Breaking News
May 24, 2018 - Health Tip: Why Get a Biopsy
May 24, 2018 - Metabolic Syndrome Prevalence by Race/Ethnicity and Sex in the United States, National Health and Nutrition Examination Survey, 1988–2012
May 24, 2018 - Motivation to move may start with being mindful
May 24, 2018 - Advanced genetics study of TB bacteria uncovers virulent ‘Beijing lineage’ strain among young adults
May 24, 2018 - Friends tend to have similar pain tolerance levels, study reveals
May 24, 2018 - Now more of us can count on more time dodging the dementia bullet
May 24, 2018 - Global healthcare access and quality improved from 2000-2016
May 24, 2018 - Virtual follow-up visits for hypertension care just as effective as in-person office visits
May 24, 2018 - New research reveals links between type 1 diabetes and mental health
May 24, 2018 - Antioxidant-enriched multivitamin may decrease respiratory illnesses in CF patients, finds study
May 24, 2018 - Antidepressant treatments increase risk of weight gain, study finds
May 24, 2018 - INSYS Therapeutics Confirms Outcome of FDA Advisory Committee Meeting on Buprenorphine Sublingual Spray
May 24, 2018 - Poor older adults with Medicaid insurance more likely to die after hospital discharge
May 24, 2018 - Early-life obesity linked to children’s lower perceptual reasoning and working memory scores
May 24, 2018 - Health and diagnostics to soon be digitalized with advent of AI
May 24, 2018 - USC researchers develop new portable device for early-stage malaria detection
May 24, 2018 - Psychologists show that depression accelerates brain aging
May 24, 2018 - Novel IR imaging offers rapid and reliable analysis of cancer tissues
May 24, 2018 - Tau mutations may serve as novel risk factor for cancer
May 24, 2018 - Sun Pharma Announces FDA Approval of Yonsa (abiraterone acetate) to Treat Metastatic Castration-Resistant Prostate Cancer
May 24, 2018 - Nurse dead in Congo as Ebola vaccination campaign starts
May 24, 2018 - Unique imaging technique identifies biomarkers of cellular damage done by diabetic retinopathy
May 24, 2018 - Study identifies key food allergy policies that parents want in schools to improve safety of kids
May 24, 2018 - Formaldehyde risk found to be higher in e-cigarettes than originally thought
May 24, 2018 - NIH commences first-in-human trial evaluating experimental treatment for Ebola
May 24, 2018 - Study finds no link between surveillance intensity and detection of recurrence or survival in CRC patients
May 24, 2018 - FDA Alert: Oral Over-the-Counter Benzocaine Products: Drug Safety Communication
May 24, 2018 - Fiber-fermenting bacteria improve health of type 2 diabetes patients
May 24, 2018 - Free e-cigarettes do not help smokers quit, money does finds study
May 24, 2018 - Higher exposure to carbon monoxide in utero increases risk of poor lung function in infants
May 24, 2018 - Neurologists identify new type of vertigo
May 24, 2018 - Scientists identify new inherited neurodevelopmental disease
May 24, 2018 - New family support program improves patient-centered care and lowers hospitalization costs
May 24, 2018 - Researchers take important step toward finding protein biomarkers during cancer surgery
May 24, 2018 - Deadly form of black lung disease found to be increasing among U.S. coal miners
May 24, 2018 - Robust Immune Responses for Herpes Zoster Subunit Vaccine
May 24, 2018 - Optical Coherence Tomography | Texas Heart Institute
May 24, 2018 - Type 2 diabetes slowly rising in Auckland kids – Pacific and Māori have highest rates
May 24, 2018 - Study explores brain chemistry of alcohol exposure in people with family history of AUD
May 24, 2018 - Study shows AVATS procedure as safe, effective alternative for patients deemed ‘inoperable’
