Use Of Skin-lightening Products Research Articles

Health Risk Associated with Conventional Skin Lighteners and Female Civil Servants’ Comprehension of Skin Lightening Ingredient Information in Anambra State

Skin-lightening products have been in use for many years to lighten skin colour. However, these products contain chemicals that can alter the skin's chemical structure and inhibit the production of melanin. Therefore, users of these products need to understand the ingredients and the potential health risks associated with their use. A study was conducted to assess the health risks associated with conventional skin-lightening products and to determine how well female civil servants understood the ingredient information on the product packaging. The study aimed to determine how many women read the ingredient information on these products, how many understood the information, and how many were aware of the health risks associated with their use. The study was conducted as a survey of 348 civil servants from 21 Ministries in Anambra State using an online sample size calculator. The study was anchored on the Individual Difference theory and selective perception media effect. The survey found that a significant number of female civil servants in Anambra state do not read the ingredient information on skin-lightening products. It was also discovered that the majority of female civil servants in Anambra State do not comprehend the product ingredient information because of its technical nature. Despite this, the study found that most women were aware of the health risks associated with the use of these products. The study concluded that female civil servants in Anambra State were aware of the ingredient information composition on skin-lightening products, but did not read it, making it difficult for them to understand and interpret the information. However, most of these women were still aware of the health risks associated with the use of skin-lightening products but still used them because of the benefits they claimed to have experienced. The study recommended that manufacturers and brand designers should simplify the technical language used to describe the product ingredients to make it easier for users to understand. Additionally, regulatory agencies like NAFDAC and SON should ensure that manufacturers produce skin products that do not contain harmful chemicals like hydroquinone, corticosteroids, and mercury. If these chemicals are used, users should be informed of the negative side effects.

Perceptions of Sun Protection, Skin Tone, Colorism, and Dermatologic Care Among South Asians in the USA.

South Asians (SAs) are among the fastest growing populations in the USA. Colorism - the system of inequality that views lighter skin as more advantageous in society - is prevalent in SA culture. This study evaluates motivations of sun protection use, attitudes of colorism, and skin lightening (SL) practices among SA Americans. Two-hundred-four participants recruited from online forums and ResearchMatch completed a questionnaire. Over half (111/204) reported use of sunscreen, of which 39.6% (44/111) reported daily or frequent use. Nearly half of respondents (98/204) believed that they are not at risk for skin cancer, with 37.7% (77/204) reporting minimal knowledge of skin cancers and only 4.9% (10/204) receiving a total body skin exam. One-third (65/204) reported being more concerned about prevention of tanning than skin cancer. In total, 38.2% (78/204) of respondents reported use of SL products, of which 33.3% (26/78) reported hydroquinone-based products and 26.9% (21/78) were unaware of the ingredients in their SL product. Only 16.7% (13/78) consulted a medical professional before using SL products. While many agreed that SA culture places high importance on light skin with regards to beauty standards (82.3%, 168/204), less noted that lighter skin is more beautiful (37.0%, 74/204). SL users more strongly agreed with colorism attitudes than non-users. Limitations include a small sample size with younger participants. Dermatologists must be mindful of the cultural motivations for skin tone preferences, sun protection habits, and SL behaviors and provide culturally relevant education on sunscreen, skin cancer, and risks of SL for the SA community.

Skin-lightening products and Jordanian women: Beliefs and practice. A cross-sectional study.

The use of skin-lightening products (SLPs) among Jordanian women has immensely increased and healthcare professionals have a vital role in raising public awareness of SLPs. The aim of this study is to identify SLPs practices among Jordanian women and their basic knowledge of the agents and the side effects associated with using these products. A cross-sectional study conducted during October to December of 2022. Jordanian women above 18 years of age were invited to participate via a survey link. Descriptive statistics were used, and logistic regression was applied to screen for variables affecting the knowledge score of the participants. The mean age of the study participants (n = 384) was 32.04 (SD = 12.678). Results demonstrated that more than half of the participants (n = 193) reported current or past use of SLPs. Additionally, less than one-fifth (18.2%) of the participants (n = 70) reported previously experiencing some side-effects after using SLPs. About 90% of participants thought that these side-effects were caused by the active ingredients in SLPs. Most of the participants were able to identify some of the active ingredients used in SLPs such as Vitamin C (87.8%) and Hydroquinone (62.0%). It was also found that young participants, and those employed, or university students had higher knowledge scores of SLPs' active ingredients, and of their side-effects. This study demonstrated that Jordanian women are adequately informed about skin-lightening products. Moreover, the practices revealed an educated pattern of action when obtaining information regarding SLPs. Fundamentally, healthcare providers should be influential in educating consumers on the proper use. Strict guidelines and policies should target the practices concerned with these products.

