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Razi S, Tan IJ, Pathak GN, Rao B. Unraveling the mirage of fairness cream commercials: A cross-sectional analysis of commercials from South Asia. J Cosmet Dermatol 2024; 23:1713-1717. [PMID: 38247030 DOI: 10.1111/jocd.16188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/04/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Fairness products are an essential component of daily beauty routines for many individuals in subcontinental Asia. However, it is important to be aware that these products often contain ingredients that can be detrimental to the skin and are banned in several developed countries. OBJECTIVE Our study aims to analyze the content of fairness cream commercials in order to gain a deeper understanding of the information used to persuade and influence consumers to use these products. METHODS Fairness cream commercials originating from countries in subcontinental Asia, including India, Pakistan, Bangladesh, Sri Lanka, and Nepal, were specifically searched and analyzed on the YouTube platform. RESULTS An analysis of 152 fairness cream commercials on YouTube identified 84.21% of commercials targeted female consumers, while only 15.79% targeted male consumers. 77.63% of commercials used celebrities in their commercials and 47.37% of commercials mentioned specific ingredients. CONCLUSIONS Based on our findings, it is crucial for dermatologists to take an active role in educating patients and consumers about the potential risks associated with certain ingredients found in fairness creams. Dermatologists should emphasize the importance of prioritizing overall skin health rather than solely focusing on skin lightening.
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Affiliation(s)
- Shazli Razi
- Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, New Jersey, USA
- Rao Dermatology, Atlantic, New Jersey, USA
| | - Isabella J Tan
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Gaurav Nitin Pathak
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Babar Rao
- Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, New Jersey, USA
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
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2
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Ishack S, Lipner SR. Exogenous ochronosis associated with hydroquinone: a systematic review. Int J Dermatol 2021; 61:675-684. [PMID: 34486734 DOI: 10.1111/ijd.15878] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/26/2021] [Accepted: 08/12/2021] [Indexed: 11/29/2022]
Abstract
Exogenous ochronosis is a potential side effect associated with hydroquinone, and treatment is often unsatisfactory. Our study objectives were to review data on hydroquinone-associated ochronosis to determine risk factors for patients experiencing this adverse event. On September 27, 2020 (MEDLINE/PubMed), and October 30, 2020 (Scopus and Web of Science), databases were searched for "ochronosis + hydroquinone" by both authors to reduce risk basis. PRISMA reporting guidelines were used to select 56 articles with a total of 126 patients with hydroquinone-associated ochronosis. Included articles described hydroquinone-associated ochronosis. Articles were excluded if they had irrelevant content, were non-English language text, and were non-case studies. Full text articles were assessed and recorded. Cross-tabulation analysis was performed on categorical data, and Fisher exact test was performed. Ochronosis was most often reported in middle-aged women (53.2%), of African descent (45.2%), Black races (55.5%), and Fitzpatrick skin types V-VI (52.4%). It was most frequently reported with unknown and hydroquinone concentrations greater than 4% (32.5 and 35.7% cases, respectively). Median duration of use was 5 years, with only four cases reported with courses 3 months or shorter and eight cases reported with use 1 year or less. All patients presented with facial blue-black or gray-blue macules in a reticulate, lace-like fashion. Histopathology consistently showed solar elastosis and brownish-yellow, 'banana-shaped' fibers between degenerated collagen fibers of the papillary dermis. Based on these findings, we conclude that hydroquinone in concentrations above 4% and in treatment courses longer than 3 months may be associated with new-onset ochronosis.
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Affiliation(s)
| | - Shari R Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
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3
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Nyoni-Kachambwa P, Naravage W, James NF, Van der Putten M. A preliminary study of skin bleaching and factors associated with skin bleaching among women living in Zimbabwe. Afr Health Sci 2021; 21:132-139. [PMID: 34394290 PMCID: PMC8356578 DOI: 10.4314/ahs.v21i1.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Skin bleaching was reported to be commonly practiced among women and Africa was reported to be one of the most affected yet the subject is not given much attention in public health research in Zimbabwe despite the adverse effects of skin bleaching on health. Method This study was an exploratory cross-sectional survey to explore skin bleaching, skin bleaching patterns and factors associated with skin bleaching among women living in Zimbabwe. An online self-administered questionnaire was sent out to women on social network i.e. WhatsApp, Facebook, LinkedIn and Twitter. Findings A total number of 260 respondents, mean age 31.69 (SD, 8.12) years participated in the survey. The prevalence of skin bleaching among the participants was 31.15%. The major reason reported for skin bleaching was to have smooth and healthy skin alongside other factors such as beauty, gaining social favours for example getting married and good jobs. Occupation, complexion and marital status were associated with skin bleaching. The odds of skin bleaching for participants who were employed was 1.45(95% confidence interval [CI],0.32–1.91);p-value 0.02, dark skinned participants 2.56(95% CI, 0.76–2.87);p-value 0.01 and unmarried participants 2.87(95% CI,0.29–3.58);p-value 0.03. Conclusion Evidence from the research suggests skin bleaching might be common among women living in Zimbabwe and possibly poses serious health threats to the women. Skin bleaching seems to be deep rooted in colourism. The colourism seems to be taken advantage of by the cosmetic industry which produce the potentially hazardous products which promise the revered light skin to women but which comes with a price. However, the study provides a base for future studies to explore more on skin bleaching practices among women living in Zimbabwe.
