•Only 81 dermatologists serving 198m people

By Chioma Obinna

WORRIED by the  increase in skin bleaching among Nigerians and  unregulated sale of bleaching agents in the country, dermatologists have raised the alarm over the effects of the practice.

The dermatologists under the auspices of the National Association of Dermatologists, NAD, have called for urgent enforcement and regulation of the use and illegal sale of skin bleaching/lightening agents.

Making the call  in Ile Ife during its 2018 Scientific Conference and Annual General Meeting, the specialists said the move became  necessary  to check the rampant cases of skin  and kidney cancers and other related disorders in the country.

According to the World Health Organisation, WHO, an estimated 77 per cent of Nigerian women use skin-lightening products, the figure which is reputed to be the world’s highest percentage.

Good Health Weekly findings show that not only women  are obsessed with bleaching their skins even  men are involved in the practice.

Many of the bleaching creams and lotions contain chemicals such as mercury, allantoin, irgasan, etc that have been identified as being carcinogenic.

Over the years, experts at the dermatology departments of  Teaching Hospitals across the Federation have decried the practice of skin bleaching, which they described as a major challenge to all dermatologists in Africa andone that deserves urgent political action due to the devastating consequences of skin cancer, ochronosis, fungal infections, acne, and striae.

Lamenting what they  described as  “disproportionate” number of specialist dermatologists in the country, NAD lamented  that  only 81 dermatologists are currently serving the nation’s population of 198 million (a ratio of 1:2.4 million).

Appealing for urgent action, the dermatologists urged the Federal government to focus on increasing interest in dermatology through continuous sensitisation of students and residents about the scope and range of the specialty.

In a communique the National President, Dr Grace Okudo and Secretary General Dr Chinwe Onyekonwu stressed the need to improve access to dermatologic care at the community levels through the provision of adequate funding by the government.

NAD maintained that there should be provision of requisite infrastructure and incentives to enhance dermatologic care in rural areas in addition to frequent outreach programmes by dermatologists; training of general practitioners resident in the communities on the diagnosis and treatment of common skin diseases among others.

According to the experts: “The dermatologic needs of rural communities in Nigeria have not been met due to the virtual absence of dermatology care in these communities.”

Another source of worry is the absence of dermatologic coverage under the National Health Insurance Scheme, NHIS, despite the fact that a third of visits to hospitals are skin related.

NAD argues that inclusion of dermatologic services in the NHIS would increase access.

They identified  Neglected Tropical Diseases, NTDs, in dermatologic practices in Nigeria, noting with dismay the absence of dermatologists in the relevant committees saddled with the responsibility of assisting the World Health Organisation, WHO, achieve its goal of reducing and/or eradicating NTDs.

“Majority of NTDs have skin manifestations and close to half can be diagnosed by their characteristic cutaneous features. These cutaneous manifestations are largely responsible for the morbidity, stigmatisation, social isolation, and psychosocial impact of these diseases.

“The role of  dermatologists in ensuring early and accurate diagnosis, effective management, and eventual control of NTDs cannot be over-emphasised, thus if the goal of reducing the burden of NTDs is to be achieved, dermatologists must be at the forefront of such programmes,” they noted.

They however, recommended that dermatologists in collaboration with other medical workers should increase surveillance and reporting of NTD at the Local, State, and Federal levels.

There is also the need for involvement of dermatologists at all stages of programmes targeted at the control, elimination, and/or eradication of NTD, including policy making, programme development, planning, implementation, monitoring and evaluation.

While recommending that dermatologists should assist in training competent hands in the identification, diagnosis and management of these diseases, they noted the need for increased government and donor funding for disease surveillance, research and treatment protocols for NTDs.