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116]

Review Article

The unhealthy obsession with fairness and the menace of

fairness creams in India
ABSTRACT
Humanity has been obsessed with the partiality towards fair skin since time immemorial leading to unhealthy practices. The recent
manifestation of this obsession is the huge number of fairness creams which has flooded the Indian cosmetic market. Some corticosteroid
creams are also used as fairness creams because of the side-effect of hypopigmentation which is mistaken for fairness. Such misuse of
topical corticosteroids leads to unwanted physical and psychological side-effects which have been collectively described as “Topical steroid
dependent/damaged face” (TSDF). Concerted efforts by professional and social organizations [such as IADVL and Pigmentary Disorders
Society (PDS)], politicians and media representatives, to fight this social menace of fairness craze and fairness creams have started yielding
some positive results recently.
Keywords: Fairness, fairness creams, menace, obsession

INTRODUCTION humanity (however, this does not include the interracial

Since the early days of civilization, people with fair skin have
had an advantage in various walks of life. This obsession
with fair skin has led to a craze for fairness among darker
skinned individuals leading to efforts to lighten the skin
with the help of fairness creams. The cosmetic and
pharmaceutical industries have further enhanced this
obsession by producing fairness creams. While some
creams are marketed to lighten skin color, creams
containing topical corticosteroids (TCs) are covertly used
for the same purpose taking advantage of the
hypopigmentary side effects of these drugs. The use of
fairness creams has led to a plethora of psychosocial and
medical problems. Efforts to tackle this menace have started
but are still ineffective.
FAIRNESS
Fairness or light skin color is described as the quality of
having light-colored skin or fair complexion.[1] Since the
early ages of human civilization fairness has been equated
with beauty. Colorism, also known as skin color
stratification, has been used to describe the prejudice
based on skin color prevalent within various races of
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discrimination causing friction between various
communities and nations). This prejudice creates a
privileged position within individual communities for
those who possess a lighter complexion. Colorism has
been prevalent across centuries in various regions of the
world such as India, Eastern Asia, Africa, Latin America, and
USA.[2] The prejudice resulting from colorism has led to the
system of “pigmentocracy.” Pigmentocracy is a practice
whereby people with lighter skin tones are given more
privilege than those with darker skin color.[3] Throughout
the world, pigmentocracies have given rise to a social
hierarchy, wherein the highest social status has been
conferred on lighter skinned persons with the lowest
status being allotted to the dark-skinned individuals.[4]
ARIJIT COONDOO1, RASHMI SARKAR2
1
Department of Dermatology, KPC Medical College, Kolkata,
2
West Bengal, India, Department of Dermatology, Lady
Hardinge Medical College, New Delhi, India
Address for correspondence: Dr. Arijit Coondoo, Flat 1H, Canvas,
46/2, Bosepukur Road, Kolkata 700042, West Bengal, India.
E-mail: acoondoo@gmail.com
Submission: 16 March 2021 Revision: 26 March 2021
Acceptance: 2 April 2021 Published: 7 April 2021
This is an open access journal, and articles are distributed under the terms of the
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows
others to remix, tweak, and build upon the work non-commercially, as long as
appropriate credit is given and the new creations are licensed under the identical
terms.

DOI: For reprints contact: WKHLRPMedknow_reprints@wolterskluwer.com

10.4103/Pigmentinternational.
Pigmentinternational_19_21 How to cite this article: Coondoo A, Sarkar R. The unhealthy obsession with
fairness and the menace of fairness creams in India. Pigment Int 2021;8:4-7.

