title: Women's perceptions of the benefits and risks of skin-lightening creams in two South African communities.
abstract: BACKGROUND
  Skin-lightening products are commonly used by black communities in South Africa and worldwide. This practice has deep historical and cultural roots and is associated with adverse cutaneous effects.
  
  
  METHODS
  A cross-sectional survey of 579 African and Indian women aged 18-70 years was conducted in two large public hospitals in Durban, South Africa.
  
  
  RESULTS
  There were 292 Africans and 287 Indians included in the survey sample. Of these 32.3% had used skin-lightening products (60% of Africans and 40% of Indians). Most of those who had used skin lighteners (85 of Africans and 76% of Indians) claimed awareness of the adverse effects of the products, although this did not appear to inform knowledge of the product, how it was used, nor the decision to use the product. Most users (90%) expressed satisfaction with results achieved but 32% reported adverse events.
  
  
  CONCLUSIONS
  Skin-lightening products are used by a third of African and Indian women in South Africa Cultural and historical perceptions equating a fairer skin with social advantage are pervasive and strongly reinforced by the media. There is a poor understanding of the risks associated with the use of these products. Public education campaigns are required to teach consumers about these risks and the importance of concomitant use of sunscreens with these products.
authors.affiliation: Division of Dermatology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Ncoza
authors.initials: N
authors.lastname: Dlova
authors.forename: Saja H
authors.initials: SH
authors.lastname: Hamed
authors.forename: Joyce
authors.initials: J
authors.lastname: Tsoka-Gwegweni
authors.forename: Anneke
authors.initials: A
authors.lastname: Grobler
authors.forename: Richard
authors.initials: R
authors.lastname: Hift
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People / Q000523:psychology*; D003258:Consumer Behavior; D003430:Cross-Sectional Studies; D003469:Culture; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010465:Perception; D018570:Risk Assessment; D062327:Skin Lightening Preparations / Q000009:adverse effects; D013019:South Africa; D044465:White People / Q000523:psychology; D055815:Young Adult
chemical_list: D062327:Skin Lightening Preparations
keywords: African; Indian; cosmetic habits; ethnic; skin bleaching; skin lightening