Skin Bleaching in Medical and Aesthetic Discourse
About the author: Tanisha Jemma Rose Spratt is a PhD student in the Department of
Sociology, studying at Newnham College, University of Cambridge. In using two
chronic diseases as case studies (vitiligo and alkaptonuria), Tanisha is
exploring the relationship between patient experiences of chronic illness and
identity in the United States, with a particular emphasis on the ways in which
race, gender, class, and illness are performed and constructed as separate but
related identities. In this post, she considers the tensions between skin
bleaching as an aesthetic practice and skin bleaching as a necessary but
unwanted treatment of a medical condition.
During a live televised interview with Oprah Winfrey on
February 10th, 1993 Michael Jackson publically announced that he had
vitiligo, an autoimmune disease that causes the subject to lose pigmentation in
sporadic patches of their skin. This announcement was made in response to
Winfrey’s question about his alleged skin bleaching practices, and the public
assumption that this was driven by his desire to look white. Refuting this
claim, Jackson argued that his whiteness was something that he had no control
over because it was an inevitable result of his disease’s progression. His
white skin signified his illness, not his aesthetic preferences.
In the UK, once vitiligo has spread to over 50% of the body,
dermatologists often recommend that patients bleach their remaining skin
pigment with specialized creams in order to have a uniform appearance.[i]
The medicalization of seemingly aesthetic practices like skin bleaching raises
a series of interesting questions about the patient’s moral culpability. Skin
bleaching has long been considered a taboo subject in communities of colour,
particularly in black communities. It is often assumed that the black subject
who bleaches does so because he or she is ashamed of being black, and wants to
subscribe to an idealized understanding of what it means to be “beautiful” (i.e.
white). But when a person bleaches because of their medical condition the moral
culpability of the act is arguably diminished. Are black people who have this
disease to blame for bleaching their skin in order to have one consistent skin
colour? Should they be demonized in the same way that black people who bleach
their skin in order to look “lighter” are often demonized in popular culture
and socio-political discourse?
Vitiligo is often referred to as a “cosmetic disease”
because it does not have an adverse effect on the patient’s bodily health.
Whilst the patient needs to exercise caution when facing sun exposure because
of the sun’s harmful effect on depigmented patches, it does not cause any known
damage to bodily organs, bones, or muscles. Moreover, because this disease only
manifests itself externally, any physical alteration to the body is seen as an
attempt to improve one’s appearance. In this way, the patient’s bleaching
practices are rooted in a desire to adhere to a particular beauty aesthetic, which
some would argue makes their motivations comparable to the motivations of
ordinary people who bleach. The key difference lies in the fact that the
vitiligo patient’s whitening and/ or lightening is inevitable and, thus,
involuntary. Many people of colour who have this disease often claim that they
would, if possible, re-pigment their depigmented areas in accordance with their
natural skin colour. They do not want to bleach to “look white,” but are faced
with the choice of having a uniform (and seemingly “normal”) appearance through
bleaching or an “abnormal” appearance through leaving their vitiligo untreated.
This choice inevitably compels them to consider bleaching; as noted by one of
my study participants, “I would rather just have it be all one colour versus
the patches.” In seeking to have a uniform appearance the subject demonstrates
their desire to subscribe to popular beauty ideals, but this is in reaction to
the stigmatising aspects of their disease and, therefore, differs significantly
from the motivations of the ordinary person who bleaches for aesthetic
purposes. The vitiligo patient is, arguably, compelled to make this choice
because there is currently no cure for this disease.
The patients that I have spoken to thus far have not
expressed any concerns about the moral implications of skin bleaching. Again,
because the patient’s whiteness is inevitable, for them it is more a question
of speeding up the process of whitening than anything else. One of the key
reasons why many of my participants have thus far chosen not to bleach is
because of their awareness of the irreversibility of this treatment. As noted
by one African-American patient, “the only reason [why] I wouldn’t [bleach] is
because what if they do find a cure? If they do find a cure and I’ve already
[bleached] then I can’t go back and get my colour back.” Clearly this patient
does not perceive white skin to be preferable, she would much rather revert to
a state in which her natural skin colour covered the entirety of her body. Her
sole concern is that in seeking a “normal” appearance through bleaching she
would run the risk of losing the possibility of regaining her dark pigment if a
cure was one day discovered. This opinion has been shared by almost all of the
vitiligo patients that I have interviewed so far. This preoccupation, I would
argue, diminishes the moral implications involved in skin bleaching for
vitiligo patients – it is conceived of by many as an unfavourable option that
would enable them to combat the stigmatising aspects of their disease rather
than a way of subscribing to prevalent beauty norms that equate beauty with
whiteness and/ or lightness.
Vitiligo can be psychologically devastating, and skin
bleaching can be seen as necessary in combating the stares and questions that
patients face on a daily basis. In concealing their disease through skin
bleaching, patients are able to live their lives unencumbered by the social
effects of their disease, and are given back their confidence both within
public and private spaces. There is a significant difference between bleaching
because of vitiligo and bleaching because of a desire to look light-skinned or
white, and these differences need to be considered when addressing case studies
such as Michael Jackson’s. Following his death Jackson’s post-mortem report
confirmed that he had vitiligo, yet many people across the world refused to
believe it, arguing instead that his “whitening” was the product of a
deep-seated desire to look white because of the ways in which this “look” has been
(and continues to be) idealized in Western cultures. Vitiligo patients across
the world face this type criticism when confronted by members of the public who
are unaware of the nature of their condition. My research addresses this issue
by situating vitiligo and another disease called alkaptonuria within a broader
discussion concerning the social effects of hypervisible and invisible diseases
on the daily experiences of patients in the US.[ii]
[i]
NHS,
“Treating vitiligo,” 17/10/2016 <http://www.nhs.uk/Conditions/Vitiligo/Pages/Treatment.aspx>
[accessed 20/11/2016].
[ii]
Alkaptonuria
is a rare genetic disease that causes black cartilage and skin pigmentation,
which often leads to decreased mobility and social isolation.
