Skin Lightening Causes and Complications

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 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.

Colorism attitudes and use of skin lightening agents in the United States

Skin lightening (SL) is a practice involving the use of chemicals to lighten the skin that is more common among skin of color (SOC) individuals, particularly women, and can lead to adverse health consequences.

Objective

In this study, we examine SL habits, including both general lightening and lightening for the treatment of a skin condition, among SOC individuals in the United States and the role of colorism in motivating these behaviors.

Methods

A cross-sectional survey was administered to SOC individuals through ResearchMatch, an online national health registry. Demographics, rates of SL, SL habits, and perceived colorism among SL users and nonusers were collected and analyzed with χ2, Fisher's exact, Analysis of variance (ANOVA), Spearman correlation, and t tests.

Results

A total of 455 participants completed the survey. Ninety-seven participants (21.3%) reported using SL agents: 73.2% (71/97) used SL agents for the treatment of a skin condition and 26.8% (26/97) used the products for general SL. Only 22.6% (22/97) of SL users consulted a medical provider before using the products. Forty-four participants (45.4%) were unaware of their SL product ingredients, and 35.1% (34/97) reported using hydroquinone-based products. Composite colorism scores were significantly higher in SL users than nonusers (20.03 vs 18.20; P < .001).

Limitations

This study used self-reported racial/ethnic groups to characterize those with SOC rather than assessing actual skin tones of participants, which could have led to variability.

Conclusion

SL among SOC individuals is prevalent in the U.S. and poses a health risk, as many SL users are unaware of product ingredients, do not consult a medical provider before use, and have access to potentially unsafe formulations. Dermatologists should address skin tone and pigmentary concerns with their SOC patients.

TFOS Lifestyle: Impact of cosmetics on the ocular surface

In this report the use of eye cosmetic products and procedures and how this represents a lifestyle challenge that may exacerbate or promote the development of ocular surface and adnexal disease is discussed. Multiple aspects of eye cosmetics are addressed, including their history and market value, psychological and social impacts, possible problems associated with cosmetic ingredients, products, and procedures, and regulations for eye cosmetic use. In addition, a systematic review that critically appraises randomized controlled trial evidence concerning the ocular effects of eyelash growth products is included. The findings of this systematic review highlight the evidence gaps and indicate future directions for research to focus on ocular surface outcomes associated with eyelash growth products.