The cosmetic medical economy of the inner city

Take a walk downtown Joburg and you’re sure to find someone who will remind you that you need a bit of aesthetic assistance. It could the lady that approaches you with her hair extensions to remind you of your bad hair day, the brother selling slim-fit tights to point out that your potbelly is visible to all, the mama selling potions to help you recover that lost lover or the creams to help you get that extra “va-voom”. Regardless of your insecurity, the message from Joburg’s medical economy is clear: everyone falls short of something; they’re here to help you find it, then fix it.

By Nozipho Mpanza

Poster poster on the Joburg street pole, who is the fairest of them all? Well, of course it is she with the fair skin who flaunts her enlarged breasts, bums and thighs or he whose ‘package’ has done well with some extra help.

“If you’re going to ask me all of these questions, you’re going to have to sit here and ask me while I work, I’m busy,” says Lilly as she signals forward to her next customer. She is standing behind the counter table of her cosmetic stand, situated in a shop owned by other traders where she rents a small corner.

The view from her stand is busy; she sits across from the Noord market in Joburg where thousands of people pass through on their way to the taxi rank. Lilly is a stern woman. She’s always busy but she enjoys chatting.  The traders across from her sit under the scorching sun. Many of them are seated on the floor or along the pavement, trying desperately to escape the blistering heat.

Lilly doesn’t have these problems. She sits on a stool with her containers laid out in front of her and a roof over her head. It hasn’t always been this way for her.  She used to sit along the pavement outside of her shop and sell her facial creams for years before she could afford to be here.

Lilly doesn’t have these problems. She sits on a stool with her containers laid out in front of her and a roof over her head. It hasn’t always been this way for her.  She used to sit along the pavement outside of her shop and sell her facial creams for years before she could afford to be here.

“The metros used to chase us away and then I found a place on another side of town but business fell there so I came back here,” she says. Lilly says she fought for her trading corner in this shop owned by Pakistanis; she describes herself as a fighter.

The metro police regularly come into this side of town to raid the stalls of the informal traders all around Lilly’s store.

She recalls how she quickly she used to pack up her stock when she heard that they would be coming. Sometimes, she managed to make it in time but at the times that she didn’t, they would take her stock. Now she enjoys the benefits of having a stall.

No more panic and running, business is uninterrupted.

A woman, dressed in orange crop pants and a floral shirt, stops in front of her counter, picks up Carolight facial whitening cream and smells it. “How much?” the woman asks.

“Sikesty rand,” says Lilly as she stands, stopping the woman from dipping her finger into the cream. The customer sighs in discouragement.

“How much you have sisi?” Lilly asks in an attempt to negotiate. The lady reveals that she only has fifteen rand. “Will you give me for fifteen?” she asks. Lilly retreats back into her stool. “No, next time sisi”.

Lilly sees characters like orange-pants-mama daily.

People are always trying to bargain with her. She’s open to bargaining but refuses to be exploited because she has leverage; her creams can’t be found on retail shelves.

What’s in the cream?

”The government here doesn’t want them because they have hydroquinone,” says Lilly of her products, looking morose but sounding unbothered.

The creams are not sold in South African retail stores because they have been banned from trade by the government. Lilly imports them from other African countries including Mozambique, Congo and Ghana. The creams arrive by bus, train and ship. Lilly has many suppliers across the African continent, she cannot limit her supply chain to one distributor because the products come at different times and from different places.

The other prevailing ingredient in Lilly’s creams is mercury.  A study conducted by the World Health Organisation in 2011 found that 35% of women in South Africa use skin lightening products, on a regular basis, that contain mercury.

Hydroquinone is a skin lightning agent that hampers the production of melanin for one’s skin. It is used to remove dark spots and reduce skin pigmentation.

Medical experts warn against the use of these chemicals for daily usage creams. “Those chemicals are damaging and can cause scarring, leading to stretch marks, low resistance to infections and irreversible damage to pigmentation,” scolds head of dermatology department at the University of Kwa-Zulu Natal and President of the African Women’s Dermatology Society Professor Ncoza Dlova.

Regulation and legislation

A woman comes to the counter to buy cream. She tells Lilly that her cream is almost finished and she has seen the dark marks under eyes go away. They exchange pleasantries, then the lady points to Carolight and nods. Lilly stands from her chair and disappears into the back of the shop for a few minutes before re-appearing with a sealed box of the cream. The woman pays and sets off.

The containers displayed on Lilly’s counter are all empty.

“They can’t take what they can’t see,” she says of the Metro police who occasionally raid the shops when they have permits. Although Lilly has immunity from her stock being impounded under the bylaws that prohibit trading in undesignated areas on the streets like she used to, she still faces trouble when the authorities are allowed to enter shops because her products are banned.

So she keeps her trading stock away from the eyes of authorities and goes to fetch them as she makes her sales. This way, she loses nothing by her containers being confiscated.

Lilly is pleased with this. She explains it with a sparkle of cunning genius in her eyes, flaunting the satisfaction of outsmarting the regulation systems. This method is not unique to Lilly, Martha around the corner, “Aunty” on Wanderers street and Annie outside Park Station all admit to using the same system.

