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

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

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Observations by health care professionals about wound healing in Ghanaian patients who skin-bleach

Skin-bleaching is a common practice globally and is associated with many cutaneous and systemic health risks. Anecdotally, skin-bleaching is linked to impairments in wound healing, but there are little data to support the claim. This cross-sectional survey of health care professionals serving the Greater Accra Region, Ghana region investigates their observations of wound healing in patients who skin-bleach and their methods for screening skin-bleach use in patients. A 25-item self-administered questionnaire using 5-point Likert scale was distributed with convenient sampling to physicians and nurses employed at Ghanaian hospitals. Fifty-seven electronic and 78 paper responses were collected (total = 135). Most respondents agreed that wounds in skin-bleaching patients heal more slowly (4.22), are more prone to infection (4.11), haemorrhage (3.89), wound dehiscence (3.9), and are more difficult to manage (4.13). No respondent reported universal screening of all patients for skin-bleaching, but most ask about skin-bleaching if there is suspicion of it (42.2%). Our findings support the anecdotes about observable wound healing impairments in patients who skin-bleach. There is also wide variation in skin-bleaching screening practices, suggesting a need for guidelines to properly identify these patients and facilitate early risk prevention.

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

Background

Skin 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.

Objectives

The aim of the study was to determine the prevalence, determinants and perception of use of SLP among female undergraduate medical students in Nigeria.

Methods

A 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.

Results

A 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).

Conclusion

The 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.

The dark side of skin lightening: An international collaboration and review of a public health issue affecting dermatology

Skin lightening (SL) for cosmetic reasons is associated with profound negative impacts on well-being and adverse effects on the skin, resulting in immense challenges for dermatologists. Despite current regulations, lightening agents continue to dominate the cosmetic industry. In this review, our international team of dermatologists tackles the topic of SL as a global public health issue, one of great concern for both women's health and racial implications. We have examined SL in Africa, Asia, the Middle East, and the Americas. We aim to inspire a global discourse on how modern dermatologists can utilize scientific evidence and cultural competency to serve and protect patients of diverse skin types and backgrounds. In doing so, we hope to promote healthy skin and inclusive concepts of beauty in our patients and society.