Skin-Lightening Product Use Among South Asian Americans: Cross-Sectional Survey Study

Background Despite their potential for adverse health effects, skin-lightening products remain popular among South Asian Americans. Objective This study investigates attitudes toward skin tone and the prevalence and adverse effects of skin-lightening product use among South Asian Americans. Methods We conducted a cross-sectional study, recruiting and surveying 175 women or nonbinary individuals meeting the following inclusion criteria: (1) lived in the United States, (2) identified as South Asian, and (3) were raised by parents born in South Asian countries. Results Of the 175 participants, 55 (31%) respondents used a skin-lightening product before. Parental pressure to use skin-lightening products and decreased time spent in the United States were significantly associated with skin-lightening product use (odds ratio [OR] 8.51, 95% CI 3.33-21.78, P<.001, and OR 0.70, 95% CI 0.52-0.96, P=.03, respectively). Although only 6 of the 55 (11%) users reported being aware of the potential side effects of skin-lightening products, 33 (60%) reported adverse effects, with acne, skin sensitivity, and dry skin being the most common. Users and nonusers equally endorsed statements associating lighter skin with increased attractiveness (P=.31), marriageability (P=.94), social status (P=.98), self-esteem (P=.73), and respect received from others (P=.74). Conclusions The use of skin-lightening products among South Asian Americans is common and linked to social and psychological factors. Parental pressure and cultural beauty standards may play a significant role in perpetuating this practice. This study highlights the need for educational campaigns about the potential health risks associated with skin-lightening and increased efforts to challenge harmful beauty standards.

Women's knowledge, perception, practice, and experience of using of skin-lightening products in the United Arab Emirates (UAE): A cross-sectional survey.

Skin lightening products (SLPs) are popular among women for medical and non-medical reasons. Therefore, this study aimed to determine the extent of SLP use among women, identify their sources of information, explore factors associated with SLP use and SLP related knowledge, attitudes, and practices (KAP) among women in the UAE. A structured questionnaire in English and Arabic was distributed to women in the UAE. The questionnaire included demographic characteristics, knowledge (10 items), attitudes (10 items), practices (9 items), and four additional questions on SLP use. Adequate KAP scores were defined as a score of ≥70% out of the maximum score for each KAP section. Chi-square tests were used to test associations between demographic characteristics, dichotomized KAP scores, and SLP use. The study included 370 participants, 50% of the respondents were aged 18-24, and 40% were from the Middle East, 64.8% were unmarried, 91% had university degrees, and 50% had healthcare related profession. Among the respondents 25% use SLPs, the majority use SLPs for non-medical reasons. Employment status is significantly associated with SLP use. The percentage of participants with a knowledge, attitude, and practice score of ≥70% is 66.48%, 76.75%, and 74.72% respectively. Type of profession was significantly associated knowledge and practice. In addition, nationality was also associated with practice. This study highlighted knowledge, attitude and practice gaps and varied levels of SLP-related KAP among women in the UAE. To promote the rational use of SLPs, educational campaigns and stricter regulations are necessary.

Tackling colourism through storytelling in an online course for public health professionals

