Abstract
BACKGROUND: Increasing reports of life-threatening complications in young children exposed to skin-lightening products present a significant public health concern, yet this issue remains under-researched. OBJECTIVES: To determine the prevalence, maternal perceptions and predictors of early childhood exposure to skin-lightening products among mothers in Southwestern Nigeria. DESIGN: A cross-sectional, questionnaire-based study. SETTING: Three randomly selected government-owned primary healthcare facilities in Ile-Ife, Nigeria. PARTICIPANTS: Three hundred and sixty-nine mothers aged ≥18 years, each with at least one child under 5, recruited by simple random sampling. Data were collected between May and July 2024 using pretested, interviewer-administer semistructured questionnaires. Mothers with acutely ill children were excluded. PRIMARY OUTCOME AND SECONDARY OUTCOME MEASURES: Primary outcome was the use of skin lightening products on children while secondary outcomes included maternal use, perceptions and sociodemographic/familial predictors. RESULTS: Participants' ages ranged from 18 to 54 years (mean: 30.92±6.11 years). Overall, 19.5% (n=72) mothers practised early childhood skin lightening, with 80.6% of exposed children <2 years. Maternal product use strongly predicted early childhood exposure (adjusted OR: 15.23, 95% CI 6.98 to 33.21, p<0.001), while perception of lighter skin as socially/economically advantageous increased the odds by twofold (adjusted OR:1.83, 95% CI 1.02 to 3.29, p=0.043). Other associated factors were limited awareness of health risk (OR 4.41, 95% CI 1.38 to 14.10; p=0.012) and normalisation of skin lightening practices within the family (OR 2.06, 95% CI 1.22 to 3.49; p=0.007). Socioeconomic status and education were not significant. CONCLUSION: This study highlights a high prevalence of early childhood exposure to lightening products in a semiurban Nigerian community, with maternal use emerging as a key associated factor. Although awareness of potential health risks was common, aesthetic preferences for lighter skin tones appeared to outweigh safety concerns. These findings highlight the need for culturally sensitive interventions and further research to inform strategies that promote safer childhood skin-care practices.