May 24, 2018 - Comparative Analysis of a Complex Monoclonal Antibody
May 24, 2018 - Penn investigators discover source of immune molecule involved in nasal polyps, asthma
May 24, 2018 - Berries and Grapes May Keep You Breathin’ Easy
May 24, 2018 - Access and utilization of dental services for Medicaid children 2013-2015
May 23, 2018 - New research raises concern about rate of postpartum hemorrhage
May 23, 2018 - Researchers create new modeling framework that takes a zoonotic perspective on Ebola
May 23, 2018 - Study compares bacteria in humans to the laboratory
May 23, 2018 - Frequent sauna bathing reduces risk of stroke
May 23, 2018 - Landmark trial to test implantable defibrillator in diabetic patients with history of heart attack
May 23, 2018 - Vitamin C consumption may reduce harm to baby’s lungs due to smoking during pregnancy
May 23, 2018 - Researchers complete genomic map of chronic lymphocytic leukemia
May 23, 2018 - Medical students take to the streets to learn about real world problems at the root of poor health
May 23, 2018 - New efforts to curb high blood pressure in Asia
May 23, 2018 - Malaria-causing parasite seeks refuge inside the liver to replicate and survive
May 23, 2018 - Slower rates of stimulation may be more effective in brain therapy, suggests research
May 23, 2018 - Study finds connection between one partner’s BMI and other spouse’s risk of developing diabetes
May 23, 2018 - Mapping the Genes Responsible for Pluripotency
May 23, 2018 - FDA Alert: Homeopathic Teething Drops, Nausea Drops, Intestinal Colic Drops, Stomach Calm, Expectorant Cough Syrup, Silver-Zinc Throat Spray, and Argentum Elixir by MBI Distributing: Recall
May 23, 2018 - Genetic fixer-uppers may predict bladder cancer prognosis
May 23, 2018 - Investigational technology could increase donor organ supply for lung transplants
May 23, 2018 - Prediabetic patients with OSA could lower their resting heart rates by using CPAP
May 23, 2018 - Schizophrenics’ blood samples feature genetic material from more types of microorganisms
May 23, 2018 - Subtle hearing deficits can change the brains of young people
May 23, 2018 - New study shows increased rates of hospitalization for suicide among youths
May 23, 2018 - Proportion of Drug-Intoxicated Organ Donors on the Rise in U.S.
May 23, 2018 - Using virtual biopsies to improve melanoma detection
May 23, 2018 - Compassion meditation training may increase brain’s resilience to suffering of other people
May 23, 2018 - New AAD PSA uses social media imagery to highlight tanning hazards
May 23, 2018 - Frequent MRSA surveillance could contain infection in newborns, study finds
May 23, 2018 - Medicaid expansion linked to reduction in ICU utilization
May 23, 2018 - Proteins moderating nicotine dependence may help fat cells burn energy
May 23, 2018 - Researchers identify mechanisms that regulate mammary gland development
May 23, 2018 - ‘Low-Alcohol’ Booze Labels May Backfire
May 23, 2018 - Social isolation could increase risk of death, hospitalizations for heart failure patients
May 23, 2018 - New research shows that children with autism are able to create imaginary friends
May 23, 2018 - New technology could make prosthetic use more intuitive and reliable
May 23, 2018 - HU researchers explore how simulated microgravity affects gene expression, muscle cell differentiation
May 23, 2018 - Researchers develop injectable bandage to stop fatal blood loss, activate wound healing
May 23, 2018 - Exercising for 4-5 days per week is needed to keep the heart young
May 23, 2018 - Porvair Sciences offers wide range of reagent reservoirs for use with automated liquid handling systems
One Woman’s Fight Against ‘Poison’ Skincare

