Sitting in a mall in southern Metro Manila, budding YouTube star Raf Juane holds up a phone showing a picture of his younger self.
The boy staring back from the smartphone screen looks like any other emo kid in the early 2000s: purple hair dye, smudged black eyeliner, and painted overgrown fingernails flashing a peace sign. But even with the screen’s brightness turned up, Juane’s skin is noticeably darker in the photo.
It was taken before he began his regimen of skin-whitening treatments at the age of 13.
Now 21, the up-and-coming beauty guru seems wholly unselfconscious about his transformation into a pampaputi mentor, literally “whitening” mentor, as some of his followers have dubbed him.
“My whitening videos are my top videos,” he says. “Like my gluta video. The one about gluta drip has 150,000 [views].”
In that video, uploaded in August, Juane details his experience undergoing a glutathione drip procedure, a relatively new skin-lightening trend in the Philippines that intravenously delivers glutathione, a substance intended for treating chemotherapy patients that produces a whitening side-effect.
From August to September, Juane underwent 13 sessions. The results were immediate: his pores began to blur after the first visit and his skin began lightening significantly after five.
The treatment has never been approved by the Philippine Food and Drug Administration (FDA), which has warned of “serious consequences” for those using high doses.
When Coconuts Manila spoke with Juane last month, he was in the process of trying out three different kinds of glutathione pills he plans to review, but none of them, he said, compared to the drip.
“As of now, I haven’t found a capsule that whitens and makes the skin glow. But the IV can give you both.”
Like most countries in Southeast Asia, the Philippines has a longstanding obsession with fair skin, something myriad studies have credited to both pre-colonial hierarchies and, more significantly, beauty standards derived from Western colonizers.
Influence from TV and films, where stars to this day remain almost uniformly light-skinned, plays a very real role in reinforcing those standards.
But the obsession with skin-lightening comes at a cost some would argue is higher than the millions of dollars Filipinos annually spend on treatments and products pursuing it.
According to PhD scholar E.J.R. David, author of Brown Skin, White Minds, the psychic toll inflicted by the desire for lighter skin manifests itself in numerous negative ways including “lower self-esteem, greater depression symptoms, and lower levels of life satisfaction.”
“The evidence is clear that it has serious negative effects on the mental health and well-being of Filipinos,” he said in a recent interview with Coconuts.
Unfortunately, that desire also fuels an entire industry.
Whiteness on tap
“You look like you didn’t get much sleep, ma’am,” a drip lounge employee said on a sunny day this October to a woman, about 40 years old, who sat in a leather recliner.
At first blush, the place looks like any other spa. Soaps, lotions, and supplements welcomed guests on a shelf next to the entrance. But next to the seated woman was a tall metal rod. Atop it was an IV bag, the type you’d see in a hospital. It was filled with a transparent yellow liquid slowly making its way into her arm.
The procedure is known as the “drip” and the clinic has been specializing in it for four years.
“The most popular [service], of course, is glutathione drip,” said Dr. Manuel Ma, a general surgeon who years ago took the plunge into the vastly more profitable world of cosmetic enhancements.
Glutathione or “gluta” is an antioxidant naturally produced by the body. It plays a role in a number of bodily functions including the regeneration of the immune system, repairing of tissues, and improving liver function.
Commercially, however, glutathione is most known for its side effect: skin whitening. Step into the beauty aisle of any supermarket in Manila — or Thailand, or Singapore, or Malaysia — and you will see countless products that claim to have glutathione. It can be found in soaps, creams, and oral supplements.
But those aren’t enough if you’re serious about whitening, Ma explained.
“In order for the glutathione to be effective for whitening, you need an excess of it.”
Enter the drip.
Using an IV to transfer glutathione to the body lets one take in significantly larger amounts directly into the blood stream. Drips, which are available at numerous clinics around Metro Manila, come in mixes called “cocktails” that combine whitening substances like glutathione, vitamin C, and collagen.
According to Ma, a patient should ideally get a high dose of glutathione once a week for three to four months to get maximum results. One session can take anywhere from 45 minutes to an hour.
Patients also need to be committed for the long haul.
“It’s like when your hair is white and you dye it, then it fades and you have to [dye it] again,” Ma said. “You need maintenance.”
That maintenance comes with risks, but for Ma and many Filipinos like Juane, it’s worth it.
“[There’s] no longer a reason for someone who’s kind of ugly to stay ugly, because there are already a lot of places to go to [get enhanced]. It’s your fault if you remain ugly,” the drip clinic owner said before offering a sympathetic smile.
More than skin deep
Like other aspects of Filipino culture, the desire for light skin is rooted in the country’s colonial past.
While colorism existed to some degree in pre-colonial times, particularly among royalty, the fixation with white skin as we know it today likely rode the coattails of the invading Spanish, then Americans, said David.