Objective: Strategic storytelling can be used to reframe dominant cultural narratives and improve community health outcomes. This pilot study assessed the impact of an original, online 3-week e-course, delivered from November to December 2021, in increasing learners’ knowledge of and concern for the seriousness of skin-shade discrimination and the use of skin-lightening products in India, increasing learners’ understanding of storytelling-based communication techniques for public health promotion, and increasing learners’ intentions to use strategic storytelling for social change. Design, Setting and Method: The course used case-method pedagogy to address colourism and cosmetic skin lightening. Learners ( N = 25) completed a pre-course baseline survey on their knowledge and concerns regarding colourism and the use of skin-lightening products, as well as their expectations and interests in taking the course. Following course completion, learners completed a post-webinar survey. The Wilcoxon Signed-Rank test was used to assess differences from pre- to post-course surveys on quantitative items. Open-ended responses were also analysed using qualitative content analysis for recurring themes on learner interest and experience. Results: From pre- to post-course surveys, there were significant improvements in learners’ knowledge of skin shade discrimination and the use of skin-lightening products ( p < .05). Learners indicated being more concerned about the seriousness of skin shade discrimination post-course compared to pre-course. Learners also described a positive learning experience and indicated that the e-course enhanced their understanding of strategic storytelling. Conclusion: Findings highlight the importance of an original e-course that uses case-method pedagogy to build knowledge and skills that addresses the impacts of colourism on the health of Indian adolescents and provides new directions for future research on health education interventions that aim to tackle colourism.

Skin Lightening: Knowledge, Attitude, Practices and the Motivations for its Use Among the Residents of Ikeja Local Government Area, Lagos

Background: Skin lightening has become one of the strongest desires of Nigerian women and men, and its practice keeps increasing despite its numerous side effects. Objective: To determine the knowledge, attitude, and practices of skin lightening and the motivations for its use among the residents of Ikeja Local Government Area (LGA), Lagos State. Methods: A community-based, descriptive, cross-sectional study was conducted among 296 residents of Ikeja LGA, Lagos state, using a multistage sampling technique and an electronic, self-administered questionnaire in the Google form format. Results: The mean age of the respondents was 25.92±6.15 years, with 64.0% being females, 75.0% being single, and 75.2% had at least, a tertiary education. Most (98%) respondents demonstrated a high awareness of skin lightening; 66.9% had good knowledge, while 72% had a positive attitude. About half (52.7%) of the respondents had used various skin-lightening products, while most (71.8%) claimed the main reason for their use was to treat skin disorders. Age, gender and educational level were significantly associated with the use of skin-lightening products (p = 0.001). Conclusion: There was relatively good knowledge and a positive attitude towards skin lightening but a fair practice. The commonest reason for using skin-lightening products was for self-treatment of skin disorders. Healthcare providers should provide extensive public enlightenment on the adverse effects of skin lightening.

Knowledge, perceptions, practices, and health risk awareness of African Basotho women towards skin lightening products: a cross-sectional survey

the use of skin lightening products (SLPs) by women is poorly documented in Africa, with statistics from some countries entirely missing. This study assessed knowledge, perceptions, practices and factors associated with health risk awareness of African Basotho women towards SLPs. this was a questionnaire-based cross-sectional study based on convenience sampling of females in secondary/high schools, universities, factories and business offices in Maseru City, Lesotho. Analysis of the differences in knowledge (adequate ≥50% score), perceptions, and practices between four participant groups was based on ANOVA, p<0.05. Associations between sociodemographic variables and the use of SLPs were performed using logistic regression model in SPSS version 27. a total of 468 participants out of 496 responders qualified for data analysis based on predefined data cleaning criteria. Knowledge about SLPs was adequate (78.2%, n=468). By proportion, the main sources of the SLPs were supermarkets (67.6%, n=183) and pharmacy stores (41.9%). About 43.7% (n=468) of the participants used SLPs, with the factory workers mostly associated with SLPs use (aOR: 2.91, 95% CI 1.15-7.40; p=0.02). The majority (53.4%, n=131) of users had inadequate knowledge about the link between skin lightening and skin problems. The most common reasons for use of SLPs were rash (pimples, blemishes) (43.9%, n=107), dry skin (41.1%) and skin reddening (33.6%). there was adequate knowledge and moderate practice of skin lightening among African Basotho women. Public awareness campaigns and strict regulations are required to address the problem of SLPs use.

