1
|
Regencia ZJG, Gouin JP, Ladia MAJ, Montoya JC, Baja ES. Effect of body image perception and skin-lightening practices on mental health of Filipino emerging adults: a mixed-methods approach protocol. BMJ Open 2023; 13:e068561. [PMID: 37192806 DOI: 10.1136/bmjopen-2022-068561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
INTRODUCTION The rampant distribution of idealised images on the internet may lead the general public to improve their body appearance in a way that is sometimes excessive, compulsive or detrimental to other aspects of their lives. There is a decreasing appreciation of body image among emerging adults and an increasing trend on skin-lightening practices linked with psychological distress. This protocol describes the mixed-method approach to assess the relationships among body image perception, skin-lightening practices and mental well-being of Filipino emerging adults and determine the factors that influence them. METHODS AND ANALYSIS An explanatory sequential mixed-method approach will be used. A cross-sectional study design will involve an online self-administered questionnaire of 1258 participants, while a case study design will involve in-depth interviews with 25 participants. Data analysis will use generalised linear models and structural equation modelling with a Bayesian network for the quantitative data. Moreover, the qualitative data will use an inductive approach in thematic analysis. A contiguous narrative approach will integrate the quantitative and qualitative data. ETHICS AND DISSEMINATION The University of the Philippines Manila Review Ethics Board has approved this protocol (UPMREB 2022-0407-01). The study results will be disseminated through peer-reviewed articles and conference presentations.
Collapse
Affiliation(s)
- Zypher Jude G Regencia
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Jean-Philippe Gouin
- Department of Psychology, Faculty of Arts and Science, Concordia University, Montreal, Quebec, Canada
| | - Mary Ann J Ladia
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Jaime C Montoya
- Department of Medicine, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Emmanuel S Baja
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| |
Collapse
|
2
|
Geczik AM, Falk RT, Xu X, Wiafe-Addai B, Yarney J, Awuah B, Biritwum R, Vanderpuye V, Dedey F, Adjei E, Aitpillah F, Osei-Bonsu E, Oppong J, Titiloye N, Edusei L, Nyarko K, Clegg-Lamptey JN, Wiafe S, Ansong D, Ahearn TU, Figueroa J, Garcia-Closas M, Brinton LA, Trabert B. Relation of circulating estrogens with hair relaxer and skin lightener use among postmenopausal women in Ghana. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:301-310. [PMID: 34992224 PMCID: PMC9256865 DOI: 10.1038/s41370-021-00407-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/09/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Hair relaxers and skin lighteners have been commonly used by African women, with suggestions that they may have hormonal activity. OBJECTIVES To investigate the relationship of hair relaxer and skin lightener use to serum estrogen/estrogen metabolite levels. METHODS We utilized the postmenopausal population-based controls of the Ghana Breast Health Study to estimate adjusted geometric means (GM) and 95% confidence intervals of individual circulating estrogen levels by hair relaxer/skin lightener exposure categories. RESULTS Of the 585 postmenopausal women included in our analysis, 80.2% reported hair relaxer use and 29.4% skin lightener use. Ever hair relaxer use was positively associated with estriol (adjusted GM 95.4 pmol/L vs. never 74.5, p value = 0.02) and 16-epiestriol (20.4 vs. 16.8, p value = 0.05) particularly among users of lye-based hair relaxers. Positive associations between scalp burns and unconjugated estrogens were observed (e.g., unconjugated estrone: 5+ scalp burns 76.9 [59.6-99.2] vs. no burns 64.0 [53.7-76.3], p-trend = 0.03). No association was observed between use of skin lighteners and circulating estrogens. SIGNIFICANCE This study presents evidence that circulating 16-pathway estrogens (i.e., estriol and 16-epiestriol) may be increased in users of lye-based hair relaxer products. Among hair relaxer users, unconjugated estrogen levels were elevated in women with a greater number of scalp burns. IMPACT STATEMENT In this population-based study of hair relaxer and skin lightener use among postmenopausal women in Ghana, altered estrogen metabolism was observed with hair relaxer use, particularly among women using lye-based products or with a greater number of scalp burns. In contrast, skin lightener use was not associated with differences in estrogen metabolism in this population. Continued investigation of the potential biological impact on breast cancer risk of hair relaxer use is warranted.
