Michael Jackson's health and appearance
Michael Jackson (August 29, 1958 – June 25, 2009) was an American musician and entertainer who spent over forty years in the public eye, first as a child star with The Jackson 5, and later as a solo artist. Starting in the mid-1980s it became clear that Jackson's appearance was changing dramatically. His skin tone became lighter, his nose and facial shape changed, and he lost weight. The lighter skin tone was initially caused by either skin bleaching or vitiligo. Surgeons speculated he also had a rhinoplasty, a forehead lift, cheekbone surgery, altered his lips, and had a cleft put in his chin. Those close to the singer estimated that, by 1990, he had undergone around ten procedures. His autopsy reported facial scars consistent with cosmetic surgery, plus cosmetic tattoos to his eyebrows, eyes, lips and scalp.
Jackson and some of his siblings said they had been physically and emotionally abused by their father, and in 2003, his father admitted whipping Jackson as a child. Jackson rarely spoke about it, but when he did, he became very emotional and said he would vomit before meeting his father. Physicians said he suffered from body dysmorphic disorder. Deepak Chopra, a new age doctor and friend of Jackson's for 20 years, said: "What became his compulsion with cosmetic surgery was an expression of self-mutilation, a total lack of respect for himself." At some point during the 1990s, it appeared that Jackson became dependent on prescription drugs, mainly painkillers and strong sedatives, and his health deteriorated dramatically. He went into rehabilitation in 1993 with the help of Elizabeth Taylor and Elton John, but the addiction remained. He died of cardiac arrest on June 25, 2009.
Skin color 
Jackson's skin was a medium-brown color throughout his youth, but, starting in the mid-1980s, his skin gradually grew more pale through what was widely considered to be skin bleaching and changing of his features to appear European. These changes gained widespread media coverage. According to J. Randy Taraborrelli's biography, in 1986, Jackson was diagnosed with vitiligo, which Tarraborrelli noted was sometimes considered by doctors to be a consequence of damage done by bleaching chemicals over the years. Taraborelli noted that around the time Jackson began making his nose smaller, his skin became very gradually lighter and that he was using the over-the-counter skin-bleaching cream called Porcelana to achieve that look. Taraborrelli reported that Jackson's sister Latoya used Porcelana too, and that they had crates of this cream stored at their family home Hayvenhurst, "hoarding it as the most valuable beauty product ever produced."
New York plastic surgeon Dr. Pamela Lipkin who has never treated Jackson or reviewed his medical records, said, "when you look at the other features, the skin bleaching sort of goes along with what I think was his quest for beauty, so I have to wonder what came first? Vitiligo or lighter skin?" Noting that Jackson had even skin tone when he was younger, Lipkin's interpretation was that "probably he's trying to look Caucasian."
When producer Quincy Jones who worked closely with Jackson at the time Jackson's skin transformation began, was asked about Jackson's facial transformation he stated: "It's ridiculous, man! Chemical peels and all of it. And I don't understand it. But he obviously didn't want to be black...You see his kids?"
According to the affidavit of Sergeant Deborah Linden found by Vanity Fair reporter Maureen Orth in the Santa Maria courthouse complex, Jackson told his maid Blanca Francia "that he bleaches his skin because he does not like being black and he feels that blacks are not liked as much as people of other races." Orth was also informed that Jackson referred to blacks using unique names like "spabooks."
Taraborrelli also stated that Jackson was diagnosed with lupus, that the vitiligo partially lightened his skin and the lupus was in remission and both illnesses made him sensitive to sunlight, which could have caused his lupus condition to recur. Jackson's autopsy did not confirm or refute the claim that he had lupus, and with respect to vitiligo, his skin was found to have a reduced (though not absent) melanocytes, the cells active in skin pigmentation, something which may be consistent with vitiligo.