Frequency of Use of Skin-Lightening Products, Levels of Self-Esteem and Colorism Attitudes in University Students of Karachi: A Cross Sectional Study

The objective of our study was to determine the frequency of use of skin lightening/whitening products, level of self-esteem among university students, and any association between them. A cross-sectional study was conducted at Jinnah Medical and Dental College and the University of Karachi over a period of 12 months on a convenient sample of 499 students of both genders. Self-esteem was measured using Rosenberg Self Esteem Scale, and the use of skin whitening products and attitude towards skin color was determined using a structured questionnaire. Data were analyzed using SPSS 21.0. Out of n = 499 participants, 30.9% (n = 155) responded that they had used skin lightening products during their life. Of those who said yes, 15.1% (n = 76) responded that they are currently using such products. 63.8% (n = 321) classified their complexion as medium, 29.8% (n = 150) classified it as fair and 5.2% (n = 26) classified themselves as having dark complexion. 73% (n = 367) of people were completely satisfied with their complexion, while 20.1% (n = 101) wished for a lighter shade. Self-esteem scores were calculated, and it was found that 89.9% (n = 452) participants had scores above 15, and only 9.3% (n = 47) participants had low self-esteem, having scores below 15. Only 1% (n = 5) having dark complexion, 5.4% (n = 27) having medium complexion and 2.8% (n = 14) fair suffered from low self-esteem score. The frequency of use of skin lightening products was found to be low in university students from the sample population. The majority had good self-esteem and were satisfied with their complexion. There was no relationship between complexion and self-esteem in the study sample.

Quantitative multilayered assessment of skin lightening by photoacoustic microscopy.

With the emergence of various new skin-lightening products, there is an urgent need to scientifically evaluate the efficacy and toxicology of these products, and provide scientific guidance for their use based on physiological differences between individuals. Visualized imaging methods and quantitative evaluation criteria play key roles in evaluating the efficacy of skin-lightening products. In order to quantify the changes in the multilayered morphology and endogenous components of human skin before and after the use of lightening products, high-resolution three-dimensional (3D) imaging of human skin is required. In this study, photoacoustic microscopy (PAM; SSPM-532, Guangdong Photoacoustic Medical Technology Co., Ltd.) was used to capture the morphological structures of human skin and reveal skin components quantitatively. The efficacy and safety of skin-lightening products were evaluated by measuring skin melanin concentration and observing skin morphology. The melanin concentration in the epidermis was obtained by examining the linear relationship between photoacoustic (PA) signals. Further, the epidermal thickness and the melanin distribution were obtained in the cross-sectional (x-z) and lateral (x-y) images. Finally, the efficacy of skin-lightening products was evaluated according to the concentration and distribution of melanin in the epidermis, and the safety of cosmetics was assessed by observing the vascular morphology in the dermis. PAM noninvasively could assess the multilayered morphological structures of human skin, which allowed for quantification of epidermal thickness and melanin concentration of different skin sites. Based on this, the efficacy and safety of skin-lightening products in multilayer structures were quantitatively evaluated. As a quantitative imaging method, PAM, has the potential to accurately evaluate the use of skin-lightening products. The method can also be extended to assessments within the larger field of aesthetic medicine.

Time to removal of sutures from the palmar surface of the hand in dark-skinned patients: Results in a prospective cohort of 146 hands

The objective of this study was to estimate the time to removal of a suture from the palmar surface of a dark-skinned adult hand. A descriptive and analytical study included a cohort of 146 patients, 57% male, with a mean age of 37 ± 14 years, covering a period of 10 years. The mean time to removal of sutures on the palmar surface of the dark-skinned adult hands was 21 ± 2 days. Complete epithelialization of the suture path was the clinical indication for the ideal day for removal. After removal, closure was total in 90% of cases (132 hands) and partial in 9% (14 hands). The day of suture removal was significantly (p = 0.006) related to wound healing (complete closure). Eighty-five percent of patients without complete wound closure at suture removal had history of use of skin-lightening products. Tobacco use significantly lengthened time to suture removal (p < 0.001). There was a correlation between patient age and time to suture removal. On multivariate analysis, three factors were predictive of suture removal later than day 21: being a manual worker (44% of patients) (p 0.006), suture location in a palmar fold area (<0.001) and the age of patient, the 41–50 years (p = 0.001) and >50 years (p < 0.001).

