Abstract
BACKGROUND: Individuals who practice skin lightening (SL) may develop various skin conditions, including permanent hyperpigmentation. Despite these adverse effects, people often continue using SL products in an attempt to treat the resulting hyperpigmentation, thereby creating a vicious cycle. The burden of SL among women is unknown in Tanzania. STUDY AIM: This study aimed to describe the practice of SL and its cutaneous effects among adult women in Kinondoni Municipality, Dar es Salaam. METHODOLOGY: A cross-sectional study was conducted from September 2023 to January 2024, using multistage sampling to select households and participants. Consenting members from 611 households were interviewed and examined. SL was identified through self-reported use of dermo-cosmetic products, verification of ingredients, and evidence of skin changes. Chi square test and Poisson regression were used to assess factors associated with SL practice. Statistical significance was set at p ≤ 0.05. RESULTS: A total of 1192 women with a median (IQR) age of 32 (26-42) were recruited. About half (52.3%) were married, and 46% had attained primary-level education. The overall prevalence of SL was 54.5%, with significantly higher prevalence among front desk workers (19%, p < 0.048) and petty traders (11%, p < 0.03). The most frequently used lightening agents were kojic acid (50%) and hydroquinone (34%). The majority (82%) of women practiced SL for beautification purposes, while only 1.3% used it with a medical prescription. Recommendations from spouses, friends, relatives, and cosmetic vendors, as well as product branding, affordability, and advertising significantly increased the likelihood of practicing SL (all p < 0.05). CONCLUSION: One in every two women in Kinondoni District was using SL products. The practice was common among front desk workers and petty traders, often following recommendations from friends, relatives, or cosmetic vendors. Health education on the dangers of hazardous cosmetics, along with stricter regulatory control of these products, may help reduce their usage.