Concern on Skin Lightening Product Safety: Level of Awareness and Associated Factors Among Female Users in Bahir Dar City, Ethiopia

Figures & data

Figure 1 Schematic presentation of sampling procedure.

Table 1 Socio-Demographic Background of Respondents (n = 358)

Variables		Level of Awareness		Total	Chi-Square (P-value)
		Non-Favorable Awareness	Favorable Awareness
Age	18–30	68(33.2)	48(31.4)	116(32.4)	0.017
	31–45	57(27.8)	63(41.2)	120(33.5)
	>45	80(39.0)	42(27.5)	122(34.1)
Residence	Rural	1(0.5)	4(2.6)	5(1.4)	0.090
	Urban	204(99.5)	149(97.4)	353(98.6)
Education Level	Cannot read and write	8(3.9)	2(1.3)	10(2.8)	0.000
	Can read and write	49(23.9)	14(9.2)	63(17.6)
	Primary school	49(23.9)	27(17.6)	76(21.2)
	Secondary & above	99(48.3)	110(71.9)	209(58.4)
Marital Status	Married	110(53.7)	80(52.3)	190(53.1)	0.797
	Not married	95(46.3)	73(47.7)	168(46.9)
Occupation	Governmental	49(23.9)	34(22.2)	83(23.2)	0.165
	Private work	46(22.4)	50(32.7)	96(26.8)
	House wife	41(20.0)	23(15.0)	64(17.9)
	Others	69(33.7)	46(30.1)	115(32.1)
Monthly Income in Ethiopian Birr	1000–3000	63(30.7)	41(26.8)	104(29.1)	0.667
	3001–5000	31(15.1)	30(19.6)	61(17.0)
	5001–7000	63(30.7)	48(31.4)	111(31.0)
	>7000	48(23.4)	34(22.2)	82(22.9)

Note: Statistically significant values are shown in bold (P-value <0.05).

Table 2 Skin Whitening Product Usage Pattern of Females (n = 358)

Variables		Level of Awareness		Total	Chi-Square (P-value)
		Non-Favorable Awareness	Favorable Awareness
Monthly expenditure (Ethiopian Birr) on SLPs	200–500	133(64.9)	95(62.1)	228(63.7)
	501–800	43(21.0)	29(19.0)	72(20.1)	0.328
	801–1100	21(10.2)	16(10.5)	37(10.3)
	>1100	8(3.9)	13(8.5)	21(5.9)
How often you purchase SLPs	Weekly	10(4.9)	10(6.5)	20(5.6)
	Monthly	150(73.2)	100(65.4)	250(69.8)	0.294
	Annually	1(0.5)	3(2.0)	4(1.1)
	Occasionally	44(21.5)	40(26.1)	84(23.5)
What influence you to use SLPs	Media (TV, radio)	19(9.3)	10(6.5)	29(8.1)
	Social media	70(34.1)	64(41.8)	134(37.4)	0.237
	Family	27(13.2)	25(16.3)	52(14.5)
	Friends	89(43.4)	54(35.3)	143(39.9)
SLPs make you look more beautiful?	Yes	189(92.2)	144(94.1)	333(93.0)	0.480
	No	16(7.8)	9(5.9)	25(7.0)
Your main reason to use SLPs?	To remove melisma	58(28.3)	24(15.7)	82(22.9)
	To remove acne and acne dark spot	46(22.4)	33(21.6)	79(22.1)	0.025
	To whiten my skin	68(33.2)	61(39.9)	129(36.0)
	To be more beautiful and gain confidence	33(16.1)	35(22.9)	68(19.0)
The most preferred body part you apply SLPs	Face only	174(84.9)	115(75.2)	289(80.7)
	Upper part	28(13.7)	36(23.5)	64(17.9)	0.055
	Lower part	3(1.5)	2(1.3)	5(1.4)
Satisfied with the outcome of SLPs	Yes	191(93.2)	141(92.2)	332(92.7)	0.715
	No	14(6.8)	12(7.8)	26(7.3)
Experienced side effects of SLPs such as: Inching on application area, Redness on cheeks and nose, Skin rash, Acne, Recurrent inflammation, Swelling around your eyes, Melasma, Irreversible darkening	No	106(51.7)	74(48.4)	180(50.3)	0.532
	Yes	99(48.3)	79(51.6)	178(49.7)

Note: Statistically significant values are shown in bold (P-value <0.05).

Abbreviation: SLPs, Skin Lightening Products.

Table 3 Awareness Evaluating Questions for Women Towards SLPs (n = 358)

Awareness Evaluating Questions		Level of Awareness		Total
		Non-Favorable Awareness	Favorable Awareness
Have you ever heard about skin whitening products before use?	No	0	0	0
	Yes	205(100)	153(100)	358(100)
Do you know the name of the skin whitening products you use?	No	1(0.5)	0(0.0)	1(0.3)
	Yes	204(99.5)	153(100)	357(99.7)
Is a medical prescription and supervision necessary for SLPs?	No	203(99.0)	101(66.0)	304(84.9)
	Yes	2(1.0)	52(34.0)	54(15.1)
Do you know one or more of these SLP: Beta carotene, Kojic acid, Faiza, Hydroquinone, Hydrocortisone?	No	9(4.4)	1(0.7)	10(2.8)
	Yes	196(95.6)	152(99.3)	348(97.2)
Do you know the active ingredients in skin whitening agents you use?	No	203(99.0)	123(80.4)	326(91.1)
	Yes	2(1.0)	30(19.6)	32(8.9)
Do you know that some skin lightening agents can harm your health?	No	202(98.5)	37(24.2)	239(66.8)
	Yes	3(1.5)	116(75.8)	119(33.2)

Abbreviation: SLPs, Skin Lightening Products.

Table 4 Factors Associated with Level of Awareness of Females Towards Skin Whitening Product

Variables	Level of Awareness (N = 358)		COR (95% CI)	AOR (95% CI)	P-value
	Favorable	Not Favorable
Age	48(31.4)	68(33.2)
18–30			1	1	0.017
31–44	63(41.2)	57(27.8)	1.57(0.94, 2.62)	1.39(0.66, 2.93)	0.381
≥45	42(27.5)	80(39.0)	0.74(0.44, 1.26)	0.88(0.39, 2.01)	0.764
Level of Education	2(1.3)	8(3.9)
Cannot read and write			1	1	0.000
Can read and write	14(9.2)	49(23.9)	1.14(0.22, 6.01)	1.63(0.25, 10.40)	0.608
Primary school	27(17.6)	49(23.9)	2.20(0.44, 11.13)	3.57(0.57, 22.32)	0.174
Secondary & above	110(71.9)	99(48.3)	4.44(0.92, 21.43)	7.66(1.23, 47.59)	0.029*

Notes: 1, reference group; *Statistically significant (P<0.05).

Abbreviations: AOR, Adjusted odds ratio; COR, crude odds ratio; CI, Confidence interval; SLP, Skin lightning product.