V

Background: Skin lightening products (SLP) are widely used cosmetics among people that may result in lightening of skin complexion and may damage the skin. There seems to be a strong demand for lighter skin tone that is shared globally and promoted by the media. Aims and Objectives: To investigate the knowledge, attitude, and use of SLPs and its social and psychological correlation among people in a south Karnataka district Materials and Methods: A cross sectional survey, 2000 individuals irrespective of age and sex from a district in south Karnataka responded to a questionnaire. Results: This study explored SLPs use among 2000 individuals irrespective of age and sex in Hassan, Karnataka using a questionnaire. A total of 33.8% of the sample reported currently using SLPs, with women being two times more likely using these products. Among current users, 12.8% reported past experiences of adverse side effects. “Friends” and “Family” were the most common influence for using fairness products, followed by “Advertisements”. Discussion: Cosmetics market is flooded with skin lightening products and rampant use of the same has become a major public health concern in all countries along with the reinforcement of racism and social disparities. Side effects for skin lightening products are less reported which is similar to other studies. This could be the reason why there is no regulation of the products or the ingredients in the products. Conclusion: A high prevalence of SLP use was found in a sample of population in south Karnataka, and several social and mental health-related risk factors were found that may help in guiding interventions.

A survey evaluating knowledge, perception, and use of skin lightening products among South African students.

BackgroundIn sub-Saharan Africa, the use of skin-lightening products (SLPs) for cosmetic purposes has become common practice among women with dark skin tones. Despite the associated risks, the practice is still significantly increasing in Africa. The objective of this study was to determine the knowledge, perceptions and practice toward skin lightening among young adults.MethodsA cross-sectional survey among health science students at a tertiary institution in the Western Cape of South Africa was conducted.ResultsA total of 401 participants were included in the sample. There was a low prevalence (12%) of skin-lightening practice among students, which could possibly be a result of students being aware of the associated side effects. Participants believed that family and friends are most likely to influence this behavior (48%) and perceived that individuals who practice skin lightening do so because this provides a more fashionable look (76%). Men and women were found to be equally likely to use SLPs, and those residing in urban settings are 10 times more likely to engage in the practice compared with rural dwellers.ConclusionThis study contributes valuable information on the phenomenon of skin lightening among a diverse group of young adults. The results highlight the influential role social media platforms and family members play in motivating use of SLPs. Furthermore, the equal likelihood of use among both sexes suggests that the practice is growing among males.

Prevalence, determinants and perception of use of skin lightening products among female medical undergraduates in Nigeria.

BackgroundSkin Lightening Products (SLP) are common in Africa especially in Nigeria. Adverse effects from these products present a public health concern. Data on the use of these products among medical students is scanty.ObjectivesThe aim of the study was to determine the prevalence, determinants and perception of use of SLP among female undergraduate medical students in Nigeria.MethodsA cross‐sectional descriptive study was conducted among female medical students selected by convenient sampling. An on‐line survey was done with google forms using a semi‐structured self‐administered questionnaire containing participants’ biodata, history, pattern and perception of use of SLP. Data was analyzed using IBM SPSS Statistics 20.0.ResultsA total of 110 respondents completed the study with over half (62; 56.4%) of them ranging between 20 and 24 years of age. The prevalence of SLP use was 45/110(40.9%) with facial cleansers being the commonest product used [23/45(51.1%)]. Over 80% of participants knew SLP could cause adverse effects with ‘skin irritation’ being the most identified [71/110(64.5%)]. Although most (80%) respondents did not think that light skin was superior to dark skin, ‘removal of discoloration/dark spots’ (40%) and ‘cosmetic reasons’ (37.8%) were the commonest reasons for use. Determinants of use of SLP were light skin color (OR 3.8, 1.572–9.318), history of use among relatives (OR 3.3, 1.384–7.793) and awareness of adverse effects (OR 3.3, 1.129–9.740).ConclusionThe prevalence of use of SLP was quite high among the respondents and was predicted by ‘skin color’, ‘use among relatives’ and ‘awareness of adverse effects’. Education of the general public on their adverse effects is paramount to avoid harmful use.