“During colonial times, being mestizo/a or light skinned became strongly associated with beauty and social acceptability because of its proximity to the dominant and supposedly superior and more civilized colonizers,” he said. “Dark skin was associated with being native.”
Those attitudes only became more insidious as marketing exploded in the 20th century, according to Joanne Rondilla, a visiting assistant professor at Sonoma State University.
She points to soap advertisements from the American occupation. Ads at that time linked soap to cleanliness, whiteness, and the notion of improving or civilizing one’s self.
In other words, the desire to be “white” in the Philippines, she said, is tied to the underlying perks that supposedly come with it — a higher social class, greater income.
“It’s never about a particular flaw that you have. I think a lot of beauty processes really come down to class,” Rondilla said.
For skin-whitening evangelists like Dr. Ma, those aspirations of upward social mobility make for a key selling point.
“Our world right now is very competitive. You apply for a job, you need to be good looking,” he said. “So a lot of opportunities are missed by some individuals because they’re dark. They don’t have good complexion; they don’t enhance their beauty.”
On some level at least, he’s not entirely wrong.
Research by economist Daniel Hamermesh from the University of Texas in Austin has indicated that attractive men and women earn as much as 4% more than “average-looking” people, are promoted faster, and achieve higher positions in their companies.
In the Philippines, where popular ideas of beauty are routinely linked to lighter skin, this means one’s complexion can have a perceived bearing on success.
But for Rondilla, rationalizations like those offered by Dr. Ma are self-serving in the extreme for an industry that has carefully nurtured the skin color fixation for its own benefit.
The assistant professor, who wrote a dissertation on beauty and skin color hierarchy in the Philippines and the US while earning her PhD at the University of California Berkeley, became interested in the topic after herself working in the cosmetics industry.
“They’re going to frame it as, you know, these processes are good for you because they’re good for your health…we’re not trying to change who you are as a person, we’re trying to help you become the best or the better version of yourself,” she said.
That “better version,” of course, routinely happens to be several shades paler.
Unapproved, but unregulated
One of the most popular services at Ma’s clinic, the “Cinderella Drip” — a combination of vitamin C, glutathione, and alpha-lipoic acid from South Korea — can cost as much as PHP6,000 (US$117.24) per session, more than a quarter of the average monthly family income in the Philippines.
Those who want lighter skin but can’t afford glutathione treatments invariably turn to cheaper alternatives.
Juane, the vlogger, recalled a time when he was reduced to using a bleaching soap that sold for less than PHP20 (US$.39).
It worked at first, but the whiter skin came with negative side effects.
“You’ll really get whiter for a week. Then every time you wash, you’ll notice there’s really a difference. But after one week has passed, [the skin] will darken. It’s like it’s getting burned,” he said.
Joan Dulfo, a dermatologist who graduated from Far Eastern University-Nicanor Reyes Medical Foundation, said side effects like the burn Juane described are common when using whitening products.
One type of chemical burn is called ochronosis, which is usually caused by high amounts of hydroquinone, a chemical found in many skin-whitening products.
“[The] common percentage that you can buy off-the counter is hydroquinone 2 percent. But you can [find] hydroquinone [up to] 4 to 6 percent,” Dulfo said.
The Philippine FDA, which has prohibited drugs with more than five percent hydroquinone entirely, first jumped into the glutathione debate in 2011, just as the drip was becoming a popular whitening tool.
At the time, the agency released an advisory explicitly warning people against using glutathione in that manner, deeming high doses “unsafe” and warning of “serious consequences to the health of users.” The US FDA has also advised that such products are “potentially unsafe and ineffective.”
Six years later, glutathione drips — which can also be easily sourced online — remain unapproved in the Philippines as a skin whitener, though the FDA maintains no jurisdiction over the clinics and spas that use them.
Policing doctors who use glutathione in an unapproved manner is instead left to the country’s Professional Regulation Commission. In practice, however, enforcement is slow and irregular.
That’s a fact that seems unlikely to change anytime soon, said David.
“There’s a lot of money in the skin-whitening industry in the Philippines. It has become a very powerful industry,” explained the author, who went on to describe a conversation he had with Philippine Vice President Leni Robredo at a recent event by non-profit organization FYLPRO.
“She said something like ‘There will be a lot of opposition if a policy to regulate or stop it is imposed… It’s not going to be easy. It has to be deliberate, it has to be a product of collaboration with many other groups and government agencies’,” David recalled.
But with a multimillion-dollar industry at stake, how realistic are hopes for that kind of collaboration?
Until that does happen, Juane and thousands like him — fueled by the constantly reinforced message that their acceptance and success depends on it — have little incentive to give up their light-skinned dreams.
“It’s the same as putting on contact lens, [and] changing your hair, right?” he asks earnestly. “Why does skin lightening need to have a negative connotation?”