4 © 2021 Pigment International | Published by Wolters Kluwer - Medknow

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Coondoo and Sarkar: Obsession with fairness in India
Pigmentocracy in India has led to a social hierarchy wherein
people of lighter skin have had the advantage of being more
educated, more wealthy, and more powerful. Additionally, at
various stages in history, India has been invaded and Indians
have been overpowered by aliens possessing lighter skin.
These social and other factors have led to a general notion of
supremacy of fairer skinned individuals over their lighter
skinned counterparts.[5] In modern India, this
pigmentocracy has led to a fairness craze.[6]
FAIRNESS CRAZE
The fascination with fairness of skin in India has been
prevalent since time immemorial. However, in modern
times this obsession has turned into a fairness craze
emanating from a mistaken notion that fairness of
skin results in an increased advantage in social circles,
matrimonial market, and professional fields.[7]
Advertisements in the print, audiovisual, electronic, and
social media depicting individuals with lighter skin to be at
an advantage over others has further fanned this craze. The
fair complexioned people have been portrayed as the
beautiful people who are more marriageable, confident,
and professionally successful.[4] The cosmetic industry,
realizing a vast business opportunity, has milked this
obsession by marketing skin lightening creams popularly
known as fairness creams.[8]
MENACE OF FAIRNESS CREAMS
The business of fairness creams started with the marketing of
Afghan Snow the first face cream in India in 1919.[9] In the
modern era, the first fairness cream was marketed in 1975.[10]
The market for fairness creams for women is rising at the rate
of 18% and at the rate of 6% to 8% for men every year. By the year
2023 the market is expected to reach Rs 5000 crores.[11] This
huge expansion of the market is principally due to a number of
reasons, such as (a) the fairness craze epidemic, (b) the
cosmetic industry which exploits this craze to market a
host of skin lightening products, (c) the marketing of these
creams as cosmetics rather than drugs, and (d) clever
advertisements with endorsements by celebrities.[6]
According to the World Health Organization (WHO), a drug
is defined as “any substance or product that is intended
to be used to modify physiological systems or pathological
states for the benefit of the system.”[12] Fairness creams
contain a number of chemicals such as stearic acid,
palmitic acid, glycerin, phenol, cetyl alcohol, etc. These
chemicals may decrease melanin synthesis or may interfere
with the transfer of melanosomes from melanocytes
to keratinocytes.[8] Hence, by definition, cosmetics are
drugs. However, they are marketed freely without any
Pigment International | Volume 8 | Issue 1 | January-April 2021
evidence-based data and are registered with the Central
Drugs Standard Control Organization as cosmetics.[13]
Additionally, the constituents may produce a large number
of dermatological (allergic contact dermatitis, contact
leukoderma, exogenous ochronosis) and systemic side
effects.[14] Facial creams also contain nanosized reduced
graphene oxide which may excite oxygen in air to produce
superoxide anion on exposure to sunlight. The superoxide
anion damages living cells, resulting in mutation of facial
skin. Hence, fairness creams are liable to be carcinogenic
in nature.[15] Advertisements of fairness creams are not
controlled by the Drugs and Magic Remedies
(Objectionable Advertisements) Act, 1954. Hence, without
the control of any regulatory body fairness creams can be
freely advertised thus fanning the fairness craze further.[14]
These advertisements are endorsed by celebrities (usually film
stars) with a huge fan following. The fans following these
celebrities believe their endorsement and use these products
blindly.[6] However, recently the Advertising Standards Council
of India (ASCI) issued certain guidelines for celebrities
endorsing skin lightening products recommending
restrictions on portraying any discrimination due to skin
color.[16] The problem of fairness creams and their
advertisement gets more complicated when a TC
containing cream is advertised as a skin lightening by a
pharmaceutical company as happened in 2015.[17]
ABUSE OF TCs AS FAIRNESS CREAMS
The misuse of topical steroids as cosmetic creams was first
reported from India in 2006.[18] The skin of the face is very
thin resulting in increased permeability of creams. This is
particularly true about TCs; the higher the potency the more is
the permeability.[6] TC application on the face can result in a
number of side effects including hypopigmentation which
may occur quite rapidly. This iatrogenic hypopigmentation is
often misunderstood as fairness by the laymen. Among other
reasons for such misuse is the urge to obtain instant
fairness.[19] Kligman et al. in 1975 advocated the use of a
combination of hydroquinone, tretinoin, and dexamethasone
for the treatment of hypermelanosis.[20] The higher the
potency of TC the more was the hypopigmentation.[6] This
observation led the pharmaceutical industry to introduce
creams containing TC of higher potency which were
marketed as “modified Kligman regimen.”[21] In India,
unrestricted production, promotion, sale, and long-term
use of the various triple combination creams containing TC
of various potencies has resulted in a large number of side
effects which may negate the cosmetic benefits that may
result from such usage. It also results in addiction to the
drug.[22] Such a physical and psychological dependence on the
drug, collectively described as an entity called “topical steroid
5
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Coondoo and Sarkar: Obsession with fairness in India
damaged/dependant face (TSDF)” which may be the ultimate
result of misuse of TC as fairness cream.[23]
TACKLING THE MENACE
The menace of fairness craze fanned by fairness cream
advertisements has encompassed Indian society in its
tentacles for a prolonged period. However, recently some
signs of a fightback by social activists and celebrities have
raised hopes of a fightback. “Dark is beautiful” is a social
awareness campaign launched in 2009 by Kavitha Emmanuel,
founder of “Women of Worth” to draw attention to the
injustice meted out socially to dark colored individuals due
to the bias for fair skin ingrained in the fabrics of Indian
society.[24] Alert doctors and social activists have joined hands
to form action forums and taskforces such as the IADVL
taskforce against topical steroid abuse (ITATSA) for
effective and organized campaigns against the use of
topical steroids as fairness creams.[6] Though there are no
regulations against the advertisement and marketing of
fairness creams, the Advertisement Standards Council of
India (ASCI) has recently recommended that advertisement
of fairness creams should not send a wrong message based on
skin color showing people with darker skin as inferior to fair
skinned persons. Such advertisements should not make them
unhappy or depressed or portray them to be at a disadvantage
in the various aspects of life including marriage, job
placement, promotions, etc.[25] Celebrity endorsements
misleading their fans to believe in the capability of fairness
creams to improve the quality of skin and life of individuals
are one of the main causes of the fairness craze. Recently,
the Consumer Protection Bill, 2019 seeks to penalize
misleading advertisements placed on virtually any medium,
including television, radio, print, outdoor advertisement,
e-commerce, direct selling, and telemarketing.[26] Another
hopeful sign is the recent spate of celebrities refusing to
endorse fairness creams as well as countercampaigns by
celebrities.[27,28] Another ray of hope, though faint, for
the campaign against fairness creams, has been kindled by
some demands raised in Parliament by a lone Member of
Parliament (MP) in 2016.[29]
CONCLUSION
The fairness craze is a social menace which threatens to rip
the fabric of Indian society. Fairness cream advertisements
which promise lighter skin tone deceive and demean people
and fan the fairness craze. Such fairness creams and their
advertisements lead to a feeling of inadequacy in the minds
of darker skinned individuals. Endorsements of fairness
creams by celebrities mislead their fans and need to be
stopped forthwith.
6 Pigment International | Volume 8 | Issue 1 | January-April 2021
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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