title: Use of skin-lightening products among selected urban communities in Accra, Ghana.
abstract: BACKGROUND
  The practice of skin lightening has been reported from North America, Europe, Asia, and Africa. In literature, some prevalence rates exceed 50%, and both sexes are involved. Common agents used include hydroquinone, mercury, corticosteroids, and caustic agents. The agents are easily accessible and affordable with very little regulation. Cutaneous and systemic side effects occur but do not appear to be a deterrent, as the notion of light skin as a surrogate for beauty is strong. In Ghana, anecdotal reports of high bleaching rates among certain urban communities resulted in a study supported by the Food and Drugs Authority to determine various facets of this practice.
  
  
  METHODS
  A cross-sectional study among adults in selected urban fishing communities of Accra was undertaken. Consecutive cases were enrolled after written informed consent. A questionnaire was administered, followed by physical examination and clinical photographs. Descriptive statistics were used to analyze the data.
  
  
  RESULTS
  Of the 555 participants from the three communities, prevalence was 279 (50.3%). Duration of use ranged from 2 months to 17 years. Approximately 212 (76%) used more than one product, and 231 (82%) used agents on their face and body. Dermatological features were hypopigmentation 270 (96.8%), other color changes including ochronosis 241 (86.4%), changes in consistency 141 (50.3%), striae 157 (56.3%), and infections 42 (15.1%).
  
  
  CONCLUSIONS
  The prevalence of skin bleaching was 50.3% in these communities, which is high considering the adverse effects from the practice. We recommend regulation of products by enforcing the law, more education, and a population prevalence study.
authors.affiliation: Dermatology Unit, University of Ghana School of Medicine and Dentistry, Accra, Ghana.|Department of Medicine and Therapeutics, Korle-Bu Teaching Hospital, Accra, Ghana.
authors.forename: Margaret
authors.initials: M
authors.lastname: Lartey
authors.affiliation: Department of Microbiology, University of Ghana School of Biomedical and Allied Health Sciences, Accra, Ghana.
authors.forename: Francis D
authors.initials: FD
authors.lastname: Krampa
authors.affiliation: Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences, Accra, Ghana.
authors.forename: Mubarak
authors.initials: M
authors.lastname: Abdul-Rahman
authors.affiliation: Department of Medicine and Therapeutics, Korle-Bu Teaching Hospital, Accra, Ghana.
authors.forename: Naa L
authors.initials: NL
authors.lastname: Quarcoo
authors.affiliation: Department of Community Health, University of Ghana School of Medicine and Dentistry, Accra, Ghana.
authors.forename: Phaedra
authors.initials: P
authors.lastname: Yamson
authors.affiliation: Department of Medicine and Therapeutics, Korle-Bu Teaching Hospital, Accra, Ghana.
authors.forename: Paa G
authors.initials: PG
authors.lastname: Hagan
authors.affiliation: Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences, Accra, Ghana.
authors.forename: Yao
authors.initials: Y
authors.lastname: Tettey
authors.affiliation: Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences, Accra, Ghana.
authors.forename: Richard
authors.initials: R
authors.lastname: Gyasi
authors.affiliation: Department of Pathology, University of Ghana School of Biomedical and Allied Health Sciences, Accra, Ghana.|Office of Research Innovation and Development, University of Ghana, Accra, Ghana.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Adjei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced; D017496:Hypopigmentation / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009794:Ochronosis / Q000139:chemically induced*; D010781:Photography; D010808:Physical Examination; D012874:Skin Diseases, Infectious / Q000139:chemically induced*; D062327:Skin Lightening Preparations / Q000009:adverse effects* / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D013997:Time Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D062327:Skin Lightening Preparations