Madina Majshanu
BBC, Nigeria
A mother in Nigeria is visibly distressed as she holds tightly to her two-year-old son, who has burns and light spots on his face and legs.
This 32-year-old woman, under pressure from her family, used skin-whitening products on her six children, and now deeply regrets the consequences of using these products.
Fatima, whose name has been changed to protect her family's identity, says one of her daughters covers her face when she leaves the house to hide her burns.
The second one's skin is now darker than before and has a light circle around her eyes, while the third one has whitish spots on her lips and knees.
The two-year-old still has open wounds that are slow to heal.
"My sister gave birth to fair-skinned children, but mine are darker-skinned."
"I noticed that my mother preferred my sister's children because of their skin color, and that hurt me a lot," says Fatima.
She says she used creams she bought at a local supermarket in the city of Kano, in northern Nigeria, without a doctor's prescription.
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At first, the cream seemed to work.
Grandma began to treat Fatima's children, who were then between the ages of two and 16, better.
But then burns and scars appeared on the children's skin.
Skin whitening products are used in various parts of the world for cosmetic purposes, but they often have deep cultural roots.
Nigerian women use skin-lightening products more than women in any other African country - as many as 77 percent of them use them regularly, according to the World Health Organization (WHO).
In the Republic of Congo, that percentage is 66 percent, in Senegal 50 percent, and in Ghana 39 percent.
The creams may contain corticosteroids or hydroquinone, which can be harmful if used in large amounts, and in many countries they can only be obtained with a doctor's prescription.
Other ingredients sometimes used include the toxic metal mercury, as well as kojic acid, a byproduct of the production of the Japanese alcoholic beverage sake.
Possible side effects include dermatitis, acne, and changes in skin pigmentation, but also inflammatory disorders, mercury poisoning, and kidney damage.
The skin can also become thinner, meaning wounds heal more slowly and are more likely to develop infections, warns the World Health Organization (WHO).
The situation is so serious that the Nigerian National Food and Drug Control Agency (Nafdac) declared a state of emergency in 2023.
Women, like Fatima, are increasingly bleaching their children's skin.
"Many people associate fair skin with beauty or wealth," Zainab Bashir Yau, owner of a dermatology clinic in Abuja, the Nigerian capital, tells the BBC.
"Women tend to, as they say, protect their children from such discrimination by bleaching their skin from birth."
She estimates that 80 percent of the women she meets are already bleaching their children's skin or planning to do so.
Some people's parents bleached their skin when they were babies, so they just continue the practice.
One of the most common ways to tell if someone is using skin whitening products in Nigeria is by the dark color of their knuckles.
The rest of the hands or feet become lighter, but the knuckles usually remain dark.
However, smokers and drug users also sometimes have dark spots on their hands due to smoke, so users of skin-lightening products are sometimes mistakenly classified as these groups.
Fatima says that's exactly what happened to her daughters, who are now 16 and 14 years old.
"They have experienced discrimination in society, everyone points fingers at them and calls them drug addicts."
"It hit them a lot," she says.
Both have lost potential fiancés because men don't want to be associated with women suspected of using drugs.
I visited a popular market in Kano state, where people who call themselves "mixologists" make skin-whitening creams.
There are many shops in the market selling thousands of these creams.
Some are already made and lined up on the shelves, but customers can also choose raw ingredients and have the cream made in front of them.
I noticed that many whitening creams whose labels said they were intended for babies contained substances that are subject to special regulations.
Other sellers have admitted to using ingredients such as kojic acid, hydroquinone and the powerful antioxidant glutathione, which can cause rashes and other side effects.
I've also seen teenage girls buying whitening creams for themselves, but also in large quantities to resell to their peers.
The woman, who had spots on her hands, insisted that the salesperson add a skin-whitening agent to the cream he was making for her children, even though the substance is intended only for adults and children are not allowed to use it by law.
"Even though I have spots on my hands, I'm here to buy creams for my children so they can have fair skin."
"I believe my hands are like this only because I used the wrong cream."
"Nothing will happen to my children," she said.
One salesperson said that most of his customers use the creams because they want their babies' skin to be "glowing" and "radiant."
Most of them seemed unaware of the approved doses of these ingredients.
One retailer said that when someone wants a very light complexion, they use "a lot of kojic acid," well above the recommended amount, and a smaller amount when they want a more subtle change.
The approved dosage of kojic acid in creams in Nigeria is one percent, according to Nafdac.
I've even seen dealers giving women injections.
Dr. Leonard Omokpariola, the Director of Nafdak, said efforts were being made to inform and educate people about the risks.
He also says that raids are now being carried out on markets, and that authorities are trying to seize skin-whitening ingredients at Nigeria's borders.
However, he admitted that sometimes it is difficult for law enforcement officers to recognize these substances.
"Some of them are shipped in unmarked containers, so unless you send them to a lab for analysis, you have no way of knowing what's in them."
Fatima says her actions will haunt her forever, especially if the scars on her children's skin don't heal.
"When I told my mother what I had done because of her behavior and when she learned about the dangers of the cream and the stigma her grandchildren faced, she was sad that they had to go through all of that, and she apologized," Fatima said.
She is determined to help other parents not make the same mistake.
"Even though I stopped (using the cream)… the side effects are still there."
"I ask other parents to use my case as an example."
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