WITH many Jamaicans continuing to shrug off medical warnings about the dangers of skin bleaching, health professionals at May Pen Hospital in Clarendon say they are seeing an uptick in the number of patients returning to seek care after surgery because their wounds are not healing.

According to Nurse Sarekhi Sewell, when the patients return to the hospital, investigation by the medical professionals often find that some of them are taking a longer time to recover because of their unhealthy lifestyle habits such as skin bleaching.

“We have a lot of patients who have been coming to the clinics for months because they have to do several surgeries. Their wounds are not healing based on lifestyle choices. A lot of them are bleaching, so the skin integrity is not good. If they get stitches, it breaks down, and it’s just not healing,” Sewell told the Jamaica Observer.

Skin bleaching, the practice of using chemical substances or steroid creams to reduce the melanin concentration in the skin and make it lighter, has been a burning issue in Jamaica and other countries for decades.

Locally, the practice is deeply ingrained among Jamaicans who hope to transform their dark complexion to a lighter hue in the belief that fairer skin could be their ticket to a better life.

Most Jamaicans who bleach their skin use over-the-counter creams, many of them knock-offs imported from abroad. Long-term use of one of the ingredients, hydroquinone, has long been linked to a disfiguring condition called ochronosis that causes a splotchy darkening of the skin. Doctors say abuse of bleaching lotions has also left a web of stretch marks across some people’s face, affects the development of the brain, can cause kidney failure, trigger irritable behaviour, memory loss, and weak muscles.

Dr Wayne Wright, a junior general surgeon at May Pen Hospital, explained that during the skin-lightening process the skin layers are broken down by these steroid creams and become thin.

“It makes the skin a lot harder to deal with. It makes wounds a lot more devastating because, after applying all of these steroids to your skin, it makes it a lot easier for you to pick up infections, so we’re seeing a lot of [patients] coming in with fungus growing on their skin,” said Dr Wright.

“The skin is just thinner, so it tears through a lot more easier and it bleeds more. It just doesn’t heal as well as normal skin without any steroids or bleaching agents added to it,” he told the Sunday Observer.

General, laparoscopic and bariatric surgeon Dr Alfred Dawes agreed, saying that skin bleaching has such severe consequences that he refuses to operate on patients who are engaged in the process.

“I’ve found that immediately after surgery the steroids in the creams slow down and prevent adequate wound healing. As a result, patients who bleach their skin have a greater chance of getting wound infections,” said Dr Dawes.

“Compounded with that, long-term bleaching, I have found, destroys the dermis, which is the thicker part of the skin. It thins it out significantly and you will notice that when you are closing the wounds with the stitches, the stitches tear through the skin like wet tissue paper, and because of that you have poor wound healing and poor cosmetic outcomes,” he told the Sunday Observer.

Dr Dawes said that to reduce the post-operative medical complications that will arise due to skin bleaching, he advises patients to go six weeks to three months without bleaching before they can have surgery.

“The damage to the skin is done already, but if the wound is open because the stitches tear through, then at least the chances of an infection and healing won’t be as bad as if they are actively bleaching,” he explained.

He stressed the importance of educating Jamaicans about this reality, noting that many who practice skin bleaching never think about the long-term consequences.

In addition to skin bleaching, nurse Sewell said she has witnessed patients who smoke and drink having difficulty recovering from wounds.

“These are often men who are going to parties, they are drinking and smoking, so in the event that they are in an accident, when they do come to the hospital, their treatment is definitely affected because the drinking and the smoking don’t go well with antibiotics,” she said.

Sewell urged patients to be careful about their lifestyle choices as they have a wider impact.

“We have to encourage patients about the lifestyle choices they are making, not just for themselves, but because of how it impacts their family and how it impacts the hospital. There are so many resources that we use just caring for these persons for probably avoidable incidents,” she said.

Dr Derrick McDowell, an orthopaedic surgeon and sports medicine physician, further noted that while smoking affects wound healing, it also affects bone healing.

“When you smoke you take in inhalants from the burning tobacco that causes a problem with blood circulation and blood flow, so it basically makes you hypoxic, meaning that it makes the oxygen concentration in the area for healing very low, and bones need a little oxygen to heal. If you smoke it will affect wound healing, yes, but it will also affect bone healing. Bones don’t heal if you smoke,” he told the Sunday Observer.

“If I have to do an elective surgery, and I need to do a bone procedure and the person is a smoker I will not do it until the person stops smoking because the bone will not heal,” he stressed.

He also cautioned individuals about being around people who smoke, noting that second-hand smoke has the same effect of delaying bone healing.