Rachna Rozine* still recalls the morning she woke up to the blisters.

They were small to start with, and only on her forehead and shoulders. But over the next couple of days, they grew larger and spread across her skin. As the initial boils burst, larger ones formed in their place.

Soon, the then 22-year-old student’s entire face was covered in blisters. Within three days, they began to itch, and on the fourth day, they were burning.

‘I had no idea what was happening,’ says Rachna, so ashamed that she refuses to let Friday reveal her identity. ‘I was scared. It felt like my face was falling apart. I’d had acne when I was younger, but this was on a whole different level.’

She went to a doctor in Sharjah, who immediately asked her what skin products she’d been using.

Rachna – who was born in the UAE but whose family is originally from West Bengal, India – listed the usual cosmetics: mascara, foundation, moisturisers. Then she showed the doctor a bottle of what was labelled Magic Cream. She’d bought it at a neighbourhood store a fortnight earlier. 
It promised to make her skin fairer if she lathered it on twice a day. She’d made the purchase after a lifetime of being told her skin was too dark to be beautiful, to ever find a husband, or achieve real success.

‘And that was just my family saying these things,’ she says.

‘I’m not joking. My parents have been so loving and encouraging all through my life – they’d do anything to see me happy, really – but ever since I was six or seven, there was always this thing that I wasn’t quite perfect because I wasn’t fair enough. It’s a cultural thing in India. It goes back generations. Light is right.’

The doctor, says Rachna, took one look at the Dh35 cream and shook his head.

‘I’ll always remember his exact words,’ she recalls. ‘He said, “Well, we don’t know for sure if this is the cause of the blisters because there are no ingredients on the label, but I dread to think what you’ve been rubbing on yourself”.’

She stopped using the cream and the blisters faded a week later. She had an arranged marriage after two years, and 
her newborn daughter is as just as dusky as her mother.

‘She’s beautiful,’ says Rachna. ‘I wouldn’t change her for the world.’

Rachna’s story doesn’t have an entirely happy ending though. On her jawline, just visible, there remains the faint scarring of those blisters.

‘They’re there for good now,’ she says. ‘They won’t ever go away.’

Yet, she was one of the lucky ones. Skin-whitening products across India, Pakistan, Philippines and swathes of South East Asia and Africa have long been linked to far more serious health issues than just mere boils.

Unregulated and unregistered lotions and potions, containing all manner of hazardous chemicals, are reported to have caused everything from marbling skin and eczema to life-altering and life-shortening illnesses such as cancer, kidney failure, high blood pressure, memory loss and diabetes. Used by pregnant women, they have been directly linked to babies being born with learning difficulties and physical disabilities.

Now, for the first time, there is real concern that the craze for fairness creams is spreading across the region. Potentially poisonous ingredients such as mercury, steroids, magnesium peroxide, bleach and hydroquinone were reportedly found in unlicensed creams at levels above the legal limit of four per cent, and leading UAE dermatologist, Dr Ikramullah Al Nasir, tells Friday that he fears it could have serious consequences.

Dr Al Nasir – the founder of Dermacare Skin Centre in Jumeirah – whose clients include UAE personalities and Bollywood stars, says the availability of unregulated products online, combined with the belief that fairer is better among some Asian communities, has led to an explosion of such creams here.

‘There are no figures,’ says the 50-year-old doctor, ‘but what we’re seeing is more and more young people – mainly Indians, Pakistanis and Filipinos – coming to clinics with horrendous skin conditions. With my clinical experience and instinct, I instantly know these are caused by such creams.

‘But that’s just the tip of the iceberg. While some of the creams have been found safe and cleared for use by the authorities, there are several spurious and black market products [available online] containing ingredients that could be extremely damaging to the skin.

‘We have a ticking time bomb of young people who are, in the long term, risking serious and even terminal illness.’

To make matters worse, there is a global rise in the usage of skin-whitening injections, which are largely prepared from glutathione, an antioxidant. It works by breaking down melanin production in the body, so the concentration of skin pigment is diluted, resulting in the lightening of skin tones.

Although research into the side effects of glutathione is ongoing, it has been found that it may block the effects of a variety of chemotherapeutic drugs.

Additionally, the very act of injecting comes with its own risks.

‘In India and Pakistan, some people are going to backstreet shops to get these injections and these places don’t have the same medical standards or levels of cleanliness required to perform such procedures safely,’ says Dr Al Nasir. ‘This leads to a whole series of risks such as contracting hepatitis and even HIV.’

Thankfully, authorities in the UAE are in overdrive to tackle the issue.

Strict licensing laws mean that shops found selling illegal and unregulated creams face swift and appropriate action. Any product found to contain more than 4 per cent hydroquinone is automatically banned from sale.

There have been simultaneous efforts to educate consumers as well. As early as 2012, Health Authority – Abu Dhabi launched a campaign warning people to stay clear of any creams that contained mercury – it is one of the most common ingredients in unregulated skin-whitening creams. The authority also published a list of red-alert ingredients including mercurous chloride or calomel, which were found in some products.

Despite these efforts, the demand for fairness products has grown unabated.