To treat these conditions, Jackson used Solaquin, Tretinoin, and Benoquin. He also had hydroxychloroquine injected directly into his scalp regularly. The treatments he used for his condition further lightened his skin tone, and with the application of pancake makeup to even out his skin tone, he could appear very pale. For example, Stevie Nicks recalled, in a Rolling Stone interview: "I remember before [we performed at Bill Clinton's 1993 inauguration], Michael sent somebody to find out if I had any foundation make-up he could borrow. I was using some light Chanel foundation at that time, and Michael sent back a note to say, thanks, but the foundation wasn't quite light enough for him."
In February 1993, Jackson gave a ninety-minute interview with Oprah Winfrey, his first televised interview since 1979. During this interview, he stated that he never bleached his skin and even stated that skin bleaching products do not exist, stating publicly for the first time that he suffered from a skin disease, and that he used heavy makeup to even out his complexion. The interview was watched by 62 million Americans. It also started a public discourse on the topic of vitiligo, a relatively unknown condition before then.
During the Australian leg of the HIStory World Tour, Jackson married his dermatologist's nurse, Debbie Rowe. The pair first met in the mid-1980s, when Jackson was diagnosed with vitiligo. She spent many years treating his illness, as well as providing emotional support, and they built a strong friendship before becoming romantically involved. The couple divorced in 1999 and remained friends thereafter.
Cosmetic procedures and diet 
His facial structure changed too; several surgeons speculated that, by the mid-1990s, he had undergone multiple nasal surgeries, a forehead lift, thinned lips, and cheekbone surgery. According to biographer J. Randy Taraborrelli, Jackson had his first rhinoplasty after breaking his nose during a complex dance routine in 1979. However, the surgery was not a complete success, and he complained of breathing difficulties that would affect his career. He was referred to Steven Hoefflin, who performed his second rhinoplasty in 1981. Katherine Jackson, though, has said in a recent interview that Michael's intentionally got his first nosejob from Steven Hoefflin. Taraborrelli stated Jackson had a third rhinoplasty three years later and a fourth in 1986. Jackson wrote in his 1988 autobiography Moonwalk that, in addition to the two rhinoplasties, he also had a dimple created in his chin. From 1986 onward he was a regular client of Arnold Klein, a dermatologist who specializes in dermal filler injection, a non-surgical cosmetic procedure.
In his book, Jackson attributed the changes in the structure of his face to puberty, a strict vegetarian diet, weight loss, a change in hair style and stage lighting. Jackson denied allegations that he had altered his eyes. By 1990, the full extent of Jackson's surgery was widely debated; those close to him estimated he had undergone ten operations on his face up to this point. In June 1992, the Daily Mirror ran a full front-page picture, allegedly of Jackson's face, which they described as "hideously disfigured" by plastic surgery. Jackson sued the tabloid, and, in 1998, they agreed to an out-of-court settlement with Jackson. At the High Court, the paper's former editor acknowledged that after meeting Jackson in person, he believed that Jackson was neither hideously disfigured nor scarred at all. A Daily Mirror solicitor maintained that the publication did not tamper with the picture.
Media reports stated that Jackson's autopsy reported scars beside his nose, behind his ears, and on his neck, "probably" from cosmetic surgery, plus cosmetic tattoos on his eyebrows, around his eyes and lips, and on his scalp (at his receding hairline).
In the unedited version of the documentary Living With Michael Jackson, which was shown in court in 2005, Jackson said he had two procedures on his nose so that he could breathe better. When he was asked about his cheeks, Jackson answered: "These cheekbones? No. My father has the same thing. We have Indian blood."
On the last day of the trial in 2005, the media used specific angles and lighting to accentuate Jackson's nose, as well as his cheeks and his skin tone.
Health concerns 
Childhood and mental health 
Jackson and some of his siblings stated that they were physically and mentally abused by their father Joseph from a young age, through incessant rehearsals, whippings and the use of derogatory names such as "big nose" for Jackson; this abuse had affected Jackson through all his life. In one altercation—later recalled by Marlon Jackson—Joseph held Michael upside down by one leg and "pummelled him over and over again with his hand, hitting him on his back and buttocks". Joseph would often trip the boys or push them into walls.
