International Journal of Dermatology

The refusal of skin bleaching the other side of “xessal”


  • Conflicts of interest:
    Michèle Verschoore is Medical Director of L’Oréal Research and Innovation. The other authors declare no conflicts of interest.

Fatimata Ly, MD
Maitre de Conferences Agrégé
Université Ckeikh Anta Diop de Dakar
Médecin-Ched du Service de Dermatologie
EPS Institut d'Hygiéne Sociale de Dakar
BP 5825 Dakar Fann


In sub-Saharan Africa and particularly in Senegal, the obsessional search for a clear complexion by using bleaching compounds is the cornerstone of cosmetic culture. A large proportion of the female population uses bleaching compounds for cosmetic purposes. Thus, the prevalence of this practice is 67% in some areas in Dakar.1 In a previous study, the main recorded motivations for using skin bleaching products in the urban female population were aesthetic logic, beauty, and pomptool. No inferiority complex o with respect to the skin was found.2 Despite the high prevalence of users, a persistence and discovery of the aesthetic issue of black skin were found. Our aim was to analyze the motivations, arguments, and explanations of Senegalese women who refused to engage in the act of skin bleaching. First, our approach was whether black skin was perceived as a medium for the identity and aesthetic standards in Senegal and, secondly, if it was the center of aesthetic ambivalence


We used qualitative methods combining individual interviews and focus groups. The latter method was developed by Gisele Simard since 1988.3 The focus or discussion group appears to be very appropriate in the African context, as it is an oral method that well suits the so-called oral societies. In addition, to guide our discussions and analyze results, we recruited native researchers who not only spoke local languages but also had strong mastery of the sociocultural issues in question. An analytical model was developed to quantify the qualitative data following the approach that was significantly instrumental to the body of research on family in Cameroon and in Africa in general.

Data were collected by grid from April 1 to 30, 2008; the grid included 17 half open questions. Senegal is a sub-Saharan country with 11 million inhabitants, and approximately 2 million inhabitants live in its capital, Dakar. The per capita gross national income is US$700. Forty percent of the population lives in cities. The literacy rate in this area is 50.4% in women and 72.8% in men. Fifty-seven percent of the population is under 20 years of age.4

The study was conducted in Senegal’s capital and its Districts: “Pikine”, “Parcelles Assainies”, and “Médina”, and in Mbour 80 km from Dakar. The themes were identified by researchers and investigators. More than 90% of the population are Muslim. The most spoken language is Wolof.

We included Senegalese women, age 40–60 years old, regardless of age, religion, and occupational group. We carried out eight individual interviews of women in different social and occupational groups: fashion designer, model maker, doctor, pharmacist, artist composer, jurist, lawyer, and painter. Six focus groups were also formed; each group comprising seven women from different socioprofessional backgrounds: students, members of association “black women”, housewives, etc.

To validate the collected data and results, we conducted logical cross-checking by the method of immediate induction and content analysis of all the translated interviews (from Wolof to French) on a corpus. This cross-checking allowed us to find from a limited sample the types of idea that triggered and ordered the responses of the interviewed women in a synthetic way. The women were asked about their motives for refusing skin bleaching. In a second step, they were asked to voice their opinions, views of society, and attitudes towards their black skin.

The grid included open-ended or half-open questions and the themes were identified before the start of the study regarding the design and theory construction.


The main results were based on three areas: the symbolism of black skin, link between beauty and black skin, and ambivalence between black skin and self-esteem.

The black skin as an identity medium

The main idea is that skin color first functions as if it stands for identity; some women think that by refusing skin bleaching you display a high sense of maturity and posses a strong personality. Religious considerations were also frequently mentioned in the comments of women; demotivating them from skin bleaching, embracing refusal to skin bleach. Indeed violating the authenticity of natural skin is considered as an act of disobedience to the divine order. Deliberately altering one’s skin by cosmetic depigmentation, is equivalent to blemishing the original body, undermining the divine creation – blaspheme. As good Muslims, the interviewed women suggested coexistence, by divine Will, of different beauty and of the infinite number of beautiful colors of the skin.

Another observation was the importance attached by interviewed women to the nourishing and reproductive function of the skin. Thus, they sighted several instances in which skin bleaching could be of great risk or could expose one to certain risks (e.g., during surgery in the case of complications or even death during delivery if natural healthy skin has been destroyed).

A significant proportion of women interviewed also shared similar views: our black skin envelopes our lives, the fact that we can feel the blackness of our skin contributes a great deal to how we live this unique sensation of protection, which does not only encloses but also coats at the same time this inalienable cultural identity. Black skin is also seen as a symbol and an emblem of identity, which reveals that we are a well-balanced healthy people who are proud of their culture, origin, education, roots, and skin. Upbringing was also frequently brought up to justify their refusal for not spending money on skin bleaching.

The link between beauty and black skin: “I am black and beautiful”

Women who use bleaching compounds for cosmetic purposes and those who refuse skin bleaching both define beauty as being attractive and having good qualities. The skin is characterized by its qualities: complexion, tone, radiance, softness, and evenness. The black beauty is qualified as “black diamond”, “blue woman” or “princess”, and is characterized by its rarity. The other qualities of black skin are the ability to better protect from skin aging and hide irregularities and skin defects.

Women who have refused to skin bleaching usually resort to a diversity of products, which they perceive as containing only natural compounds. In fact, generally they have an obsession that drives them to avoid products with a high probability of damaging their skin. They always use natural herbal products (aloe vera, shea butter, avocado oil), in particular without hydroquinone. Maintaining the beauty of black skin requires multiple daily rituals. The ultimate is to rejuvenate firmness and to enhance black skin. With this aim in mind, participants reported frequent use of natural products to optimize their appearance, with great attention to avoid substances considered harmful, toxic, and dangerous. It is also believed that by maintaining the radiance and shine of black skin and keeping it healthy helps prevent the premature aging observed in white women and those using skin bleaching agents (corticosteroids and hydroquinones). The women follow a more logical preservation of their natural complexion than that of refusing the act of skin bleaching.

