Skin lightening practices: an epidemiological study of South African women of African and Indian ancestries

Abstract

SummaryBackground Cutaneous adverse sequelae of skin lightening creams present with myriad skin complications and affect dermatology practice, particularly in subSaharan Africa where such products are widely used, with a prevalence of 25-67%. Objectives To examine the skin lightening practices of both African and Indian women living in South Africa. Methods A cross-sectional survey was undertaken in the general outpatient departments of two regional university hospitals in Durban, South Africa. All consenting African and Indian women aged 18-70 years were recruited and asked to complete a questionnaire. Results Six hundred women completed the questionnaire, of whom 32Á7% reported using skin lightening products. The main reasons cited were treatment of skin problems (66Á7%) and skin lightening (33Á3%). Products were purchased from a variety of sources. Twenty-five percent reported using sunscreen. Conclusions The use of skin lightening cosmetics is common among darkly pigmented South African women, including those of both African and Indian ancestries. Despite more than 20 years of governmental regulations aimed at prohibiting both the sale of cosmetics containing mercury, hydroquinone and corticosteroids, and the advertising of any kind of skin lightener, they are far from having disappeared. The main motivations for using these products are the desire to treat skin disorders and to achieve a lighter skin colour. Television and magazine advertisements seem to influence womens' choice of these products and, thus, would be efficient channels for raising public awareness about the dangers of using uncontrolled skin lighteners.

phenomenon of skin lightening: Is it right to be light?

“…In a recent South African study of 600 women of African and Indian ancestry, it was reported that 32.7% used skin lightening products, but the main reason cited was treatment of skin problems (66.7%), with skin lightening accounting for only 33.3% of use. 44 This point emphasises the need to inform populations that early and prompt treatment of conditions such as acne vulgaris reduces the risk of scarring.…”

Differences in drug quality between South Africa and Germany

“…This lack of power could also be the explanation for the infiltration of large numbers of illegal skin lightening products in South Africa. [25,45] While the skin lightening products legally obtained in Germany for this study were all free from corticosteroids and hydroquinone, the products confiscated in South Africa contained substances that are not permitted in products that can be sold without prescription because of possible hazards for the public (which was the reason for their confiscation). [46] In particular, products containing hydroquinone are a high risk for consumers, as their visual appearance does not convey to unsuspecting customers that they are products which contain a highly potent, dangerous substance.…”

“…Tablets from each batch were investigated (n = 5 per batch). The pH 6.8 dissolution test was performed over 1 h. At sampling times (5,10,15,20,30,45 and 60 min), 5 ml of media was withdrawn from the vessel and filtered through 0.45-lm PTFE membrane filters. The first 3.5 ml of the filtrate was returned to the dissolution vessel, and the remaining 1.5 ml was transferred into 2 ml microreagent tubes.…”

Cosmetics use and age at menopause: is there a connection?

“…Skin lighteners are commonly used in minority races/ethnicities (98–101), and as a result this population of women are at particular risk of exposure to toxic chemicals that are in skin lightening products such as mercury, hydroquinone, and steroids (102, 103). Vaginal douching, which a study on the National Health and Nutrition Examination Survey (NHANES) 2001–2004 found to be more common in black women than white or Mexican American women, is significantly associated with higher urinary concentrations of MEP (104).…”