Breaking News
March 22, 2018 - FDA Approves Ilumya (tildrakizumab-asmn) for the Treatment of Moderate-to-Severe Plaque Psoriasis
March 22, 2018 - Beer Raises Heart Rate; KardiaBand Hyperkalemia Test; CHD Clinics
March 22, 2018 - A retinal implant that is more effective against blindness
March 22, 2018 - New system based on artificial intelligence provides reliable detection of breast cancer
March 22, 2018 - Research offers new understanding about cause of Parkinson’s disease
March 22, 2018 - HORIBA’s Microsemi CRP analyzer improves quality of care in emergency pediatric units, study shows
March 22, 2018 - Range of Vaginal Dryness Products Can Help Postmenopausal Women: Study
March 22, 2018 - Higher Dose Tx Deemed Safe in Pulmonary TB
March 22, 2018 - Discovery of new ALS gene points to cytoskeleton as potential target for drug development
March 22, 2018 - Diet soda associated with higher odds of diabetic retinopathy
March 22, 2018 - LSD reduces ‘sense of self’
March 22, 2018 - Vitamin D deficiency linked to metabolic syndrome in postmenopausal women
March 22, 2018 - Changes in the intestines may be responsible for reversal of diabetes after bariatric surgery
March 22, 2018 - iPads and Cancer; Clot Retrieval and Stroke: It’s PodMed Double T!
March 22, 2018 - Premature births linked to changes in mother’s bacteria
March 22, 2018 - Brain SPECT scans predict treatment outcomes in patients with depression
March 21, 2018 - Researchers succeed in integrating artificial organelles into cells of living organism
March 21, 2018 - Researchers discover ‘missing mutation’ in severe infant epilepsy
March 21, 2018 - Researchers develop statistics-based computational scheme to zoom in on brain function
March 21, 2018 - Verge joins Genomics England’s Discovery Forum industry partnership
March 21, 2018 - Trovagene Announces First Patient Successfully Completes Cycle 1 of Treatment with PCM-075 in Combination with Low Dose Cytarabine (LDAC) in AML Trial
March 21, 2018 - Congenital Cardiac Cath Tx Often Strays from Guidelines
March 21, 2018 - Marked increase in cardiovascular risk factors in women after preeclampsia
March 21, 2018 - New app may help predict, track manic and depressive episodes in bipolar patients
March 21, 2018 - Discovery of genes could lead to development of novel therapies for EBV-related cancers
March 21, 2018 - High-fat, high-cholesterol diet depletes ranks of artery-protecting immune cells
March 21, 2018 - Research misconduct allegations shadow likely CDC appointee
March 21, 2018 - Most Breast Ca Patients Fail to Get Genetic Counseling
March 21, 2018 - Lopsided ear function can lead to lopsided brain development
March 21, 2018 - Acupuncture helps manage menopausal symptoms, review finds
March 21, 2018 - Motor skill training may contribute to reading skills in obese children
March 21, 2018 - Poor dental health may be related to increased diabetes risk
March 21, 2018 - Chronic opioid users at increased risk of complications after spinal fusion surgery
March 21, 2018 - Study uncovers potential therapeutic target against large family of parasites
March 21, 2018 - NSAID use linked to increased risk of atrial fibrillation
March 21, 2018 - Scientists develop brain “stethoscope” that can detect silent seizures
March 21, 2018 - New method predicts effects of global warming on disease
March 21, 2018 - Insurance Company Hurdles Burden Doctors, May Harm Patients
March 21, 2018 - Renal Transplant from HCV-Positive Donors Feasible
March 21, 2018 - Myelodysplastic syndrome: MedlinePlus Medical Encyclopedia
March 21, 2018 - Research reveals brain mechanism involved in language learning
March 21, 2018 - Many parents still hesitate to try early peanut introduction, survey finds
March 21, 2018 - Audiologist urges tinnitus sufferers facing ‘revolving door healthcare’ to seek support
March 21, 2018 - Study reveals impact of prostate cancer on wives and partners of sufferers
March 21, 2018 - ‘Almost a Miracle Drug’: What We Heard This Week
March 21, 2018 - Study shows NIH spent >$100 billion on basic science for new medicines
March 21, 2018 - Columbia researchers identify nerve cells that drive fruit fly’s escape behavior
March 21, 2018 - Sartorius Stedim Biotech selected by ABL Europe to supply single-use process technologies
March 21, 2018 - Increase in coffee consumption may help battle against colon cancer
March 21, 2018 - Hydrogel may accelerate healing of diabetic ulcers
March 21, 2018 - Dermira’s Two Phase 3 Trials Evaluating Olumacostat Glasaretil in Patients with Acne Vulgaris Did Not Meet Co-Primary Endpoints
March 21, 2018 - DePuy Synthes introduces ACTIS Total Hip System for improving initial implant stability
March 21, 2018 - ‘Oh, It Was Nothing’
March 21, 2018 - Herbal drug kratom linked to salmonella illnesses, CDC says
March 21, 2018 - New optical point-of-care device could enhance screening for thyroid nodules
March 21, 2018 - FDA Expands Approval of Adcetris (brentuximab vedotin) for First-Line Treatment of Stage III or IV Classical Hodgkin Lymphoma in Combination with Chemotherapy
March 21, 2018 - Eosinophilic Esophagitis: Late Manifestation of Allergic March
March 21, 2018 - Signaling pathway involving the Golgi apparatus identified in cells with Huntington’s disease
March 21, 2018 - Quintupling inhaled steroid doses may not benefit children with asthma
March 21, 2018 - Study shows clear connection between cardiovascular fitness in middle age and dementia risk
March 21, 2018 - Premature babies have higher risks of health complications in Bangladesh
March 21, 2018 - Child’s temperament and parenting influence weight gain in babies
March 21, 2018 - Researchers find the heart to be capable of arrhythmia termination after local gene therapy
March 21, 2018 - Inhealthcare to provide digital infrastructure for NHS to help protect people from falls
March 21, 2018 - Flu Season Finally Slowing Down
March 21, 2018 - Mixed Results for Shorter DAPT in ACS Patients
March 21, 2018 - Scientists discover fish scale-derived collagen effective for healing wounds
March 21, 2018 - Genomics England announces new partnership to improve efficiency of next-generation sequencing analysis
March 21, 2018 - Adjuvant AC chemotherapy found to be effective in treating HRD-positive breast cancer patients
March 21, 2018 - Researchers identify new treatment targets for lung diseases using big data
March 21, 2018 - Kids see more women in science than five decades ago
March 21, 2018 - Research shows link between chronic fatigue syndrome and lower thyroid hormone levels
March 21, 2018 - Alzheimer’s disease on the rise
March 21, 2018 - Two Agents Equal as Pretreatment for Adrenal Tumor Surgery
March 21, 2018 - ‘Icebreaker’ protein opens genome for T cell development, researchers find
March 21, 2018 - Women in medicine shout #Metoo about sexual harassment at work
March 21, 2018 - Mother’s pre-pregnancy waist size may be linked to child’s autism risk
March 21, 2018 - Second hand marijuana smoke can cause serious damage
March 21, 2018 - International study shows benefits of using MRI at the start of prostate cancer diagnosis
March 20, 2018 - Santhera Reports Outcome of Exploratory Trial with Idebenone in PPMS Conducted at the NIH
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.


Tagged with:

About author

Related Articles