Collapse
Affiliation(s)
- Ashley M Geczik
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Xia Xu
- Protein Characterization Laboratory, Leidos-Frederick, Inc, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Seth Wiafe
- Loma Linda University, School of Public Health, Loma Linda, CA, USA
| | - Daniel Ansong
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Thomas U Ahearn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jonine Figueroa
- The University of Edinburgh, Cancer Research UK Edinburgh Center, Edinburgh, UK
| | - Montserrat Garcia-Closas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| |
Collapse
|
3
|
Tesfamariam S, Bahta M, Weldemariam DG, Tesfamariam EH, Yemane H, Bahta I, Russom M. Awareness, Perception, and Utilization of Skin Lightening Agents Among Females of Asmara, Eritrea: A Cross-Sectional Study. Clin Cosmet Investig Dermatol 2023; 16:1191-1202. [PMID: 37187976 PMCID: PMC10178303 DOI: 10.2147/ccid.s396686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/21/2023] [Indexed: 05/17/2023]
Abstract
Background The use of skin lightening agents (SLAs) is common among African females with black skin color. Although they usually contain harmful ingredients and can cause complications, their use remains to be a common practice. This study was conducted to assess the awareness, perception, and utilization of SLAs among females residing in Asmara, Eritrea. Methods A cross-sectional analytical study using a quantitative approach was conducted in representative samples of all beauty salons available in Asmara from May to July, 2021. The study participants were selected using two-stage stratified cluster sampling and data were collected through a face-to-face interview using a structured questionnaire. Descriptive analysis and logistic regression, at bivariate and multivariate level, were performed. Results The study enrolled 721 females and 684 completed the study. The majority of the respondents had the perception that SLAs can make someone light colored (84.4%), look beautiful (67.8%), trendy and fashionable (55.0%), and white skin is more attractive than dark skin (58.8%). About two-thirds (64.2%) reported they had previously used SLAs, mainly influenced by friends (60.5%). Approximately 46% were current users, while 53.6% stopped it mainly due to adverse effects, fear of adverse effects and ineffectiveness. A total of 150 products including natural ingredients were mentioned being used to lighten the skin, and Aneeza, Natural face, and Betamethasone containing brands were among the top used products. The occurrence of at least one adverse effect due to the use of SLAs was 43.7%, while 66.5% were satisfied with the use of SLAs. Additionally, employment status and perception of SLAs were found to be determinants of being a current user. Conclusion Utilization of SLAs, including products containing harmful or medicinal ingredients, was prevalent among the females of Asmara city. Thus, coordinated regulatory interventions are recommended to tackle unsafe practices and raise public awareness to promote the safe use of cosmetics.
Collapse
Affiliation(s)
- Sirak Tesfamariam
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
| | - Merhawi Bahta
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
- Correspondence: Merhawi Bahta, Tel +2917294279, Email
| | | | - Eyasu H Tesfamariam
- Department of Statistics, Eritrean Institute of Technology, Mai-nefhi, Eritrea
| | - Hermella Yemane
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
| | - Iyassu Bahta
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
| | - Mulugeta Russom
- National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea
- Department of Medical Informatics, Erasmus Medical Center, Rotterdam, Netherlands
- European Programme for Pharmacovigilance and Pharmacoepidemiology, University of Bordeaux, Bordeaux, France
| |
Collapse
|
4
|
Muacevic A, Adler JR, Aldajani BM, Alghanemi L, Mleeh NT. A Cross-Sectional Study of the Knowledge, Practice, and Attitude Towards Skin-Lightening Products Among the General Population in the Western Region of Saudi Arabia. Cureus 2023; 15:e34069. [PMID: 36843720 PMCID: PMC9946903 DOI: 10.7759/cureus.34069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 01/24/2023] Open
Abstract
Introduction Skin bleaching is a growing phenomenon worldwide and is becoming an increasing problem. Several skin-lightening products (SLPs) containing mercury, hydroquinone, and corticosteroids have impacted serious dermatological, nephrological, and neurological side effects. There is relatively little regulation, and the products are easily accessible and inexpensive. Justifications and beliefs for the use of these products vary from culture to culture, and there is little previous research on the use and abuse of skin-lightening cosmetics among Saudi women. This study examines the knowledge, attitudes, and practices of the public in the western region of Saudi Arabia regarding SLPs to understand the situation better. Methodology An observational, cross-sectional, questionnaire-based study was conducted over two months between July and August 2022. A 29-question survey was used to collect data from the general population. The study included all women residing in the western region of Saudi Arabia. Non-Arabic speakers were excluded. RStudio (R version 4.1.1) was used to analyze the data. Results A total of 409 participants were included in this study; In general, 146 (35.7%) of the participants said they had ever used an SLP. More than two-thirds (67.1%) had been using them for less than a year. In terms of the most common site of SLPs application, women reported applying the products to the skin of their face (74.7%), elbows (47.3%), and knees (46.6%). Use of SLPs differed significantly across participants' ages, with the proportion of SLP users in the 20-30 age category significantly higher than non-users (50.7% vs. 36.9%, p=0.017), and non-users were more common than users within the age category >50 years. In addition, the proportion of SLP users relative to educational level was significantly higher among participants with a bachelor's degree than the proportion of non-users (69.2% vs. 54.0%, p = 0.009). Conclusions The results of this research show that Saudi women frequently utilize topical lightening products. Therefore, regulation and controlling the use of bleaching products is essential, as is educating women about the risks involved with this practice. The misuse of bleaching products should decline with greater awareness.