One Woman’s Fight Against ‘Poison’ Skincare

image_pdfDownload PDFimage_print

MINNEAPOLIS — Karmel Square is a hub of the Somali community here, a colorful, cheerfully noisy hodgepodge of vendors and restaurants unofficially known as the Somali Mall. Amira Adawe stops by often to buy tea and chat in Somali with friends and relatives wearing hijabs and flowing, floor-length skirts. They greet her with smiles and hugs, and she calls them “auntie.”

Her visits are more than social, however. The public health advocate scans market shelves for skin lightening creams that may contain harmful toxins — tubes and jars sold under names such as Fair & Lovely, Prime White, and Miss Beauty 7 Days White.

Some women use the creams in hopes of erasing dark spots, but many rub them over their entire bodies multiple times a day in hopes of whitening their brown skin. The practice pervades many cultures in Africa, Asia, the Middle East — and many immigrant communities in the U.S. — and Adawe has made it her mission to end it.

She began her crusade as a graduate student, after she discovered that creams sold in many Twin Cities ethnic markets contained levels of mercury thousands of times higher than the amounts considered safe by the U.S. government. But her concerns go beyond the physical harm to women. She worries as much about the damage to their self-esteem.

In Somali and other cultures, the lighter-skinned daughter is often seen as more beautiful, Adawe explained recently; in fact, the Somali term for light-skinned — cadey — is considered a compliment. “It’s used as a term of endearment,” she said, “but I think it’s so wrong to say it.”

Public health agencies in several major cities have launched their own investigations of tainted skin creams, occasionally getting advice from Adawe along the way. And now Adawe has created The Beautywell Project, to combat the stigma faced by women with darker skin and take on the industry that promises them beauty in a jar.

By day, Adawe is now a manager for the Children’s Cabinet of Minnesota Gov. Mark Dayton. In her “spare time,” she hosts a weekly radio show in Somali that reaches 80,000 people worldwide. She holds educational outreach sessions in Minneapolis and Kenya, talks with imams, and presents at national and international conferences. Sooner or later, most anyone connected with the skin-lightening issue seeks out Adawe. She fields personal pleas for help from Somali men in Minneapolis worried about their pregnant wives rubbing cream on their skin, as well as calls for help from Kenya, Canada, and Australia.

“We can’t address this issue without discussing beauty, what it means and ways to redefine beauty, as well as discussing and educating individuals about wellness,” she said in an interview.

She admits her goal is ambitious. The stigma runs deep, and skin-lightening creams are a multibillion-dollar business overseas, despite bans and public campaigns against the products in many African countries. In the U.S., creams are often smuggled in and sold in small, ethnic markets like at Karmel Square or purchased on the internet. They have been found in Somali, Hmong, Mexican, Dominican, and West Indies communities from California to Minnesota to New York. Users, and even sellers of the creams, are often unaware that they are harmful or illegal.

Somali women are reluctant to speak openly about skin lightening, and Adawe faced resistance when she began her research seven years ago. Her persistence impressed Jim Koppel, who was deputy commissioner of the Minnesota Department of Public Health at the time.

“It’s a very tight-knit community, and this put her in a tough place,” he said. “It could have had a negative impact on the businesses [that sell the creams], both financially and potentially for legal problems, and was of great concern to her personal reputation. And she went ahead and did it and continues to speak out.”

“I had to be brave enough, and, fortunately, the community saw it as an issue” and supported her, Adawe said. “That means a lot to me.”

A topic few wanted to talk about

One recent afternoon, Adawe was 35 minutes into her radio show, broadcast from the studio of KALY, 101.7 FM, a Somali-American station tucked into a corner of the International Bazaar in Minneapolis. She had been talking nonstop about skin lightening, peppering her fluent Somali with a few English words — endocrine system, mercury, hydroquinone, prescription.

Then she turned to the phones, murmuring in understanding as she listened to a female caller from a Minneapolis suburb. Do you have any more feedback, Adawe asked in Somali.

“Women who practice skin lightening and who have experienced skin damage or illness should come to the radio and discuss their experience without disclosing their names,” the caller said in Somali.

Adawe nodded. The topic of skin lightening is a delicate one, both overseas and in immigrant communities in the U.S. While the stigma associated with dark skin is deep, admitting to using skin-lightening creams is also taboo, thwarting efforts to track the prevalence of the practice. As adept as Adawe is at navigating the delicate social norms and customs of the Somali-American community she’s part of, when she began her research in 2011, she could find only seven women who would talk about their use of skin creams.

It was in those interviews that women told her that they apply the creams to their entire bodies three times a day, sometimes while pregnant or breastfeeding. Most mixed several creams together and stored them in the refrigerator.

Adawe had been suspicious of the creams since her childhood. Growing up in Mogadishu and Minneapolis in a health-minded family (her mother was the head of the maternal and child health bureau in Somalia), she watched with concern when friends’ and relatives’ skin reddened or grew discolored from using skin lighteners. Adawe is grateful for the message she received growing up with the darkest skin of three daughters: “I’m so fortunate I came from a family who embraced me for who I am,” she said.

