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Correspondence
Confessions of a Disease Monger
of an international beauty ideal [2]. Beauty pageant winners
in India are all extraordinarily tall and breathtakingly slim,
have light honey-colored skin, and peddle Western ideals
of beauty [3]. South Asian culture has carried within itself a
capacity for female objecti?cation. Matrimonial columns and
Web sites reveal the in?uence of a young woman’s skin color
on her marketability to marriage partners [3].
The craze for modern fairness creams has emerged in
the last ?fty years [2]. International cosmetics giants were
the initial manufacturers, but these days Indian and South
Asian companies are playing an important role in the skin
bleaching and cosmetic markets [2,3]. Fairness creams have
been estimated to account for up to 40% of the pro?ts of the
cosmetics industry [3]. Recently, a fairness cream has been
launched exclusively for men [4].
Advertisements aim to produce a hierarchy of values based
on the notion that “fairness” is an object of desire [2]. Being
fair has been represented as an active process. Regular use of
fairness creams has been claimed to halt the production of
melanin and to bring out “natural” beauty.
Promoting a particular body image or behavior pattern as
the preferred one and then selling medicines or products
to help people attain the particular ideal may be regarded
as disease mongering [5]. Fairness cream manufacturers
have exploited the preference for fair skin, portrayed it as a
necessary prerequisite for success, and promoted the use of
their product to achieve the ideal. Controlled studies on the
ef?cacy and safety of fairness creams are lacking.
James Phelps
I am a disease monger. I teach primary care doctors how
to identify bipolar disorder. Worse yet, I take money from
pharmaceutical companies for doing so. I use it to subsidize my
practice so that I can treat patients with no insurance, or little
money, who now account for over a third of my patients—in
part because the pharmaceuti
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