Use of skin whitening products in Sri Lanka: an observational study

Background:Fair complexion is often considered a symbol of social dignity in South Asian cultures and the use of skin whitening products is prevalent.

Objectives: To ascertain the pattern of usage and adverse effects of skin whitening products used in Sri Lanka.

Settings and Design: This observational study was conducted at an outpatient Dermatology clinic in Kandy, Sri Lanka.

Methods and Material: Patients who had a history of skin whitening product application were enrolled. Patients who used topical or systemic steroids for medical indications were excluded. Enrolled patients were evaluated by a consultant dermatologist. Data were collected by using an interviewer- administered questionnaire.

Results:A total of 100 patients (94 females) with an age range of 13 to 51 years were recruited. Most patients had applied skin whitening products on the recommendation of friends. The commonest duration of use was two to four months. The adverse effects observed were skin atrophy (63%), telangiectasia (61%), acne (48%), pigmentary changes (38%), and hypertrichosis (19%).

Conclusions:  Use of skin whitening products is associated with adverse effects such as acne, skin atrophy, hypertrichosis and telangiectasia that have some resemblance to steroid-induced skin changes. Therefore, the promotion and sale of these products should be regulated more strictly by the relevant authorities.