Collapse
|
5
|
Bastiansz A, Ewald J, Rodríguez Saldaña V, Santa-Rios A, Basu N. A Systematic Review of Mercury Exposures from Skin-Lightening Products. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:116002. [PMID: 36367779 PMCID: PMC9651181 DOI: 10.1289/ehp10808] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND The Minamata Convention on Mercury (Article 4) prohibits the manufacture, import, or export of skin-lightening products containing mercury concentrations above 1 ppm. However, there is a lack of knowledge surrounding the global prevalence of mercury-added skin-lightening products. OBJECTIVE The objective of this study was to increase our understanding of worldwide human mercury exposure from skin-lightening products. METHODS A systematic search of peer-reviewed scientific literature was performed for relevant articles in four databases (PubMed, Web of Science Core Collection, Scopus, and TOXLINE). The search strategy, eligibility criteria, and data-extraction methods were established a priori. The search identified 2,303 unique scientific articles, of which 41 were ultimately deemed eligible for inclusion after iterative screens at the title, abstract, and whole-text levels. To facilitate data extraction and synthesis, all papers were organized according to four data groups a) "Mercury in products," b) "Usage of products," c) "Human biomarkers of exposure," and d) "Health impacts." RESULTS This review was based on data contained in 41 peer-reviewed scientific papers from 22 countries worldwide published between 2000 and 2022. In total, we captured mercury concentration values from 787 skin-lightening product samples [overall pooled central median mercury level was 0.49μg/g; interquartile range (IQR): 0.02-5.9] and 1,042 human biomarker measurements from 863 individuals. We also synthesized usage information from 3,898 individuals and self-reported health impacts associated with using mercury-added products from 832 individuals. DISCUSSION This review suggests that mercury widely exists as an active ingredient in many skin-lightening products worldwide and that users are at risk of variable and often high exposures. These synthesized findings identify data gaps and help increase our understanding of the health risks associated with the use of these products. https://doi.org/10.1289/EHP10808.
Collapse
Affiliation(s)
- Ashley Bastiansz
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - Jessica Ewald
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | | | - Andrea Santa-Rios
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| | - Niladri Basu
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
6
|
Rahiman F, Davids LM, Thomas A. A survey evaluating knowledge, perception, and use of skin lightening products among South African students. Int J Womens Dermatol 2022; 7:766-768. [PMID: 35028379 PMCID: PMC8714566 DOI: 10.1016/j.ijwd.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 10/31/2022] Open
Abstract
Background In 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. Methods A cross-sectional survey among health science students at a tertiary institution in the Western Cape of South Africa was conducted. Results A 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. Conclusion This 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.
