In a world where personal choice in aesthetic enhancement is celebrated, skin tone modification in darker skin types remains a topic of contention. Dr Thembani Mentor delves into the complex societal perceptions surrounding skin tone preferences, challenging the stigmas and double standards that prevail. This article explores the historical context of skin tone trends, the current state of the industry, and calls for a more empathetic and open-minded approach to aesthetic medicine.
A Historical Perspective: From Tan to Taboo
Legend has it that in the 1920s, fashion designer Coco Chanel accidentally got sunburnt while visiting the French Riviera. When she arrived back home, her new tan made an impression on her fans, marking the beginning of the “bronze ambition.” Prior to this, in the United States and Western Europe, tanned skin was associated with the lower classes, symbolising a life of hard work outdoors under the sun.
However, after Coco Chanel was seen with a tan, darker skin, previously associated with less fortune, became a symbol of leisure, long afternoons spent on yachts, and the luxury of vacations.
Thus began the era of tanning oils, beds, lotions, bronzers, booths, spray tans, and even melanotan—a multibillion-dollar industry thriving on the pursuit of the perfect tan. On any given summer day, it’s common to see people on the beach seeking that golden glow. Despite the well-established risks of ultraviolet light exposure leading to skin cancer and other dermatological conditions, tanning remains a popular practice in many communities. Spray tans and melanotan may pose health risks, yet the practice is neither taboo nor discouraged socially.
The Double Standards of Skin Tone Preferences
Contrast this with the reaction when a Black or Asian person, or anyone with a darker Fitzpatrick phototype, expresses a desire to be a few shades fairer. Suddenly, the conversation shifts and the desire for lighter skin is labelled controversial. Remarks about body dysmorphia and self-hate abound. While the dangers of the skin-bleaching black market are well-known, have we considered that if a brown person wanting to augment their skin (skin lightening) wasn’t so stigmatised, there might be more investment in safer options for those who desire such changes?
I acknowledge and do not set aside the issues of colourism and the psychological trauma some people endure due to being born with the “wrong” skin shade. These issues should not be dismissed. For patients genuinely suffering from body dysmorphic disorder, our approach should be rooted in compassion, dignity, and patience rather than judgment and dismissal.
Challenging the Aesthetic Norms
Consider this: nearly everyone reading this has undergone some form of cosmetic augmentation. We have augmented our breasts, sucked fat from our stomachs, reshaped our noses, erased frown lines, lifted our butts, and some have lips far from their natural size. In these ways, we challenge our natural forms. So why is there such a stark disparity when it comes to phototype augmentation?
As doctors, our role is to support our patients in their personal choices, provided they are made responsibly and ethically. When faced with an ethnic patient seeking to responsibly and ethically change their skin tone, it’s crucial to set aside personal biases. It’s their choice, just as others choose different forms of cosmetic enhancements. For those unwilling or unable to assist, referring the patient to a colleague who can manage this common request is a professional and respectful course of action.
In conclusion
Skin tone preference in aesthetic medicine should be treated with the same open-mindedness and respect as other cosmetic choices. By acknowledging and challenging the double standards that exist, we can foster an environment where personal choice is truly valued, and all patients receive the support they deserve.
MBChB (Pret) AdvDip AesthMed, Cum Laude (FPD)
Dr Thembani Mentor is an aesthetic physician based in Morningside Sandton, Johannesburg and Carlswald, Midrand. She qualified with a Bachelor of Medicine and Bachelor of Surgery in 2017 from the University of Pretoria School of Medicine. Dr Mentor has an Advanced Diploma in Aesthetic Medicine from the Foundation for Professional Development. She is registered with the Health Professions Council of South Africa (HPCSA) and is a member of the Aesthetics & Anti-aging Members Society of South Africa (AAMSSA). She has trained under and worked with world-renowned South African and International aesthetic practitioners.
Dr Mentor currently sits on the board of the South African Association of Health & Skincare Professionals (SAAHSP) and serves as Ethics Director. She is a national speaker, national neurotoxin injection trainer and key opinion leader in the medical aesthetic field. Her area of expertise includes facial rejuvenation, neuromodulator injection, intradermal filler injections, bio-stimulators & bio-remodellers, chemical peels, micro-needling, vitamin and mineral infusion, and PRP therapy.