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Affiliation(s)
- Princess Nyoni-Kachambwa
- Faculty of Public Health, Thammasat University Rangsit Campus, Khlong 1, Khlong Luang, Pathumthani, Thailand
| | - Wanapa Naravage
- Faculty of Public Health, Thammasat University Rangsit Campus, Khlong 1, Khlong Luang, Pathumthani, Thailand
| | - Nigel F James
- Faculty of Public Health, Thammasat University Rangsit Campus, Khlong 1, Khlong Luang, Pathumthani, Thailand
| | - Marc Van der Putten
- Faculty of Public Health, Thammasat University Rangsit Campus, Khlong 1, Khlong Luang, Pathumthani, Thailand
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Abstract
Cosmetic skin lightening is a growing dermatologic public health problem that affects communities of color worldwide. Despite well-documented adverse health effects, cosmetic skin lightening continues to be a popular practice among patients of color. Given the US's changing demographics, it is critical for dermatologists to be knowledgeable about the medical impact as well as social and cultural implications of this practice. This review article aims to serve as a primer for the dermatologist on the medical and sociocultural aspects of cosmetic skin lightening, as well as an approach to discuss the issue of cosmetic skin lightening with patients. We conducted a comprehensive PubMed search using the terms 'skin lightening agents,' 'skin bleaching,' and 'depigmenting agents,' and reviewed the literature on cosmetic skin lightening products, active ingredients, and adverse side effects. Herein, we review the prevalence, ingredients, and health implications of cosmetic skin lightening products. We also provide recommendations for counseling patients who practice cosmetic skin lightening in a culturally sensitive manner.
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Affiliation(s)
- Natasha Masub
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Amor Khachemoune
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA.,Dermatology Service, VA New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
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Shivakumar S, Jafferany M. "The unfair drive to be fair": Psychosocial aspects and implications of the use of skin lightening agents. Dermatol Ther 2020; 33:e14091. [PMID: 32720427 DOI: 10.1111/dth.14091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 11/29/2022]
Abstract
The quest to be fair is not a concept of the new world. For centuries untold, having a lighter skin tone has been considered as a trait of beauty and supremacy. Society implicates fairness as a factor for getting a prospective life partner. Media portrays fair skin tone as a predecessor for success. These subtle influences affect young minds and drive them towards wanting fair skin. Physicians observe that it is one of the most common forms of body dysmorphic disorder. This article aims to highlight the psychosocial factors that mold this mentality and the possible ill effects it can have on a person, both psychologically as well as physically.
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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.
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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
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Tsampiras C. Walking up hills, through history and in-between disciplines: MHH and Health Sciences Education at the tip of Africa. MEDICAL HUMANITIES 2018; 44:270-280. [PMID: 30482819 DOI: 10.1136/medhum-2018-011494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/24/2018] [Indexed: 06/09/2023]
Abstract
Celebration, frustration, contestation and imagination all manifest themselves when examining the evolution of the field of Medical and Health Humanities (MHH) at the University of Cape Town (UCT). That this field has been growing at the same time as access to, inclusion in, and social justice issues linked to higher education have come under the spotlight has the potential to shape how we think and plan for the future of the field. Doing this will require treks up hills, journeys through difficult histories and dynamic dances in-between disciplines.This article examines MHH at UCT broadly, referring to projects and programmes that are underway primarily in the humanities and health sciences faculties. From this overview, the article specifically examines the curricula changes introduced in the Faculty of Health Sciences inspired by MHH and the author's interest in historical consciousness. It describes current points of intervention in physiotherapy and MBChB undergraduate curricula; and through short-term special study modules that have allowed those interested in MHH to explore relationships between health and healing and art, music, writing, yoga, PhotoVoice, drama, drawing and complex histories.It discusses some of the challenges of introducing humanities teaching into health sciences curricula; and some of the tensions that result from the meeting of divergent epistemologies and pedagogies. The article considers if, and how, MHH might engage with social (in)justice, and inclusions and exclusions and potentially offer a balm to soothe the bruising effects of oppressive histories and a hegemonically hierarchical present.