Collapse
Affiliation(s)
- Farzana Rahiman
- Department of Medical Bioscience, University of the Western Cape, Cape Town South Africa
| | - Lester M Davids
- C2L Scientific Consultancy, Rondebosch, Cape Town, South Africa
| | - Amy Thomas
- Department of Medical Bioscience, University of the Western Cape, Cape Town South Africa
| |
Collapse
|
7
|
Pollock S, Taylor S, Oyerinde O, Nurmohamed S, Dlova N, Sarkar R, Galadari H, Manela-Azulay M, Chung HS, Handog E, Kourosh AS. The dark side of skin lightening: An international collaboration and review of a public health issue affecting dermatology. Int J Womens Dermatol 2021; 7:158-164. [PMID: 33937483 PMCID: PMC8072511 DOI: 10.1016/j.ijwd.2020.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/07/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Samara Pollock
- Massachusetts General Hospital, Department of Dermatology, Boston, MA, United States
- Boston University School of Medicine, Boston, MA, United States
| | - Susan Taylor
- Perelman School of Medicine Department of Dermatology, Philadelphia, PA
| | - Oyetewa Oyerinde
- Massachusetts General Hospital, Department of Dermatology, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | | | - Ncoza Dlova
- University of KwaZulu Natal, Dermatology Department, South Africa
| | - Rashmi Sarkar
- Lady Hardinge Medical College and Hospital, New Delhi, India
| | - Hassan Galadari
- United Arab Emirates University, Department of Dermatology, Dubai, United Arab Emirates
| | | | - Hae Shin Chung
- Yonsei University College of Medicine, Seoul, South Korea
| | - Evangeline Handog
- Perelman School of Medicine Department of Dermatology, Philadelphia, PA
- Asian Hospital and Medical Center, Department of Dermatology, Philippines
| | - A. Shadi Kourosh
- Massachusetts General Hospital, Department of Dermatology, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| |
Collapse
|
8
|
Owusu-Agyei M, Agyei M, Ogunleye TA. Skin-lightening practices among shoppers in select markets in Kumasi, Ghana: A cross-sectional survey. JAAD Int 2020; 1:104-110. [PMID: 34409329 PMCID: PMC8362006 DOI: 10.1016/j.jdin.2020.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2020] [Indexed: 11/03/2022] Open
Abstract
Background Despite warnings about its harmful adverse effects and the implementation of regulatory bans, anecdotal reports suggest high use of skin-lightening agents in Kumasi, Ghana. Objective To estimate the prevalence and motivation for skin-lightening agent use and nonuse among shoppers in Kumasi, Ghana. Methods This is a cross-sectional survey of a convenience sample of shoppers in 3 of Kumasi's largest markets. Results Of 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. Limitations Using 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. Conclusion The practice of skin lightening among all participants is high and is associated with perceptions of increased beauty, attractiveness, self-esteem, and wealth.
Collapse
Affiliation(s)
- Mariah Owusu-Agyei
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Martin Agyei
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Temitayo A Ogunleye
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
9
|
Brinton LA, Figueroa JD, Ansong D, Nyarko KM, Wiafe S, Yarney J, Biritwum R, Brotzman M, Thistle JE, Adjei E, Aitpillah F, Dedey F, Edusei L, Titiloye N, Awuah B, Clegg-Lamptey JN, Wiafe-Addai B, Vanderpuye V. Skin lighteners and hair relaxers as risk factors for breast cancer: results from the Ghana breast health study. Carcinogenesis 2018; 39:571-579. [PMID: 29324997 DOI: 10.1093/carcin/bgy002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/05/2018] [Indexed: 01/14/2023] Open
Abstract
Skin lighteners and hair relaxers, both common among women of African descent, have been suggested as possibly affecting breast cancer risk. In Accra and Kumasi, Ghana, we collected detailed information on usage patterns of both exposures among 1131 invasive breast cancer cases and 2106 population controls. Multivariate analyses estimated odds ratios (ORs) and 95% confidence intervals (CIs) after adjustment for breast cancer risk factors. Control usage was 25.8% for ever use of skin lighteners and 90.0% for use of hair relaxers for >1 year. The OR for skin lighteners was 1.10 (95% CI 0.93-1.32), with higher risks for former (1.21, 0.98-1.50) than current (0.96, 0.74-1.24) users. No significant dose-response relations were seen by duration, age at first use or frequency of use. In contrast, an OR of 1.58 (95% CI 1.15-2.18) was associated with use of hair relaxers, with higher risks for former (2.22, 1.56-3.16) than current (1.39, 1.00-1.93) users. Although numbers of burns were inconsistently related to risk, associations increased with duration of use, restricted to women who predominately used non-lye products (P for trend < 0.01). This was most pronounced among women with few children and those with smaller tumors, suggesting a possible role for other unmeasured lifestyle factors. This study does not implicate a substantial role for skin lighteners as breast cancer risk factors, but the findings regarding hair relaxers were less reassuring. The effects of skin lighteners and hair relaxers on breast cancer should continue to be monitored, especially given some biologic plausibility for their affecting risk.