According to Global Industry Analysts, publishers of off-the-shelf market research, the worldwide fairness product market is worth a staggering Dh36 billion. And it is a self-perpetuating industry – customers are told that once they stop using the creams, their skin will turn dark again, so many are hooked for life.

‘It is a problem that has developed through many generations,’ says Dr Al Nasir. ‘If it’s not tackled right, solving it 
may take just as long.’

Anita Hindi, a Dubai-based engineer, says she can never remember a time when her relatives didn’t comment on her ‘rich cocoa-brown skin in a derogatory manner, or sometimes with a hint of sympathy’.

One of three sisters, the 45-year-old was always known as the dark one, and she still uses skin-whitening creams.

‘I have read that there are dangers to using them, but I personally don’t know anyone who has suffered,’ she says. ‘All I know is that it works.’

But in her story lies the foundation of Dr Al Nasir’s theory – that this is a problem, which goes back centuries to colonial times and beyond.

Historically, being light-skinned was seen as a sign of power, wealth and education. The great ruling dynasties of India, from the Aryans, to the Persians and Mughals, tended to be fair. The arrival of the British consolidated the link between fair skin and wealth and power.

Additionally, being fairer was ‘considered favourable as it indicated that the person was not a labourer and spent more time indoors, so was of a higher social order’, says Dr Hassan Galadari, assistant professor of dermatology at United Arab Emirates University, referring to the caste system.

Such beliefs have been passed down the generations. The result is that many people are socially conditioned to believe beauty really is only fair-skin deep.

‘The children exposed to such prejudices and stereotypes learn at an early age that being fair means being beautiful,’ says Dr Saliha Afridi, clinical psychologist and director of The LightHouse Arabia Community Psychology Clinic.

‘As they grow older, this view becomes so entrenched that it is then difficult to counteract, even if that means they end up risking their health to fit in with this perceived wisdom.’

So accepted, indeed, is this wisdom that when New York-based Indian-American Nina Davuluri – who has dark skin, relative to socially accepted standards – was crowned Miss America in 2014, 
many established commentators on the subcontinent said she would not have won in India – she was too dark. She was also the target of xenophobic comments and attacks based on racism and colourism on social media after she won.

Asian media as well as celebrities and public figures are equally responsible for perpetuating this idealised form of beauty.

‘Both explicitly and implicitly,’ says Dr Al Nasir, ‘newspapers, TV and the film industry constantly recreate this myth.’

But if there is a real villain in this piece – perhaps more than unscrupulous manufacturers and purveyors of such harmful products – it might just be Bollywood. 
Its ongoing fascination and idealisation of fair skin is, says Dr Al Nasir, ‘almost a national tragedy’.

Many of the industry’s biggest stars and bankable names have seen it fit to endorse (legal) whitening creams and 
appear in shocking advertisements to unbelievable effect. Katrina Kaif, Deepika Padukone, Aishwarya Rai Bachchan, Priyanka Chopra, Sonam Kapoor and Preity Zinta are among them, as is John Abraham, who became brand ambassador for a series of whitening products while dating the dusky Bipasha Basu.

But perhaps the most infamous of all is Shah Rukh Khan. The ad he appeared in for a product he endorsed for nearly eight years despite fervent criticism showed the megastar handing a young, dark-skinned fan a tube of fairness cream to achieve his dreams. Even by Bollywood standards, 
such tacit endorsement of discrimination was seen as going a little too far. A petition was launched, but unfortunately, in a country of nearly 1.2 billion people, it only received 15,000 signatures.

So, what can be done to stop young men and women from risking their health – and their lives – to be fairer?

The solution, says Dr Al Nasir, lies in education.

‘I was in Karachi four months ago at a dinner with family friends,’ he says. ‘There was a nine-year-old girl there and the grandmother kept saying, repeatedly, “Nature has been very kind to this family but I don’t know why we were sent such a dark-skinned child”.

‘There was some affection, but if you keep saying that to a child and it will destroy her confidence. It will cause her, eventually, to become clinically depressed – and the only way she will think it’s possible to end this depression is to find a way to have whiter skin.

‘I took her mother to one side and said, “She is not much darker than you or her grandmother, and you have achieved so much in life”. But the damage was already done. It is so sad. And this is something that is being repeated across India and Pakistan – in 90 per cent of homes, I’d say.’

The key, he says, is to try and rid society of these views. ‘We must show positive role models and redefine our ideas of beauty, because once the young person has it in their mind that they want to be fairer, it is already too late.

‘It is very difficult to dissuade them at that point. It is very difficult to say that perhaps the problem is something else – depression or low self-esteem – because if you say this to an Indian or Pakistani patient, it is considered an insult.’

Perhaps the last word should go to Rachna. She nods knowingly when Friday repeats these words to her. ‘As an Asian woman, it’s all around you all the time – your parents and friends say so, it’s in the films you watch, as well as the magazines you read,’ she says. ‘It’s always there.

‘It’s ridiculous because there’s nothing you can really do about it. Even if these creams worked, they’re just a deception, a disguise. And it’s tiring to wear a disguise every day.

‘I was never happier than the moment I just accepted that this is me and people would have to like me for who I am, and not based on the colour of my skin.’

*Name changed