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Manderson L, Levine S. Southward Focused: Medical Anthropology in South Africa. AMERICAN ANTHROPOLOGIST 2018. [DOI: 10.1111/aman.13097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Lenore Manderson
- University of the Witwatersrand; South Africa, and Brown University USA
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Abstract
PURPOSE OF REVIEW Colourism, a form of prejudice and discrimination based solely upon skin colour, stands to jeopardize the physical health, wellbeing and life chances of adolescents of colour, globally. RECENT FINDINGS Research shows that adolescents can experience colourism at school and college, in the criminal justice system, at work and in the media they consume. It is therefore unsurprising that adolescents of colour often express a desire for lighter skin tones and/or are dissatisfied with their skin tone. Although research is scarce, some studies include older adolescents in their samples of skin-lightening product users. This is significant as the evidence is clear that the unmonitored use of skin-lightening products can be harmful to physical and psychological health, with evidence linking skin-lightening use to skin damage, kidney failure and depression. SUMMARY Although it is evident that colourism is central to the lives of adolescents of colour, more research is needed concerning the use of skin-lightening products among adolescents. Media literacy and critical race theory offer avenues in helping attenuate the harmful impact of colourism for adolescents of colour.
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Saade DS, Maymone MBC, Secemsky EA, Kennedy KF, Vashi NA. Patterns of Over-the-counter Lightening Agent Use among Patients with Hyperpigmentation Disorders: A United States-based Cohort Study. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2018; 11:26-30. [PMID: 30057662 PMCID: PMC6057735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Background: Over-the-counter (OTC) lightening agents are commonly used to treat hyperpigmentation disorders. Objective: We sought to determine the characteristics, trends, and preferences of patients with hyperpigmentation disorders seeking OTC agents in the United States. Design: The study was a cross-sectional study of consecutive patients with a disorder of hyperpigmentation seen in a United States-based outpatient dermatology clinic. Multivariable logistic regression models were used to identify factors associated with the use of OTC lightening agents. Setting: The study setting was an outpatient US-based dermatology clinic in Boston, Massachusetts. Results: Of the 406 patients studied, the majority were women (88.9%) with Fitzpatrick Skin Types IV to VI (64.5%). The most frequent diagnoses were melasma (42.9%) and post-inflammatory hyperpigmentation (PIH, 33.9%). Of our responders, 51.0 percent reported use of OTC agents and 44.9 percent reported use of prescription lightening products. Hydroquinone was the most commonly used cream (59.1%), followed by triple combination cream (fluocinolone acetonide, hydroquinone, and tretinoin, 16.3%). Of the cohort, 28.9 percent felt that the greater expense of the product correlated with greater efficacy. After multivariable adjustment, factors associated with a greater odds of using an OTC lightening agent included having a diagnosis of melasma (odds ratio [OR] 5.36; 95% CI: 2.98, 9.63; P<0.01) or PIH (OR 2.38; 95% CI: 1.25, 4.53; P≤0.01). Conclusion: The use of OTC lightening agents is widespread among those patients with hyperpigmentation disorders who reside in the United States. Those with melasma and PIH were more likely to use an OTC lightening cream. The majority of patients believed that OTC creams were safe to use without physician supervision. In those who had also tried prescription products, triple combination was deemed most effective compared to other lightening agents.
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Affiliation(s)
- Dana S Saade
- Drs. Saade, Maymone, and Vashi are with the Department of Dermatology at Boston University School of Medicine in Boston, Massachusetts
- Dr. Secemsky is with the Department of Medicine at Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts
- Mr. Kennedy is with Saint-Luke's Mid America Heart Institute and University of Missouri-Kansas City School of Medicine in Kansas City, Missouri
| | - Mayra B C Maymone
- Drs. Saade, Maymone, and Vashi are with the Department of Dermatology at Boston University School of Medicine in Boston, Massachusetts
- Dr. Secemsky is with the Department of Medicine at Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts
- Mr. Kennedy is with Saint-Luke's Mid America Heart Institute and University of Missouri-Kansas City School of Medicine in Kansas City, Missouri
| | - Eric A Secemsky
- Drs. Saade, Maymone, and Vashi are with the Department of Dermatology at Boston University School of Medicine in Boston, Massachusetts
- Dr. Secemsky is with the Department of Medicine at Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts
- Mr. Kennedy is with Saint-Luke's Mid America Heart Institute and University of Missouri-Kansas City School of Medicine in Kansas City, Missouri
| | - Kevin F Kennedy
- Drs. Saade, Maymone, and Vashi are with the Department of Dermatology at Boston University School of Medicine in Boston, Massachusetts
- Dr. Secemsky is with the Department of Medicine at Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts
- Mr. Kennedy is with Saint-Luke's Mid America Heart Institute and University of Missouri-Kansas City School of Medicine in Kansas City, Missouri
| | - Neelam A Vashi
- Drs. Saade, Maymone, and Vashi are with the Department of Dermatology at Boston University School of Medicine in Boston, Massachusetts
- Dr. Secemsky is with the Department of Medicine at Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts
- Mr. Kennedy is with Saint-Luke's Mid America Heart Institute and University of Missouri-Kansas City School of Medicine in Kansas City, Missouri
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Mackie P, Sim F. Getting under the skin. Public Health 2018; 155:A1-A3. [PMID: 29422140 DOI: 10.1016/j.puhe.2018.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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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.
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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.
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