Is skin bleaching a sign of a mental health illness?


Is skin bleaching a sign of a mental health illness, BDD

Hand holding a jar of skin bleaching cream. Credit: Photo by from Pexels 



By: Victoria Iyeduala (Freelance Health and Wellness Writer and DLHA Volunteer)

With Editorial contribution by The DLHA Team



Key facts about skin bleaching in Africa


  • Skin bleaching is common worldwide and Africa is no exception. It is estimated that up to 40% of African women engage in the practice as of 2011.


  • The global retail market for skin bleaching products was estimated in 2021 to be approximately USSD $10.0 billion with a projection to reach $18 billion by 2030.


  • The African market for skin lightening products is believed to be quite sizable, but behind those of Asia and North America.


  • Within Africa, Nigeria has the highest number of women using skin bleaching products in Africa. 77% of Nigerian women use the products on a regular basis. It's 59% in Togo, 35% in South Africa, 27% in Senegal and 25% in Mali.


  • The common reasons given by users include cosmetics, social, cultural, economic, fashion, and “up marketing” for jobs and marriage.


  • Some commentators and health professionals have suggested that the use of skin bleaching products is of public health concern and that psychological, colourism and mental health issues may also play undeclared but significant roles in why many Africans use the products.




Skin bleaching is not only common in Africa, it is a global epidemic. Even with enough information everywhere about skin bleaching and its dangerous effects, many of the world's population, including several Africans, practice it.


Nigeria is the leading consumer of skin bleaching products in Africa followed by Togo, South Africa and Mali


Is it possible that skin bleaching is not just an attempt to look better but an act triggered by psychological or mental health issues, like Body Dysmorphic Disorder (BDD)?


In this article, will learn about

  • Body dysmorphic disorder (BDD), a mental health condition that might be associated with skin bleaching,
  • The symptoms of BDD, and
  • How to manage BDD-related skin bleaching.



What is body dysmorphic disorder (BDD)?


Body dysmorphic disorder, also called body dysmorphia or BDD, is a mental health illness that makes you think and even believe there's a flaw or defect in a specific part or certain parts of your body. You spend so much time worrying about this perceived flaw and constantly doing things to hide or remove it.


Usually, this flaw is nonexistent or minor, but you have an exaggerated imagination of its nature and how it ruins your appearance. You always think that people judge you by it even when it's not true.


You hate that part of your body because you believe it makes you ugly, undesirable or unlovable.


Facts about BDD

  • You have an uncontrollable obsession over a perceived defect or flaw in your body.
  • Most common areas of obsession are the face, skin, chest, hair and muscles (Muscle Dysmorphia, MD).
  • It's a form of obsessive-compulsive disorder (OCD).
  • The symptoms mess up your social, financial, educational and professional life.
  • It affects both men and women.
  • It's considered a common mental illness.
  • It's grossly under-recognised and under-diagnosed, especially in Africa.
  • It can lead to suicidal thoughts.



What causes body dysmorphic disorder?


Scientists do not know the specific cause of body dysmorphic disorder, but research has identified some of the following factors that may increase your risk of having BDD.

Dark-skinned Africans happy in their skin.

Dark-skinned Africans happy in their skin.

Credit — Image by Shary Reeves from Pixabay


  • You have a relative who has BDD, OCD or depression.
  • You were bullied in the past. It could be because of the part or parts of your body with the perceived flaw.
  • You were abused in the past.
  • You're a perfectionist.
  • Believing beauty stereotypes.
  • You have another mental health illness, such as another body image disorder, an anxiety disorder or depression.



How do you know you have body dysmorphic disorder?


Although BDD is barely recognised and underdiagnosed, certain symptoms have been associated with it.

You may have BDD if you experience the following;

  • Excessive preoccupation with a perceived flaw in your body.
  • You're convinced that this "flaw" or "defect" makes you ugly or unattractive.
  • Frequently doing things you think will hide the defect.
  • Regularly checking your appearance.
  • Avoiding social gatherings and activities.
  • You strive for perfection in your appearance.
  • Constantly comparing yourself to others, especially those you believe have the ideal appearance you crave.
  • You constantly seek reassurance from others about your appearance but still find it difficult to believe anything positive they say.


BDD symptoms are impulsive, time-consuming behaviours. They reduce your performance at work or school, cost money, and can be harmful.


You should speak to a psychologist or mental health nurse or doctor if you exhibit these symptoms.


Excessively preoccupied with a perceived flaw in your body

You spend too much time worrying about a flaw or defect you think you have. This flaw may not be real or so slight that people don't notice it.


You're convinced that this "flaw" or "defect" makes you ugly or unattractive

It can go as far as not being able to look at yourself in the mirror or take photos without being appalled by your appearance.


Frequently doing things you think will hide the defect

You're constantly doing certain things every time, which could sometimes be harmful, to hide or remove this fault in your appearance. It could be always

  • Wearing long dresses, long-sleeved shirts, trousers, face covering and hair coverings.
  • Wearing makeup or excess makeup.
  • Picking at your skin or plucking at your hairs.
  • Using filters in your photos.
  • Undergoing cosmetic procedures such as tanning, skin lightening, hair transplants, etc.