One night while Jackson was asleep, Joseph climbed into his room through the bedroom window. Wearing a fright mask, he entered the room screaming and shouting. Joseph said he wanted to teach his children not to leave the window open when they went to sleep. For a number of years afterward, Jackson suffered nightmares about being kidnapped from his bedroom. By the early 1980s, he was deeply unhappy; Jackson explained, "Even at home, I'm lonely. I sit in my room sometimes and cry. It's so hard to make friends... I sometimes walk around the neighborhood at night, just hoping to find someone to talk to. But I just end up coming home."
Although it had been reported for a number of years that Jackson had an abusive childhood, he first spoke openly about it in his 1993 interview with Oprah Winfrey. He grimaced when speaking of the childhood abuse at the hands of his father; he believed he had missed out on much of his childhood years, admitting that he often cried from loneliness. In the same interview, speaking of his father, Jackson said, "There were times when he'd come to see me, I'd get sick... I'd start to regurgitate. I'm sorry... Please don't be mad at me... But I do love him." In Jackson's other high profile interview Living with Michael Jackson (2003), the singer covered his face with his hand and began crying when talking about his childhood abuse.
Jackson recalled that Joseph sat in a chair as the group rehearsed, saying, "He had this belt in his hand. If you didn't do it the right way, he would tear you up, really get you. It was bad. Real bad." In 2003, the singer was accused of child sexual abuse and was acquitted two years later. During the investigation, Jackson's profile was examined by Stan Katz, a mental health professional, who spent several hours with the accuser as well. According to J. Randy Taraborrelli, the assessment made by Katz was that Jackson had become a regressed ten-year-old. Some medical professionals have publicly stated their belief that the singer also had body dysmorphic disorder, a psychological condition whereby the sufferer has no concept of how his or her physical appearance is perceived by others.
Weight and drug addiction 
The changes to his face were, in part, due to periods of significant weight loss. Jackson became slimmer in the early 1980s because of a change in diet and a desire for "a dancer's body". By 1984, Jackson had lost 20 pounds (9.1 kg), bringing his weight to 105 pounds (48 kg) on a 5 foot 9 (1.75 m) frame, the slimmest he had ever been as an adult. Witnesses reported that Jackson was often dizzy and speculated that he was suffering from anorexia nervosa. Following accusations of child molestation in 1993, Jackson stopped eating, losing even more weight.
In late 1995, Jackson was rushed to a hospital after collapsing during rehearsals for a televised performance (which was subsequently cancelled); a non-related writer claims that the incident was caused by a stress-related panic attack, while medics cited irregular beats, gastro-intestinal inflammation, dehydration, and kidney and liver irregularities. In none of these hospitalizations, including this one, did medics find drugs in Jackson's system. The BBC reported that during his 2005 trial, the singer again suffered from stress-related illnesses and severe weight loss.
A biographer states that in 1993, the entertainer admitted taking Valium, Xanax and Ativan to deal with the stress of the child sexual abuse allegations made against him, while Jackson himself does not mention sedatives, he stated that painkillers actually were prescribed to soothe excruciating pain that he was suffering after recent reconstructive surgery on his scalp. A few months after the allegations became news, Jackson had lost approximately 10 pounds (4.5 kg) in weight and had stopped eating. In a court deposition unrelated to alleged child abuse, Jackson was visibly drowsy, lacked concentration and repeatedly slurred while speaking. He could not remember the dates of his prior album releases or names of people he had worked with. It took him several minutes to name some of his recent albums.
Jackson also stated during the 1993 interview that he first began taking painkiller medications regularly in 1984. In January 24 of that year, Jackson was filming a Pepsi commercial when his hair caught on fire from faulty pyrotechnics on stage that were intended to be part of one of many being filmed. He sustained second-degree burns to his scalp and never fully recovered from the injury or from the lingering pain. He reportedly began taking the painkillers after refusing at first in order to deal with the intense pain.
