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Background
The desire for fair skin is commonly encountered in communities
with dark skin due to a long-held and deeply rooted sociocultural
belief that lighter skin color is more beautiful, associated with higher
prestige, and gives more social advantage. The use of skin-lightening
agents is very high in sub-Saharan Africa, with the highest
prevalence reported in Nigeria. Despite high awareness of the
harmful effects of skin-lightening agents, many individuals still use
these agents, highlighting the fact that deep psychosocial forces may
drive their continued use. To guide interventions and find a lasting
solution to this epidemic, these factors need to be established to
tailor solutions appropriately.
Objective
This study was conducted to determine the psychosocial factors
that are associated with the use of skin-lightening agents among
young female undergraduate students in Nigeria.
Methods
This was a descriptive cross-sectional study involving consenting,
consecutive undergraduate students from four university campuses
in Nigeria. Validated questionnaires were used to assess self-esteem
(Rosenberg’s self-esteem scale), sexual attitude (Brief sexual attitude
scale), depression (PHQ-9), body dysmorphic disorder (BDDV), and
social desirability (Marlowe-Crowne scale). Bleaching agents were
categorized as soaps, creams, triple-action creams, and a
combination of any of these.
Results
There were 678 female respondents (66.2%) with a mean age of
21.8 (3.2) years. The majority (93.8%) practiced one or more forms of
skin bleaching (95% confidence interval: 91.9-95.6). However, with
triple-action creams eliminated, the prevalence was 84.3%. The
majority (66%) of agents were self-prescribed, and the most common
reasons for use were to treat a skin condition and preserve or
maintain the skin tone by preventing tanning from the harsh tropical
sun. There was a significant relationship between body dysmorphic
disorder and checking the active ingredient with the use of bleaching
creams and/or creams. There was no relationship between self-
esteem, sexual attitude, depression, and the practice of all forms of
skin bleaching. Interestingly, 87% of male participants preferred
lighter-complexioned female partners.
Conclusion
The results suggest that medical and social, rather than
psychological, factors are associated with use of skin-lightening
agents in the study population.
http://dx.doi.org/10.1016/j.ijwd.2019.06.010
Clean cosmetics: Does science back up this new trend?
Neera Nathan MD, MSHS, Molly Wanner MD, MBA
Department of Dermatology, Massachusetts General Hospital, Boston,
Massachusetts
Background
“Clean”cosmetic and personal care products are a popular new
beauty trend that has been touted by international retailers,
celebrities, and the media and is projected to generate N$20 billion
in revenue by 2024. This new wave of products is being prepared
without common additives that proponents believe may be harmful;
however, little is known about the science behind these claims.
Objective
As the medical authority in skincare, dermatologists would
benefit from an understanding of the evidence that supports
avoiding certain ingredients, if any, in cosmetic or other topical
personal care products.
Methods
An Internet search was performed to determine the ingredients
commonly avoided in the production of clean cosmetic and personal care
products. A PubMed literature search was performed to identify relevant
studies on the side effects of the identified chemicals, including
methylchloroisothiazolinone (MCI), vitamin A derivatives, fragrance,
phenoxyethanol, petroleum distillates, formaldehydes, triclosan and
triclocarban, toluene, resorcinol, butylated hydroxyanisole, boric acid
and sodium borate, phthalates, placenta extract, parabens, PEGs and
ceteareth (1,4-dioxane), and coal tar ingredients.
Results
The majority of ingredients avoided in clean cosmetic and
personal care products could be categorized into one of three
groups: irritants or allergens (MCI, vitamin A derivatives, fragrance,
phenoxyethanol, petroleum distillates, and formaldehydes),
potential endocrine disruptors (triclosan and triclocarban, toluene,
resorcinol, petroleum distillates, butylated hydroxyanisole, boric acid
and sodium borate, phthalates, placenta extract, parabens, and
phenoxyethanol) ,and potential carcinogens (PEGs and ceteareth
[1,4-dioxane]), formaldehydes, coal tar ingredients, petroleum
distillates, and placenta extract). There were substantial data to
support avoiding topical application of certain irritants or allergens,
including MCI, fragrance, and formaldehyde/formaldehyde releasers,
due to the known associations with allergic contact dermatitis. There
was no clear evidence in humans that topical exposure at routine
doses of potential endocrine disruptors caused hormonal
abnormalities, in part due few human studies being available and
the unclear significance of levels of these chemicals found in bodily
fluids with respect to topical exposure. There was evidence to
support the link between formaldehyde and cancer formation in
both animals and humans at high doses, including through topical
exposure. Although some data show that coal tar has been linked to
cancer with occupational exposure, topical use of coal tar products in
dermatology to treat psoriasis and eczema has not been associated
with an increased rate of skin cancer or internal cancers.
Conclusion
There appears to be evidence to support avoiding some, but not all,
chemicals omitted from clean products, including MCI, fragrance, and
formaldehyde, due to the relative frequency of associated allergic contact
dermatitis, in addition to the known carcinogenic nature of formaldehyde
in humans with topical exposure, albeit at high doses. More data are
needed to determine the impact of routine topical application of potential
endocrine disruptors on human health.
http://dx.doi.org/10.1016/j.ijwd.2019.06.011
White ambition leading to topical corticosteroid misuse - A beauty
myth in skin of color
Sitaula Seema MD
a
, Amrita Neupane MBBS
b
, Anil Kumar Das MD
b
a
Department of Dermatology, Alka Hospital, Kathmandu, Nepal
b
Department of Dermatology, IOM, Teaching Hospital, Kathmandu, Nepal
Abstracts278