Collapse
Affiliation(s)
- Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Jonine D Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.,Usher Institute of Population Health Sciences and Informatics, Edinburgh Cancer Research Centre, Edinburgh, Scotland
| | | | | | | | | | | | | | - Jake E Thistle
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Sagoe D, Pallesen S, Dlova NC, Lartey M, Ezzedine K, Dadzie O. The global prevalence and correlates of skin bleaching: a meta-analysis and meta-regression analysis. Int J Dermatol 2018; 58:24-44. [PMID: 29888464 DOI: 10.1111/ijd.14052] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/29/2018] [Accepted: 04/23/2018] [Indexed: 02/04/2023]
Abstract
PURPOSE To estimate and investigate the global lifetime prevalence and correlates of skin bleaching. METHODS A meta-analysis and meta-regression analysis was performed based on a systematic and comprehensive literature search conducted in Google Scholar, ISI Web of Science, ProQuest, PsycNET, PubMed, and other relevant websites and reference lists. A total of 68 studies (67,665 participants) providing original data on the lifetime prevalence of skin bleaching were included. Publication bias was corrected using the trim and fill procedure. RESULTS The pooled (imputed) lifetime prevalence of skin bleaching was 27.7% (95% CI: 19.6-37.5, I2 = 99.6, P < 0.01). The highest significant prevalences were associated with: males (28.0%), topical corticosteroid use (51.8%), Africa (27.1%), persons aged ≤30 years (55.9%), individuals with only primary school education (31.6%), urban or semiurban residents (74.9%), patients (21.3%), data from 2010-2017 (26.8%), dermatological evaluation and testing-based assessment (24.9%), random sampling methods (29.2%), and moderate quality studies (32.3%). The proportion of females in study samples was significantly related to skin bleaching prevalence. CONCLUSION Despite some limitations, our results indicate that the practice of skin bleaching is a serious global public health issue that should be addressed through appropriate public health interventions.
Collapse
Affiliation(s)
- Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Ncoza C Dlova
- Dermatology Department, University of KwaZulu-Natal, Durban, South Africa
| | - Margaret Lartey
- Department of Medicine and Therapeutics, University of Ghana School of Medicine and Dentistry, Accra, Ghana.,Department of Medicine, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Khaled Ezzedine
- Department of Dermatology, Hôpital Henri Mondor, Créteil, France
| | - Ophelia Dadzie
- Departments of Dermatology and Histopathology, Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK
| |
Collapse
|
11
|
Brennan R, Wells JSG, Van Hout M. "Saving Face": An Online Study of the Injecting Use of DIY Botox and Dermal Filler Kits. Plast Surg (Oakv) 2018; 26:154-159. [PMID: 30148126 DOI: 10.1177/2292550318767432] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study reports on an empirically underdocumented practice in contemporary aesthetic enhancement culture, the self-injection of unregulated DIY Botox and dermal filler kits purchased online. Data were collected from 4 online discussion forums containing disclosures in relation to use of DIY kits and analyzed using ethnographic content analysis. Motivation to source DIY Botox and dermal fillers online was grounded in desire to avoid financial cost of professional services and a lack of confidence in practitioners. Future intentions to order online raw materials and "formulas" to prepare dermal fillers at home were expressed. Individuals taught themselves to inject through watching YouTube tutorials and downloading Botox injection maps from the Internet. Although individuals demonstrated awareness of the health risks involved with self-injection of unregulated products, this was not a deterrent. Future research is warranted to document the injecting practices and health outcomes of individuals who inject DIY Botox and dermal filler kits to inform targeted harm reduction interventions by health-care practitioners.
