Standing in a small wooden booth cluttered with brightly colored cosmetics boxes a heavily made up woman unwraps a syringe and a needle, then fills the syringe with pink cream that's been decanted from a blue packet. "You must only use a small amount, otherwise you can become albino. This is strong stuff," she says as she pricks her customer's skin.
The popularity of skin-bleaching injections has rocketed over the last 18 months according to Dr Pranav Pancholi, a Harvard-trained dermatologist who works at Kenya's Shah Hospital. Pranav says because it's a recent phenomenon, no one really knows what the long-term health implications are.
Rose injects Mercy, a customer, with skin whitening cream.
On River Road the skin bleaching specialists hawk their goods sitting on stools in the street or standing in the doorways of their shops, some of which are just wooden booths rammed full of small colored boxes and creams. The more ramshackle beauty salons have gaudy hand painted signs, and sit sandwiched between seedy bars, DVD sellers, and starkly lit brothels. Others are slightly more upmarket, with large glass windows and neon signs.
The sellers are all women and know how to hustle. They can be brash and aggressive, often standing outside and whispering and hissing at women who pass by to entice them into their shop.
When I first went to River Road and started to talk to people about taking photographs the sellers harassed me, asking me what I wanted, and even pushing me into a room where they could quiz me about what I was doing. They demanded over $500 to tell their story then kicked me out onto the street with dirty looks when I refused to pay it. Skin bleaching is a sensitive topic in a conservative and religious country like Kenya, and operating unlicensed salons that offer injections is against the law. It only survives though institutionalized bribery and if any of the skin bleachers get into trouble it's likely they'll need to make a hefty payout to avoid jail.
Rose shows her elbows – the only evidence of what color her skin used to be.
Rose is different to the other women I meet. Self-assured, but less aggressive. She is proud of her business and willing to show me around without extorting me for money. Under her heavy makeup her skin is thin and pale after five years of continuous whitening treatment. Her previous skin color is only hinted at by areas of darker skin around her knuckles and elbows.
At first she denies that she provides the skin bleaching injections, but after an hour of talking she tells me that she does offer the injection treatments and agrees to show me how they work.
Rose's workplace is one of the many rickety and disorganized looking skin treatment booths. In the tiny room Rose proudly shows me her book of accounts, thick with names and numbers. She also introduces me to a customer who is waiting for her first skin bleaching injection, a giggly, outgoing woman in her mid-twenties who didn't want to be names, so I'll call her Mercy. Mercy tells me that she lives close to River Road and also sells bleach creams.
Mercy is excited about receiving the expensive treatment. As we wait for Rose to get a syringe from a nearby pharmacist she tells me that she has been using skin whitening creams for a couple of years and they have already helped to "brighten" her skin color, but she finds the process too slow.
A box of skin whitening treatment.
When she gets back from the pharmacy Rose carefully prepares the injection and I take a look at the treatment's packaging.
According to the box the treatment should show visible results in one to two weeks. It comes from Kinshasa in the Democratic Republic of Congo, and it contains AHAs, or alpha hydroxy acids.
Later I show Dr Pranav a photograph of the treatment's packaging and he tells me alpha hydroxy acids are a type of corrosive compound used in chemical peels and can cause serious health problems if used incorrectly. Medical professionals don't normally inject products containing AHAs as they can cause serious infection and kill body tissue causing flesh to waste away. Pranav also explains that the black market creams and treatments used in Kenya often contain powerful steroids that cause skin to become thin and easily damaged.