Jackson's health had deteriorated to the extent that he cancelled the remainder of his tour and flew with friends Elizabeth Taylor and her husband to London. When the singer arrived at the airport, he had to be held up by his two friends; he was then rushed to the home of Elton John's manager and then to a clinic. He was searched for drugs on entry; vials of medicine were found in a suitcase. He took over the fourth floor of the hospital and was put on Valium IV to wean him from painkillers. The singer's spokesperson then told reporters that Jackson was "barely able to function adequately on an intellectual level". While in the clinic, Jackson took part in group and one-on-one therapy sessions. According to Taraborrelli, in January 2004, as his trial approached, Jackson became dependent on morphine and Demerol and was being treated for this dependency by herbalist Alfredo Bowman in Colorado.
In an interview with Aphrodite Jones, Patrick Treacy, a cosmetic surgeon who treated Jackson between July 2006 and early 2007, as well as shortly before his death, stated that he would have known if Jackson would have been also treated by another physician and that he never saw any drugs in the house. He also said that Jackson did not have insomnia and never asked him for narcotics. Treacy stated Jackson was in good physical health; he said Jackson always insisted on the presence of an anesthetist when Propofol was administered.
Christopher Rogers, a medical examiner who conducted the autopsy on Jackson in 2009 testified in the trial against Dr. Conrad Murray that, in his opinion, Jackson "was healthier than the average person of his age." He also said: "The theory that seems less reasonable to me is that Mr. Jackson woke up, and although he was under the influence of sedative medications, managed to give himself another dose." Rogers said the arteries around Jackson's heart were free of fat and cholesterol, which is unusual for a 50-year-old individual; Jackson was 5ft. 9in and weighed 136lbs, which would be within a normal weight range, although he was thin, Rogers testified in court. According to his costumer Michael Bush, Jackson lost so much weight during a concert due to loss of water that the costumes Jackson wore at the end of the show had to be smaller than those he wore at the beginning of the show; usually, he was a 28-inch waist.
Toxicologist Dan Anderson testified that Demerol was not detected in Jackson's system. According to Dr. Nader, Kamangar, a sleeping expert at UCLA drugs such as Demerol can cause insomnia. In the case of Jackson, insomnia could have been caused by "anxiety for performing" as well.
Following Jackson's death, a police warrant issued against his attending physician, Conrad Murray, stated that Jackson's many doctors had used nineteen distinct aliases, such as "Omar Arnold," "Josephine Baker," "Fernand Diaz," "Paul Farance," "Peter Madonie," "Faheem Muhammad," "Roselyn Muhammad," "Blanca Nicholas," "Jimmy Nicholas," "Bryan Singleton," "Frank Tyson," and "Rob Kaufman" while prescribing medications for Jackson. He also took prescriptions as "Prince," "Michael Amir," and "Kai Chase," the names of one of his sons, his spokesperson, and his former personal chef, respectively. Police found a CD mentioning the "Omar Arnold" alias when they raided the Las Vegas, Nevada home and office of Conrad Murray, Jackson's personal physician. Use of pseudonyms by celebrities' doctors is common practice for maintaining the confidentiality of patients' medical history, and does not necessarily indicate addiction.
Following Jackson's death, reports of his use of pethidine (Demerol) surfaced. Cherilyn Lee, a nurse who provided nutritional counseling to Jackson, said that on April 12, 2009 he asked her for unspecified "products for sleep." On April, 19 2009 he told her the only medicine that would help was propofol.  Lee refused, telling him, "Michael, the only problem with you taking this medication ... is you're going to take it and you're not going to wake up." Jackson dismissed the warning, telling her he had been given the drug before, by IV injection, and that his doctor told him it was safe. He did not name the doctor. An overdose of propofol can cause the patient to stop breathing, leading to a shortage of oxygen and a buildup of carbon dioxide in the body which can lead to arrhythmias and cardiac arrest. It was the last time they met. 
According to Lee, she received a frantic call on June 21, 2009 from an aide on Jackson's staff. The aide reported that Jackson was feeling ill. Lee reported overhearing Jackson complain that one side of his body was hot, the other side cold. She believed that somebody had given him something that affected his central nervous system. She advised the aide to take him to the hospital.