Regularly checking your appearance

You're always checking yourself out in a mirror or any reflective surface you see, such as your phone or windows. It could be to assure yourself you look okay or try to fix yourself up.


Avoiding social gatherings and activities

You are afraid to go out. You worry that people will notice your flaw, stare at you or mock you. You get anxious when people look at you.


You strive for perfection in your appearance

You're always trying out solutions to hide or remove the perceived flaw but are never satisfied with the results. For instance, you undergo numerous cosmetic procedures but are always looking for a better outcome.




Is skin bleaching in Africa a sign of body dysmorphic disorder?


So how is body dysmorphia linked to skin bleaching, especially in Africa?

Let’s consider Rachel's story below.

Four years ago, Rachel was a dark-skinned beauty. But she hated her complexion. She'd been feeling this way since she was a teenager.


She woke up every morning, looked at herself in the mirror and wished she could wash away her skin colour. She believes it makes her ugly and undesirable. 


She started having these thoughts when her light-skinned classmates teased her about how dark she was. Rachel had to endure statements like,


"You're as black as the back of a firewood stove pot."


"You'd go unnoticed in the dark of the night because you're as dark as night."


The guys only gave attention to the light-skinned girls in class.


Gradually, she started believing these things and wishing she had light skin. She felt anxious whenever she went out because she thought people gossiped about her skin even when it was not true.


She began looking for "solutions" to get fair skin.


She spent loads of time and money on skin-lightening products, such as pills and creams. Her skin became lighter and lighter as she continued using the products. She wasn't satisfied until she's convinced her complexion is perfectly light and will forever be so.


There are many similar stories like this in Africa because of the popular stereotype that light-skinned people are more beautiful than dark-skinned ones. The media is a big promoter of stereotypes about light skin.


It could be due to Western influence, where most people are white. Like other things from the West, such as fashion, most Africans have made white skin their standard of beauty and something that gives you special privilege. This idea of “colourism” is rooted in the minds of Africans that believe dark skin is a flaw or a limiting factor.


Many people who feel this way bleach their skin to look 'perfect'. These are signs that could show they have BDD. So, in some cases, skin bleaching in Africa may be associated with body dysmorphic disorder.



How can BDD-associated skin bleaching be managed?

Cosmetic procedures such as skin whitening do not help if you have BDD. Since you'd likely never be satisfied with the outcome, you'll keep wanting more – perfection.


Body dysmorphic disorder gives us another point of view on tackling skin bleaching in Africa.


If skin bleachers with co-occurring BDD can be made aware of the possibility that their skin lightening activities may not just be because they like fair skin, but because it's an obsession they can't control, it might make it a less judgemental issue.


This could make it easier for such bleachers to examine their reasons for doing so and seek help.


To treat skin bleaching in a person with BDD, you need to treat the BDD first.


There are treatments for BDD. These treatments help reduce and manage the symptoms of BDD. But before treatment, there must be a diagnosis of BDD, which could be difficult in the African context.


Some of the reasons people with BDD may not seek help include:

  • You're scared of what people may say if you're diagnosed with a mental health problem.
  • You're not comfortable with sharing your feelings with a professional.
  • You don't even know you have this disorder or don't think your behaviour is abnormal.


These reasons limit the number of people diagnosed with BDD and treated.


So, creating awareness around body dysmorphia and how it may be the reason for the prevalence of skin bleaching in Africa should be a public health priority. Initiatives can be created to help people realise they can seek help.


BDD is treated with therapy and medications. Your psychologist or other mental health specialists will recommend the best option for you.


Following your treatment plan properly will help

  • reduce the symptoms of the disorder;
  • control the impulse to bleach your skin;
  • increase your awareness and appreciation of the beauty of your complexion and accept your skin as it is.




Body dysmorphic disorder could be another explanation for the popularity of skin bleaching in Africa. It's a possibility that you may be lightening your skin because of this mental health disorder. Talk to a therapist if your skin-bleaching tendencies resemble BDD symptoms.




1. BDD – The International OCD Foundation

2. Are your body flaws real or perceived?  The Guardian Nigeria News - Nigeria and World News. (2018, February 15). Retrieved January 23, 2023.

3. Body Dysmorphic Disorder (BDD): Symptoms & Treatment. Cleveland Clinic. Retrieved January 23, 2023.

4. Body dysmorphic disorder (BDD). NHS.UK. Retrieved January 23, 2023. 

5. Substance Abuse and Mental Health Services Administration, S. A. (2016, June 1). DSM-5 Child Mental Disorder Classification - DSM-5 Changes (See section 3.3.11). Retrieved January 23, 2023.

6. Paying a high price for skin bleaching. United Nations. Retrieved January 23, 2023.

7. Colourism: How skin-tone bias affects racial equality at work. World Economic Forum. Retrieved January 23, 2023.

8. The desire for lighter skin. (2019, March 28). Wellcome Collection. Retrieved January 23, 2023.

9. Africa: Where black is not really beautiful. BBC News. Retrieved January 23, 2023.

10. Global View Research: Skin Lightening Products Market Size, Share & Trends Analysis Report By Product (Creams, Cleanser, Mask), By Nature, By Region, And Segment Forecasts, 2022 – 2030. Retrieved January 23, 2023.


Related: Skin bleaching in Africa: Whay you should know



Publihed: February 1, 2023

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