Officials from the Johannesburg Metro Police Department (JMPD) say they cannot do much about this since it is not in their authority to search warehouses. A JMPD official explains that they are instructed to confiscate goods which are in plain sight. They do not have the authority to search warehouses or store rooms, furthermore, they are not trained to identify the legality of the goods but the legality of the trader.

Therefore, their business is to only confiscate goods from the trader if he/she has no license to sell, not to focus on whether the goods are banned or not.

ALWAYS READY: The Johannesburg metro police department is an active part of Joburg’s market life. The officials are mandated to ensure that all vendors and traders comply with by-laws and take action against offenders. 


COMPETITION: Skin lightening creams have become popular in Joburg’s market places. Shown here are some of Lilly’s competitors.

SWEET DEAL: A whole new look is seemingly easy to come by in the streets of Joburg.

The creams are popular among young black women, especially those familiar with them from their home countries. “This thing is like a peanut in my home country, it’s easy to find,” Lilly says of the facial creams.

The instruction is to apply to the face and neck twice daily and results will be visible in a month.

The best results are achieved if the user sticks to one product, “don’t mix,” she says sternly as she holds the containers up to illustrate. At the price of R60, Lilly makes a profit of R10 for each unit of cream that she sells.

Her highest sales period is “at the end of the month,” but says her gains are negligible after paying school tuition for her three children aged ten, eight and four years old and then buying food.

Lilly knows her products very well. She was fifteen years old when she started using the cream herself.

At 36 years’ old now, she still swears by the cream she started using sixteen years ago to even and lighten her skin.

She’s proud of how she’s always been able to sell the product by example “they just look at my face and buy,” she says of how she convinces customers to purchase.  She has been making her livelihood from her beauty products since she arrived in South Africa from DRC in 2000.

Lilly recalls being one of few traders selling facial lightening creams when she arrived in South Africa 16 years ago.

The market has changed and Joburg’s cosmetic economy has since attracted many more sellers who aim to make a living off people’s desire for beauty and social acceptance.

A young boy hands out flyers in the middle of Wanderers street in Joburg’s CBD. “*Chief Luke, fresh from the mountains,” it reads.

After four rings, a man picks up the phone. It’s Chief Luke. He speaks in a friendly and gentle tone. Luke is both a manufacturer and retailer for his product. He has been making and selling cosmetic products for “a long time”.

“There are no side effects to my products,” he says proudly. His offerings vary from penis, hips and bum enlargement creams to potions for retrieving your lost lover.

Chief Luke mixes his products to conform to the standard size. “12 Centimeters is the standard size for a penis,” he says as he describes the specifications around which he makes his mixtures. His penis enlargement cream is sold in a tub weighing five grams and guarantees results within 17 days. The instruction is to apply the cream twice a day for the 17-day-period and see results. “The cream is permanent,” he says.

Confidence oozes out of the Tanzanian craftsman over the telephone as he speaks about the successes of his products. He has never received negative feedback from any of his clients. He mixes his creams using loco medicine- a mixture of trees, leaves and grassroots. The herbs are sourced from all around Africa and he says his creams are applicable to men of all ages.

The bum and hip enlargement creams, much like the penis enlargement cream, have permanent effects. The 17-day results period applies equally and the R700-R750 cream can also be used for breast enlargements.

“You cannot get a large penis from rubbing cream, any qualified doctor knows that there is no such thing. They are playing at the ignorance of the people,” says an irritated Dlova.

But, Luke’s certainty in the success of his product tells a different tale. He must be an industry leader in his field. Although there are hundreds of posters shouting “PENIS ENLARGEMENT. HIPS AND BUMS ENLARGEMENT” all around town, many of the numbers lead to one of two people: Luke or the man who seems to be his greatest competitor, Frank.

Frank is much less friendly. Much like Luke, his magic lies too in his creams. The Congolese man offers his creams at a standard rate of R450 and guarantees results within seven days with identical instructions to Luke’s.

Although widely advertised, endless follow up calls to the cellphone numbers attached to the posters pasted on street lamps and “danger boxes” all around the city show that the medical economy for cosmetic procedures in Joburg is tiny. Perhaps run by no more than five practitioners. Most of them charge a standard R100 consultation fee before purchasing the product and few will give you the correct name.

It’s difficult for them to talk about their businesses. They don’t trust anyone and the value of their trade is in its secrecy.

The art of the trade

DO IT YOURSELF: How to create your own beauty treatment’s using Joburg’s secrets. 

It’s 4.30pm and Lilly is almost headed home to her husband and children  in Ridge Park towards the south of Johannesburg. Although exhausted, she must hurry home to prepare food for her husband and children. He doesn’t like to arrive home before her.

“God willing, tomorrow is another day.”

Although different in their contexts, Lilly, Luke and Frank have come in pursuit of success in Joburg’s concrete jungle and tomorrow is indeed another day to make it happen – this is Joburg, you will always find someone with a profitable insecurity.

*Names have been changed.