title: Survey on skin-lightening practices and cosmetics in Kigali, Rwanda.
abstract: BACKGROUND
  The use of skin-lightening (SL) cosmetics appears to be common throughout the world, especially among dark-skinned women from sub-Saharan Africa.
  
  
  OBJECTIVE
  The aims of this study were to evaluate the extent of the practice of SL in Kigali, the capital city of Rwanda, the motivations behind this practice and the complexity of the adverse effects observed.
  
  
  METHODS
  An inventory of products sold on the Kigali market and their contents were compared with the results of a survey investigating the products used by the local population in order to deduce the proportions of people who depigment. The prevalence and severity of SL side effects (dermatitis, skin cancers, etc.) were evaluated in collaboration with dermatologists and general practitioners through a specific questionnaire and interviews. The sociological profiles of adolescents and their motivations for practicing SL were studied using qualitative and descriptive approaches through semi-direct individual and collective interviews.
  
  
  RESULTS
  A total of 27 creams were identified and classified according to labeled ingredients known to be depigmenting agents; 35% of the surveyed population were found to use products with skin-bleaching properties, but only 27% stated that they used the products specifically for these depigmenting properties. An inquiry into the motivations of adolescents indicated that they know about and practice SL but are restricted by family, religion, and Rwandese culture. Whenever side effects appear, consumers opt either to stop bleaching practices for a short period or to switch from their commercial topical product to another one with, presumably, a different composition.
  
  
  CONCLUSIONS
  Albeit that many people acknowledge that there are possible side effects of using preparations commonly used in SL, the practice is generally continued. Although it is important to question the rationale behind the practice of SL, it is equally important to develop and propose safer products.
authors.affiliation: Laboratoire de Pharmacognosie, de Bromatologie et de Nutrition Humaine, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Brussels, Belgium.|Centre de Recherche en Phytomédicaments et Sciences de la Vie, Institut de Recherche Scientifique et Technologique (IRST), Butare, Rwanda.
authors.forename: Léocadie
authors.initials: L
authors.lastname: Kamagaju
authors.affiliation: Laboratoire d'Oncologie et de Chirurgie Expérimentale, ULB Institut Jules Bordet, Brussels, Belgium.
authors.forename: Renato
authors.initials: R
authors.lastname: Morandini
authors.affiliation: Department of Dermatology, King Faisal Hospital, Kigali, Rwanda.
authors.forename: Françoise
authors.initials: F
authors.lastname: Gahongayire
authors.affiliation: Laboratoire de Pharmacognosie, de Bromatologie et de Nutrition Humaine, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Brussels, Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: Stévigny
authors.affiliation: Laboratoire d'Oncologie et de Chirurgie Expérimentale, ULB Institut Jules Bordet, Brussels, Belgium.
authors.forename: Ghanem
authors.initials: G
authors.lastname: Ghanem
authors.affiliation: Socio-Anthropologie du Développement, Institut des Sciences Humaines et Sociales, University of Liège, Liège, Belgium.
authors.forename: Gautier
authors.initials: G
authors.lastname: Pirotte
authors.affiliation: Laboratoire de Pharmacognosie, de Bromatologie et de Nutrition Humaine, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Brussels, Belgium.|Service de Chimie Thérapeutique et de Pharmacognosie (Therapeutic Chemistry and Pharmacognosy Service), University of Mons (UMONS), Mons, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Duez
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003358:Cosmetics / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003879:Dermatologic Agents / Q000627:therapeutic use*; D003906:Developing Countries; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012432:Rwanda; D012737:Sex Factors; D062327:Skin Lightening Preparations / Q000627:therapeutic use*; D012880:Skin Pigmentation / Q000187:drug effects*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003358:Cosmetics; D003879:Dermatologic Agents; D062327:Skin Lightening Preparations