Skin-lightening practices among shoppers in select markets in Kumasi, Ghana: A cross-sectional survey

BackgroundDespite warnings about its harmful adverse effects and the implementation of regulatory bans, anecdotal reports suggest high use of skin-lightening agents in Kumasi, Ghana.ObjectiveTo estimate the prevalence and motivation for skin-lightening agent use and nonuse among shoppers in Kumasi, Ghana.MethodsThis is a cross-sectional survey of a convenience sample of shoppers in 3 of Kumasi's largest markets.ResultsOf the 350 shoppers who were approached, 334 consented, for a response rate of 95%. Data were analyzed on 331 completed surveys. A total of 40.4% of individuals reported current or past use of skin-lightening products, and 26.6% of men reported history of product use compared with 56.5% of women. Female sex was significantly associated with skin-lightening product use (odds ratio 3.59; 95% confidence interval 2.26-5.70). Users of skin-lightening agents were more likely to agree with statements that associated lighter skin with beauty, self-esteem, attractiveness, and wealth.LimitationsUsing a nonrandomized convenience sampling method on a single city limits the generalizability of the results. Response, recall, and social desirability biases may have skewed the results, especially given the stigma associated with skin-lightening agent use.ConclusionThe practice of skin lightening among all participants is high and is associated with perceptions of increased beauty, attractiveness, self-esteem, and wealth.

Mercury Exposure Associated with Use of Skin Lightening Products in Jamaica.

Background.Skin bleaching is a major health concern among Jamaicans. A common ingredient in skin lightening products is mercury. Mercury is a toxic substance that can cause damage to the gastrointestinal tract, nervous system and kidneys.Objective.The objectives of this study were to use different analytical techniques to measure mercury concentrations in popular skin lightening products used in Jamaica and to assess individual levels of mercury exposure based on product usage.Methods.Sixty skin lightening products were purchased from different vendors across various locations in Jamaica. Each product was initially screened for mercury using a portable handheld energy dispersive X-ray fluorescence (XRF) analyzer. In addition, 25 out of 60 products were further measured using cold vapor atomic absorption spectroscopy (CVAAS). Questionnaires were distributed to users of skin lightening products to determine their usage patterns.Results.Six products had mercury concentrations above the United States Food and Drug Administration (FDA) allowable limit of 1 ppm, of which three products contained alarmingly high concentrations (i.e. > 400 ppm). The majority of products (57 out of 60) had mercury concentrations below 10 ppm. The mercury concentrations in skin lightening products ranged from 0.05 ppm to 17,547 ppm. In our sample, 51% of women and 49% of men used skin products more than once per day.Conclusions.On average, creams contained more mercury than lotions and soaps. Individuals who use skin lightening products in Jamaica may be at risk for high mercury exposure, as some popular products were found to have mercury concentrations above the allowable limit.Competing Interests.The authors declare no competing financial interests.

Skin lightening practices, beliefs, and self-reported adverse effects among female health science students in Borama, Somaliland: A cross-sectional survey.

BackgroundSkin-lightening (SL) products are common, especially in Africa. Adverse effects from these products represent a public health concern. Use of these products in Somaliland is unknown.ObjectiveThis study aimed to determine the prevalence of use of SL products among female health science students, beliefs about these products and practices, and adverse effects experienced.MethodsThis was a cross-sectional survey of a convenience sample of female health science students at Amoud University in Borama, Somaliland.ResultsOf the 400 students who were invited to participate, 265 completed the survey (response rate: 66%). Mean participant age was 21.1 years (standard deviation: 2.0 years). The majority of students were single (91.2%) with a Fitzpatrick skin type of 3 or darker (94.2%). Past or present use of SL products was reported by 25.6% of participants, and 52.2% admitted to current use. Compared with non-users, more SL product users agreed that lighter skin color gives a woman more confidence, helps a woman have better job opportunities, and increases chances of getting married. They also agreed that advertisements on television for SL products influence a women’s preference for a lighter skin tone (p < .05). More than 60% of participants were unsure what active ingredients were in their SL products. Only 9% denied any undesirable adverse effects, and the remainder reported an array of local and systemic adverse effects. The vast majority realize that SL products may cause undesirable local (92%) and systemic (89%) adverse effects.LimitationsGeneralizability is limited because a nonrandomized convenience sample from one university was studied. Response bias also may have skewed results.ConclusionUse of SL products among female health science students in Somaliland is common, and causes cutaneous and systemic adverse reactions. Use appears influenced by beliefs about the benefits of lighter skin color. Education is needed on the proper use of these products, how to avoid harmful products, and how to prevent complications.

