Bleaching and skin-lightening practice among female students in South India: A cross-sectional survey.

ABSTRACT

BACKGROUND: Bleaching with skin-lightening preparations is a common practice in our society. Particularly, a practice simply known as "bleaching"-referring to application of skin-lightening chemicals including ammonia, hydrogen peroxide, and hypochlorite, repeated at intervals, as a salon-based or home-based procedure appears wide-spread among young females in India. However, there is limited medical literature on "bleaching." AIMS: We aimed to estimate the prevalence of "bleaching" among female students of our campus and to assess the knowledge, attitude, and practices regarding "bleaching" in the same population. METHODS: A cross-sectional, questionnaire-based survey was conducted among the female students of the campus following a presurvey focus group discussion with a representative group. A pilot survey conducted to standardize the survey questionnaire showed a high reliability (Cronbach's alpha > 0.7). Descriptive statistical methods were used to assess survey results, and frequencies were presented as percentages. RESULTS: A total of 880 valid responses were analyzed (age group 17-30 years, mean age-20.24 years). 34.77% had done "bleaching" at least once. 63.8% of respondents did not know the ingredients, and 40.5% did not know about the side effects of "bleaching." 60.06% of those who bleached had experienced an adverse effect. 58.18% respondents knew about "bleaching" from friends/relatives and 17% from parlors. Only 2.3% respondents had consulted a dermatologist, and only 22.8% had used sunscreens. Top motivation to bleach was to lighten facial hairs (19.5%), for a "lighter" complexion (15.1%) and achieve "glow" before a function (15.2%). CONCLUSION: Facial skin and hair "bleaching" is common in our society, and awareness regarding "bleaching" is low even among educated youth.