The sentence “Nigra sum, sed formosa” (“I am black but beautiful”) attributed to the Queen of Sheba in the bible summed up many representations by respondents who feel particularly that black skin was not synonymous with ugliness! Thus, the madness of “whitening” cannot be felt by the amazons of blackness; for them to be black is more than just a color of the skin; they see it as a state of inner equilibrium!

Self-esteem and black skin in Senegal: the ambivalence

Black skin is admittedly glorified but the activists of “black is beautiful” face, in private, the uncertainty generated by their specificity. They show, through interviews a real fall in their self-esteem or even a distortion of their self-image.

Between the lines in interviews with the women surveyed, a real contradiction between support for something that is inalienable – as referring to their core identity, the color of skin, and this intolerable and unbearable tension that demonstrates the logical impossibility of being the center of attention in a society that promotes fair skin! The following illustrates this finding:

I am not indifferent to the beauty of woman with clear complexion. Often when “Xessal” is successful it’s very nice! Let’s to dare to say it. I am a pharmacist a health worker I am afraid, above all, of the sanitary consequences of the skin bleaching. I am worried about the medical complications but in fact I confess that a good xessal is nice (individual interview, pharmacist).


The originality of our study is the method used. To our knowledge, it is the second qualitative study about the practice of skin bleaching. Indeed most studies about skin bleaching are quantitative studies carried out in hospitals.5 We used the methods of focus groups that have been validated since 1988 and have been widely used in Africa where oral tradition is predominant.

The phenomenon of skin bleaching, known as xessal in Senegal, is widely used in sub-Saharan Africa with a prevalence of 25–67%.6 For a better understanding, it is essential to know the motives of women who use skin bleaching compounds for cosmetic purposes. In a previous study, we found that the main motivations were aesthetic in nature. To prevent the initiation of skin bleaching in a group of women that refuse these cosmetics, we have conducted this second study.

Our results suggested that women refusing skin bleaching considered their black skin as a mark of their identity and ignoring its originality and specificity was the beginning of alienation. We found a strong link between skin color and intrinsic values. The basis for refusal was religion and education, which is not surprising because in Senegal religion is important in the social setting. In this study, it is important to note that women refusing skin bleaching were not indifferent to the appearance of their skin. Quite the reverse, they use many products to take care of their skin but all these products have the same attribute: they only contain natural compounds. And if they need anything better, they develop their own cosmetics based on baby products or products found in the local market. Thus during interviews we found that women had developed an intuitive grasp of cosmetology and reported a wide use of “baby creams,” diverse oils, and shea butter for cosmetic purposes.

They are in a continual sense in pursuit of beauty but not at the expense of their health unlike women who use skin bleaching agents. 6 Skin diseases associated with the cosmetic use of bleaching compounds are becoming more prevalent and are having a high impact on dermatology practice.7,8 One of the major arguments of women who refuse skin bleaching is that they love to maintain the integrity of their skin, which protects from skin aging2 and disguises irregularities and scars.

For the women interviewed in this study as well as women who practice skin bleaching, beauty is not limited to the epidermal dimension. Beauty is considered as a cultural envelope, which encompasses a group of three ideas: descent; tradition; and religion. Moreover, the same skin characteristics sought by these two groups are homogeneousness, radiance, and consistency. Thus black skin is not synonymous with self-neglect, and the women interviewed had ideas of keeping the skin looking natural rather than refusing skin bleaching, and we noticed they were receptive to the diversity of skin color.

Another argument to justify the refusal of skin whitening is the importance attached to the nourishing and procreative function of skin. Thus, the women interviewed insisted that the risk of surgical complications or death during delivery if their natural and healthy skin were destroyed. It is a well known fact that skin lightening is a common practice during pregnancy in Dakar, Senegal and the use of steroids during this period may result in harmful consequences for both the mother and her child. In the study by Mahéet al.8 68 of 99 selected women used skin lighteners during their pregnancy, the main active ingredients being hydroquinone and highly potent steroids. The side effects in women using corticosteroids were lower plasma cortisol level and a smaller placenta, with statistically significant differences.

Women who advocate natural skin have a negative perception of women who use bleaching products blaming them for having a psychologically, “very frail,” personality. They also believe that their ability to resist social influences to those friends, family, or sometimes men, contributes to the development of self-esteem. The ability to deny the dangers due to the vagaries of fashion is also seen as contributing self-esteem. However, are these women really burgeoned in a society that promotes brown skins and considers them beautiful and attractive with a real capital in terms of social prestige?2

The claim of originality, uniqueness, and the pride associated with black skin is difficult to assume in a society where it is poorly appreciated

We can note a certain ambivalence between self-esteem and black skin in Senegal. Black skin is glorified but a woman is faced with the uncertainties generated by this. David Le Breton9 once said the “human condition is bodily” but looking at the Senegalese scenario are we not tempted to say the human condition is cutaneous?


In this qualitative study conducted in an urban area in women who refused skin bleaching, black skin was perceived as related to their identity. The arguments developed to explain skin bleaching refusal are mainly based on religion and education. Other reasons put forward are the following: to keep skin natural, preserve health, and prevent skin aging. The women interviewed in this study regularly take care of their black skin to maintain its beauty and quality of resistance. Women who refuse skin bleaching had contradictory feelings in relation to it because while they refuse this practice they admire the effects of successful whitening.