After his death, the autopsy report revealed that Michael Jackson had a strong heart and was a "fairly healthy" 50-year-old. According to BBC, his weight was in the acceptable range for a man of his height, but he had punctured arms, and suffered from lung damage and some arthritis. The document shows that Jackson's most serious health problem was his chronically inflamed lungs, but this was not serious enough to be a contributing factor to his death. The post mortem did not uncover any physical problems that may have limited Jackson's ability to perform. "His overall health was fine," said Dr Zeev Kain of the University of California, who reviewed the report for AP but was not involved in the post-mortem examination, "The results are in normal limits." The autopsy also revealed that he was partially bald, and that his lips, eyebrows and scalp were tattooed.
See also 
- Taraborrelli, pp. 434–436
- "Surgeon: Michael Jackson A 'Nasal Cripple'". ABC News. February 8, 2003. Retrieved Nov. 11, 2006.
- Can Michael Jackson's demons be explained?, BBC News, June 27, 2009.
- Posner, Gerald. Deepak Chopra: How Michael Jackson Could Have Been Saved, The Daily Beast, July 2, 2009.
- Campbell (1995), pp. 89–93
- Campbell (1995), pp. 14–16
- MICHAEL JACKSON: The Magic, the Madness, the Whole Story, 1958-2009 by J. Randy Taraborrelli, pg 351
- Page 2 of 2 (2003-02-08). "Page 2: Surgeon: Michael Jackson A 'Nasal Cripple' - ABC News". Abcnews.go.com. Retrieved 2012-11-22.
- Gordinier, Jeff. "Wiseguy Music Producer Quincy Jones on Michael Jackson: Men of the Moment". Details. Retrieved 2012-11-22.
- Orth, Maureen. "Losing His Grip". Vanity Fair. Retrieved 2012-11-22.
- Time Waster. "Michael Jackson Autopsy Report". The Smoking Gun. Retrieved 2012-11-22.
- "Repigmentation in vitiligo universalis: Role of melanocyte density, disease duration, and melanocytic reservoir". Dermatology.cdlib.org. Retrieved 2012-11-22.
- "Michael Jackson Remembered: Stevie Nicks on the Ultimate Showman". Rolling Stone. 9 July 2009. Retrieved 13 September 2012.
- "Thriller for Diane Sawyer: Interview with Jackson Two". Daily News (New York). May 18, 1995. Retrieved Jul. 3, 2009.
- Lewis pp. 165–168
- George, pp. 45–46
- 'I'm a black man turning white on television'", BrisbaneTimes, December 18, 2007
- Taraborrelli, pp. 580–581
- Taraborrelli, p. 597
- Taraborrelli, p. 570
- Taraborrelli, pp. 599–600
- Taraborrelli, pp. 205–210
- Taraborelli, Randy (2009-07-01). "How Jackson's surgery was a desperate bid not to look like the father he hated". Mail Online. Retrieved 2012-04-08.
- Jackson, pp. 229–230
- "CNN.com". CNN.
- Jackson, p. 256
- "Mirror says sorry for Jackson libel". BBC. November 9, 1998. Retrieved Jul. 29, 2008.
- Nick Madigan, The New York Times, http://query.nytimes.com/gst/fullpage.html?res=9C0DE4DC1030F931A25756C0A9639C8B63,May 12,2005,
- Aphrodite Jones, Michael Jackson Conspiracy, 2007, p. 266
- Aphrodite Jones, Michael Jackson Conspiracy , Edition 2007 p. 6
- "Michael Jackson's Secret Childhood". VH1. Retrieved Jun. 20, 2008.
- Taraborrelli, pp. 20–22
- Taraborrelli, p. 206
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- Taraborrelli, p. 602
- Taraborrelli, p. 648
- Taraborrelli, pp. 138–144
- Taraborrelli, pp. 312–313
- Taraborrelli, pp. 514–516
- Taraborrelli, pp. 576–577
- "v". CNN. Dec. 8, 1995. Retrieved Feb. 23, 2010.
