomes very fragile. With a very small stress on the skin, it breaks down. That’s why you see certain people with stripes.
What advice can you offer on buying creams?
Buy the creams that are specific for your skin, which will not change the colour of your skin. Instead it should enhance your complexion. So you just need to maintain the texture of your skin. Sometimes, the products may claim to be for “toning,” that is a fallacy, such products actually bleach the skin. There is nothing like toning. It’s another name for bleaching.
So what can one use to maintain natural complexion and not tone the skin?
There’s simple Vaseline, cream lotions, shea butter and olive oil.
But those ones make a person darker?
No, they don’t darken you but it is the sun that makes you darker – not Not the cream you are rubbing. If you notice that you are getting darker because of the sun, you can use sunscreen in addition to your normal cosmetics. Everybody needs some protection from the sun, whether you have dark or fair skin. If you are often exposed to the sun, you need to protect the skin against radiation from the sun. Exposure to the sun increases pigmentation of individuals. So, if you don’t want to get darker, you can use sunscreen. We usually advise people to use cosmetics which have pH close to the pH of the skin – may be 5.4. Alternatively, you can use simple soap or synthetic detergents that don’t alter the lipid layer on your skin. You need that lipid layer to maintain the texture of your skin. Without the lipid layer, the skin will get dry and once it gets dry you won’t look nice and that’s why you go looking for other things. The lipid layer should always be protected. With appropriate cosmetics you can always protect the lipid layer. If you have oily skin you use cosmetics that are not oily. If you have dry skin you need cosmetics that would moisturise your skin to maintain the water content on your skin. If you have dry skin, there are creams or lotion for dry skin. If on the other hand, you have oily skin, you need less oil on your skin. Therefore go for creams or lotions that have less oil.
As a man, what advice do you have for men who bleach their skin?
They are also like the women who bleach: they are disturbing their skin. They are distorting the natural skin and of course problems can come later from the ingredients used to make the bleaching cream. So, whether it’s natural chemicals or ingredients used for bleaching, or the regular chemical or now that people are going into botanicals, the effect is the same.
There are lots of organic skincare products in the market. People are also mixing creams. What do you think about that?
There are some natural organic products that don’t bleach, such as shea butter and olive oil. But there are some organic products that bleach. Of course, products made from direct extracts of the organics may not bleach but most of the time, tne producers add other things to the extracts and that becomes a problem. It is better to get a natural one.
