Skin-lightening patterns among female students: A cross-sectional study in Saudi Arabia

BACKGROUND: Skin-lightening products (SLPs) are commonly used worldwide, and their improper use and overuse is becoming a burden on health care workers, including dermatologists. OBJECTIVE: This study aimed to determine the characteristics, determinants, preferences, and side effects of the use of SLPs among Saudi female students and their association with mental health. METHODS: A cross-sectional analytic study, using a self-administered prevalidated questionnaire, was conducted among female students in the Aljouf region of Saudi Arabia. We used the consecutive nonprobability sampling technique to recruit participants. The questionnaire contained demographic data, two questions about knowledge of SLPs, eight questions regarding perceptions of fair skin, and three proxy scales for mental health (depression, posttraumatic stress disorder, and Internet addiction). RESULTS: The mean age of the participants (± standard deviation) was 29 ± 9.6 years. Of the 760 responders, 427 (56.2%) used SLPs; all were women with relatively light skin (types III-V). There was a unanimous positive perception of lighter skin tone among women. The participants used skin-lighteners for cosmetic and medical conditions (67.2% and 17.5%, respectively). The practice was significantly associated with poor mental health status, poor level of knowledge, and lower sociodemographic status (p < .05). CONCLUSIONS: The use of SLPs is highly prevalent among Saudi female students. Users believe that fairer skin is associated with beauty and social advantage. Female students with a lower economic status and poor mental health are more prone to overuse SLPs. A need exists for targeted public health campaigns to raise public awareness about uncontrolled skin lightener usage.