Collapse
|
12
|
Eagles-Smith CA, Silbergeld EK, Basu N, Bustamante P, Diaz-Barriga F, Hopkins WA, Kidd KA, Nyland JF. Modulators of mercury risk to wildlife and humans in the context of rapid global change. AMBIO 2018; 47:170-197. [PMID: 29388128 PMCID: PMC5794686 DOI: 10.1007/s13280-017-1011-x] [Citation(s) in RCA: 179] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Environmental mercury (Hg) contamination is an urgent global health threat. The complexity of Hg in the environment can hinder accurate determination of ecological and human health risks, particularly within the context of the rapid global changes that are altering many ecological processes, socioeconomic patterns, and other factors like infectious disease incidence, which can affect Hg exposures and health outcomes. However, the success of global Hg-reduction efforts depends on accurate assessments of their effectiveness in reducing health risks. In this paper, we examine the role that key extrinsic and intrinsic drivers play on several aspects of Hg risk to humans and organisms in the environment. We do so within three key domains of ecological and human health risk. First, we examine how extrinsic global change drivers influence pathways of Hg bioaccumulation and biomagnification through food webs. Next, we describe how extrinsic socioeconomic drivers at a global scale, and intrinsic individual-level drivers, influence human Hg exposure. Finally, we address how the adverse health effects of Hg in humans and wildlife are modulated by a range of extrinsic and intrinsic drivers within the context of rapid global change. Incorporating components of these three domains into research and monitoring will facilitate a more holistic understanding of how ecological and societal drivers interact to influence Hg health risks.
Collapse
Affiliation(s)
| | - Ellen K. Silbergeld
- Johns Hopkin Bloomberg School of Public Health, 615 N. Wolfe Street, E6644, Baltimore, MD 21205 USA
| | - Niladri Basu
- McGill University, 204-CINE Building, Montreal, QC H9X 3V9 Canada
| | - Paco Bustamante
- University of La Rochelle, laboratory of Littoral Environment and Societies, Littoral Environnement et Sociétés (LIENSs), LIENSs UMR 7266 CNRS-Université de La Rochelle, 2 rue Olympe de Gouges, 17000 La Rochelle, France
| | - Fernando Diaz-Barriga
- Center for Applied Research in Environment and Health at, Universidad Autonoma de San Luis Potosi, Avenida Venustiano Carranza No. 2405, Col Lomas los Filtros Código Postal, 78214 San Luis Potosí, SLP Mexico
| | - William A. Hopkins
- Department of Fish and Wildlife Conservation, 310 West Campus Drive Virginia Tech, Cheatham Hall, Room 106 (MC 0321), Blacksburg, VA 24061 USA
| | - Karen A. Kidd
- Department of Biology & School of Geography and Earth Sciences, McMaster University, 1280 Main Street W., Hamilton, ON L8S 4K1 Canada
| | - Jennifer F. Nyland
- Department of Biological Sciences, 1101 Camden Ave, Salisbury, MD 21801 USA
| |
Collapse
|
13
|
Osei M, Ali M, Owusu A, Baiden F. Skin-lightening practices among female high school students in Ghana. Public Health 2018; 155:81-87. [PMID: 29328977 DOI: 10.1016/j.puhe.2017.11.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 11/13/2017] [Accepted: 11/26/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The practice of skin lightening (SL) persist despite warnings about its harmful health effects. Adolescents are particularly vulnerable and at risk of prolonged use of SL products. We explored SL practices among high school students in Ghana, West Africa. STUDY DESIGN Cross-sectional survey. METHODS We used a self-administered questionnaire in a survey on SL practices among randomly selected female students in five Senior High Schools in the Brong Ahafo Region of Ghana. We determined prevalence and used bivariate and multivariate analysis to identify factors associated with the practice. RESULTS A total of 410 students with a mean age of 17.6 years (±1.6) participated in the study. While 71.5% of students indicated that they had been approached by relatives and friends to use SL creams, 65.6% admitted to actually using it. Most (85.5%) students identified at least five friends who were using SL products at the time of the survey. Between 22.0% and 44.0% of students knew female teachers who practiced SL. Students in first year were twice as likely to practice SL compared with students in third year (odds ratio [OR] = 1.90, 95% confidence interval [CI] 1.15-3.13). Compared with those who had never been approached, students who had been approached by relatives and friends to use SL products were likely to be using it (OR = 2.24, 95% CI 1.43-3.53). Students who had sisters who used SL products were twice as likely to be users themselves (OR = 1.82, 95% CI 1.12-2.95). CONCLUSION The practice of SL among female students in this study is high, and about the same as reported among adults in Ghana and other parts of sub-Saharan Africa. This suggests that the practice is well entrenched. A ban on the sale of SL products to adolescents in Ghana should be considered.