- "v". HeraldOnline. July 8, 2009. Retrieved Feb. 23, 2010.
- "v". HeraldOnline. July 8, 2009. Retrieved Feb. 23, 2010.
- Davis, Matthew (June 6, 2005). "Michael Jackson health concerns". BBC. Retrieved Apr. 14, 2008.
- Taraborrelli, pp. 518–520
- "Michael Jackson's statement from 22nd December, 1993". MJLiveson. Dec. 22, 1993. Retrieved Feb. 23, 2010.[dead link]
- Campbell (1995), pp. 96–97
- Taraborrelli, pp. 524–528
- Taraborrelli, p. 661
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- Sandy Cohen, Michael Jackson's longtime costumer unveils book, http://www.denverpost.com/entertainment/ci_21198453/michael-jacksons-longtime-costumer-unveils-book, july 31, 2012
- Prosecutors show lineup of Jackson doctor's drugs, http://abclocal.go.com/ktrk/story?section=news/national_world&id=8381073, october 6, 2011
- Alan Duke, 'Perfect storm' of drugs killed Michael Jackson, sleep expert says, http://edition.cnn.com/2011/10/13/justice/california-conrad-murray-trial, october 14, 2011
- Michaels, Sean. "Michael Jackson aliases revealed." The Guardian. Thursday July 30, 2009. Retrieved on July 30, 2009.
- Ryan, Harriet. "Police seize medical CD labeled with Jackson pseudonym." Los Angeles Times. July 29, 2009. Retrieved on July 30, 2009.
- Harriet Ryan and Kimi Yoshino. "Investigators target Michael Jackson's pseudonyms." Los Angeles Times. July 17, 2009. Retrieved on February 23, 2010.
- Hip Hop News staff. "Dr. Allen Metzger Prescribed Medications for Both Michael and Janet Jackson!." Hip Hop News. July 6, 2009. Retrieved on February 23, 2010.
- Staff Writer (June 27, 2009). "UPDATE 3 - Jackson's family seeks second autopsy". Reuters. Retrieved July 2, 2009.
- Martin Kasindorf,Nurse: Jackson thought propofol safe with monitoring, http://usatoday30.usatoday.com/news/nation/story/2011-10-25/michael-jackson-doctor-trial/50906890/1,10/25/2011
- Elber, Lynn (June 30, 2009). "AP Exclusive: Michael Jackson, bedeviled by insomnia, begged for drug, says nurse-nutritionist". Metromix Los Angeles. Associated Press. Retrieved Jul. 1, 2009.
- AP Exclusive: Michael Jackson, bedeviled by insomnia, begged for drug, says nurse-nutritionist, by Lynn Elber, Associated Press, http://www.startribune.com/templates/Print_This_Story?sid=49548732, July 1, 2009
- Madison Gray, Nurse Tears Up Describing Michael Jackson’s Desperation for Sleep Drug, http://newsfeed.time.com/2011/10/25/nurse-tears-up-describing-michael-jacksons-desparation-for-sleep-drug/, Oct. 25, 2011
- "Michael Jackson "Desperately" Sought Sedative, Nutritionist Says". Rolling Stone. Associated Press. June 30, 2009. Retrieved Jul. 1, 2009.
- Staff Writer (October 1, 2009). "Jackson autopsy details revealed". BBC. Retrieved October 20, 2009.
Further reading 
- Campbell, Lisa (1995). Michael Jackson: The King of Pop's Darkest Hour. Branden. ISBN 0-8283-2003-9.
- George, Nelson (2004). Michael Jackson: The Ultimate Collection booklet. Sony BMG.
- Jackson, Michael (1988). Moon Walk. Doubleday. ISBN 0-385-24712-5.
- Lewis, Jel (2005). Michael Jackson, the King of Pop;: The Big Picture: the Music! the Man! the Legend! the Interviews!. Amber Books Publishing. ISBN 0-9749779-0-X.
- Taraborrelli, J. Randy (2004). The Magic and the Madness. Terra Alta, WV: Headline. ISBN 0-330-42005-4.