The color of skin: psychiatric ramifications

Skin color is one of the major attributes that defines both individual distinctiveness and differences between groups. There is a preference for lighter skin world-wide, among both light- and dark-skinned individuals, further leading to skin-color bias based upon skin-color hierarchy within certain ethnoracial groups. The psychiatric and psychosocial ramifications of skin color are important in several situations, including (1) disorders of skin discoloration (eg, vitiligo), which can significantly affect the psychosocial development of the patient especially when it has its first onset during adolescence; (2) widespread use of skin-lightening products, which are used despite knowledge about serious toxicity from inorganic mercury and potent corticosteroids that are some of their main constituents; (3) indoor tanning, which is a recognized carcinogen and practiced by over 50% of university-age adults and 20% of adolescents. Educating about photocarcinogenicity does not change tanning behaviors, which is strongly driven by peer pressure; and (4) when a psychiatric disorder, such as body dysmorphic disorder or major depressive disorder, is the primary basis for skin color dissatisfaction. Despite the role of complex sociocultural and psychiatric factors in clinical manifestations involving skin color, a supportive relation with the dermatologist can significantly aid the patient in managing their disease burden.

Skin-lightening practices behind the veil: An epidemiological study among Saudi women.

Women are adopting skin-lightening practices worldwide in an attempt to enhance their skin tone. The reasons and beliefs behind such practices vary from culture to culture. Scarce data are available for this phenomenon among Saudi women. We carried out this study to determine the practices, reasons, and correlates of skin-lightening practices among women in the northern region of Saudi Arabia. Using nonprobability convenient sampling, an analytical cross-sectional study was carried out among women attending two multispecialty hospitals in the Al-Jouf region. A prevalidated, self-administered questionnaire containing 35 items about demographic characteristics, skin-lightening practices, knowledge of skin-lightening products (SLPs), reasons, and perceptions about lighter skin tone was used to collect data. Among 605 sampled women, usage of skin-lightening practices was found in 382 participants (63.1%). All participants had relatively lighter skin. Skin type and education affected skin-lightening practices significantly (P values=0.002 and 0.012, respectively). The prevalent reason for using SLPs was cosmetic (66%). One-third of users faced side effects from these products. The SLP users believed that lighter skin tone plays a role in self-esteem, perception of beauty, social class, marriage, and employment opportunities (P values<0.01) as compared to nonusers. Media was found to influence the use of SLPs (P values<0.001). Skin-lightening practices are prevalent among Saudi women. Such practices are reinforced by a belief that fairer skin is associated with beauty, self-esteem, and financial and social advantages. A public health educational campaign is needed to decrease the usage of SLPs.

Skin-lightening patterns among female students: A cross-sectional study in Saudi Arabia.

BackgroundSkin-lightening products (SLPs) are commonly used worldwide, and their improper use and overuse is becoming a burden on health care workers, including dermatologists.ObjectiveThis study aimed to determine the characteristics, determinants, preferences, and side effects of the use of SLPs among Saudi female students and their association with mental health.MethodsA cross-sectional analytic study, using a self-administered prevalidated questionnaire, was conducted among female students in the Aljouf region of Saudi Arabia. We used the consecutive nonprobability sampling technique to recruit participants. The questionnaire contained demographic data, two questions about knowledge of SLPs, eight questions regarding perceptions of fair skin, and three proxy scales for mental health (depression, posttraumatic stress disorder, and Internet addiction).ResultsThe mean age of the participants (± standard deviation) was 29 ± 9.6 years. Of the 760 responders, 427 (56.2%) used SLPs; all were women with relatively light skin (types III-V). There was a unanimous positive perception of lighter skin tone among women. The participants used skin-lighteners for cosmetic and medical conditions (67.2% and 17.5%, respectively). The practice was significantly associated with poor mental health status, poor level of knowledge, and lower sociodemographic status (p < .05).ConclusionsThe use of SLPs is highly prevalent among Saudi female students. Users believe that fairer skin is associated with beauty and social advantage. Female students with a lower economic status and poor mental health are more prone to overuse SLPs. A need exists for targeted public health campaigns to raise public awareness about uncontrolled skin lightener usage.