Collapse
Affiliation(s)
- M Osei
- Ensign College of Public Health, Kpong, Ghana.
| | - M Ali
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana.
| | - A Owusu
- Middle Tennessee State University, MTSU Box 96, Murfreesboro, TN 37132, USA.
| | - F Baiden
- Ensign College of Public Health, Kpong, Ghana.
| |
Collapse
|
14
|
Misuse of Topical Corticosteroids for Cosmetic Purpose in Antananarivo, Madagascar. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9637083. [PMID: 28904977 PMCID: PMC5585578 DOI: 10.1155/2017/9637083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/19/2017] [Indexed: 11/18/2022]
Abstract
This cross-sectional study was conducted in Antananarivo, Madagascar, from June to September 2012. We aim to evaluate the misuse of TC on the face for cosmetic purpose and the adverse effects due to its application. A questionnaire-based analysis was done among females who use topical corticosteroids on the face for cosmetic purpose. Of the 770 women questioned, 384 (49,8%) used topical corticosteroids for cosmetic purpose whose mean age was 38 years (range 16-73 years). Two hundred and sixty-one females (68%) used TC combined with handcrafted cosmetics, and 123 (32%) used TC alone. "Pandalao," which contains salicylic acid, peppermint oil, lanolin, powder of Juanes de Vigo (mercury powder), and Vaseline, is the most handcrafted cosmetic combined with TC in our study (used by 29,4% respondents). Only one (0,26%) had obtained the TC by physician's prescription, 234 (61%) from cosmetic retailers, 92 (23%) directly from local pharmacies, 49 (12%) from beauticians, and 15 (4%) from unspecified sources. Lightening of skin color was the main reason for using TC in 44,8% of respondents in the absence of any primary dermatosis. Pigmentation disorders (63,2%) and cutaneous atrophy (52,1%) were the most adverse effects noted.
Collapse
|
15
|
Tai Y, Wang C, Wang Z, Liang Y, Du J, He D, Fan X, Jordt SE, Liu B. Involvement of Transient Receptor Potential Cation Channel Member A1 activation in the irritation and pain response elicited by skin-lightening reagent hydroquinone. Sci Rep 2017; 7:7532. [PMID: 28790335 PMCID: PMC5548750 DOI: 10.1038/s41598-017-07651-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 06/30/2017] [Indexed: 01/02/2023] Open
Abstract
Hydroquinone (HQ) is one of the most frequently used and effective skin-lightening products to treat skin hyperpigmentation disorders, including postinflammatory hyperpigmentation, melasma and solar lentigines. HQ is also widely used in cosmetic products for skin whitening. However, HQ treatment can evoke substantial skin irritation, a side effect that remains poorly understood. Here we demonstrate that HQ is an activator of the peripheral irritant receptor transient receptor potential (TRP) cation channel member A1 (TRPA1). HQ failed to activate TRPV1, TRPV4 or TRPM8. HQ-induced TRPA1 activation was dependent on essential redox-sensitive cysteine and lysine residues within N-terminus of channel protein. HQ elicited Ca2+ influx in a subpopulation of mouse sensory neurons sensitive to the TRPA1 agonist, mustard oil. HQ-induced neuronal responses were significantly reduced by TRPA1 inhibitors, and reduced in neurons isolated from Trpa1-deficient mice. In mice, intraplantar injection of HQ at clinically relevant concentrations elicited both acute pain and persistent mechanical hyperalgesia which were almost completely abolished by TRPA1 inhibitors. These findings identify TRPA1 as a molecular target for HQ and provide insights into the mechanism of HQ-induced skin irritation. These findings also suggest that selective TRPA1 antagonists may be useful to counteract HQ-induced skin irritation.
Collapse
Affiliation(s)
- Yan Tai
- Laboratory and Equipment Administration, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Chuan Wang
- Department of Pharmacology, Hebei Medical University, Shijiazhuang, 050017, China
| | - Zhihua Wang
- Department of Pharmacology, Hebei Medical University, Shijiazhuang, 050017, China
| | - Yi Liang
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Junying Du
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Dongwei He
- Department of Clinical Bio-Cell, 4th Hospital, Hebei Medical University, Shijiazhuang, 050000, China
| | - Xiaoyan Fan
- Department of Oncology, Hebei General Hospital, Shijiazhuang, 050000, China
| | - Sven-Eric Jordt
- Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, 27710, United States of America.
| | - Boyi Liu
- Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| |
Collapse
|