When Adawe became a county public health educator and a graduate student at the University of Minnesota School of Public Health, she was finally in a position to act on her concerns. She purchased 27 samples of creams to test for the toxins she suspected were present.

The tests confirmed Adawe’s fears, revealing that 11 of the products contained mercury, a known neurotoxin. Mercury has been banned in skin-lightening products by the Food and Drug Administration since 1973; the legal limit is 1 part per million. Adawe still remembers the shock she and the pollution control agency specialists who did the testing felt when they saw the results reaching 33,000 parts per million.

FDA spokeswoman Lauren Sucher said mercury is on a short list of prohibited ingredients in cosmetics. “The FDA has been aware of mercury as a potential allergen, skin irritant and neurotoxin for decades,” she said in an email.

Poisonous to the nervous, digestive, and immune systems, it is often found in unlabeled or mislabeled creams; sometimes it’s listed as “mercurous chloride,” “calomel,” “mercuric,” or “mercurio.” Just touching a washcloth or a mother’s cheek that has been rubbed with the products could be harmful to a baby, the FDA notes, interfering with brain and nervous system development.

Yet the agency was able to inspect only 0.3 percent of 3 million cosmetics shipments last year, and it tested just 364 products even though “adverse findings” are discovered in 15 percent to 20 percent of the products tested, the FDA said last June in a letter to New Jersey Congressman Frank Pallone Jr.

Even skin-lightening products sold legally in the U.S. often contain ingredients other countries recognize as potential health hazards, Adawe said. Hydroquinone, a potential carcinogen that is banned in Europe, Japan, and elsewhere, is often found in the creams, as are steroids, which can cause acne, thinning of the skin, and hypertension.

Adawe’s testing in 2011 triggered immediate action: The Minnesota Pollution Control Agency cracked down on suppliers (in a raid on one popular store, inspectors found about 20 boxes full of products that contained mercury); the FDA investigated; and the Minnesota Department of Health warned of the danger.

Elsewhere in the country, similar scenarios were playing out. Alerted through data from local and national surveys, health departments embargoed products, conducted home visits, and notified manufacturers and health agencies in other countries. In New York, for example, after finding eight skin creams with mercury after inspecting products from 22 stores, city health workers now visit stores incognito to identify products of concern, said Wendy McKelvey, executive director of environmental health surveillance and policy.

Once notified of the dangers, there’s “pretty good compliance,” McKelvey said. “They’re not wanting to sell hazardous products.”

Adawe is often consulted because she understands and is trusted by the affected community.

“I think it’s extraordinary what she’s doing,” said Lori Copan, a research scientist for the California Department of Public Health. “A person from the community is a much better spokesperson than someone working in a public health department in terms of motivating and speaking the language and being one of them. It would be fantastic for all of us in public health if we had a community leader like Amira.”

The value of that cross-cultural competence is often in the details. Inspired by Adawe’s study, an ongoing biomonitoring project in Minnesota looking at chemical exposure in pregnant women and babies now tracks urinary mercury. With Adawe’s input, the program has fine-tuned details such as how to phrase questions in surveys about use of creams.

“If you ask directly, ‘Do you use it?’ they will never, ever answer,” Adawe said. To get at the truth, she said, it’s better to start by asking what kind of moisturizer they use.

Initial results of the yet-to-be-published study show that more than 30 percent of pregnant Asian women who spoke Hmong in their interviews had high levels of mercury and received special follow-up to help them reduce their exposures. “The higher levels were likely from using skin-lightening creams and eating certain kinds of fish higher in mercury,” said Jessica Nelson, an epidemiologist and program manager at the Minnesota Department of Health, where Adawe works as a legislative liaison. (The Somali portion of the study isn’t finished yet.)

Adawe isn’t resting: She’s happy that skin lightening has been established as a public health issue. Still, Adawe said there’s plenty more to be done. Next up, she said, is trying to reframe what it means to be beautiful. She’s developing a curriculum for schoolgirls and outreach sessions focused on men, teenagers, and new teachers, which will revolve around the question: How do we change the narrative of what is beauty?

“My dream is that every woman stops using skin-lightening creams and trying to change their color,” she said, “and that they are happy for who they are.”

This post originally appeared on STAT News.

2018-01-16T15:30:00-0500

Tagged with:

About author

Related Articles