The use of skin fairness products that frequently contain toxic ingredients is associated with significant adverse health side effects. Due to the high prevalence of use in Asian and African countries, skin fairness product use is recognized as a growing public health concern. The multi-million-dollar skin fairness product industry has also been criticized for perpetuating racism and social inequalities by reinforcing beliefs about the benefits of skin fairness for cultural capital. No quantitative studies have assessed people's beliefs about fairness and reasons for using or not using these products in India, one of the largest global markets for skin fairness products. The current study explored skin fairness product use among 1,992 women and men aged 16–60 years in the city of Mumbai, India using a self-report questionnaire. A total of 37.6 percent of the sample reported currently using skin fairness products, with women being two times more likely to use these products. Among current users, 17 percent reported past experiences of adverse side effects, and "Media/TV/Adverts" were the most common prompts for using fairness products, followed by "Friends" and "Family." Men were significantly more likely than women to endorse beliefs about fairness being more attractive and were more likely to perceive family and peers as viewing fairness as beneficial for cultural capital. There were no differences between women and men currently using products in their desire to look as fair as media celebrities. Among non-users, women were significantly more likely than men to report concerns about product efficacy and side effects as reasons for non-use, while men were significantly more likely to report socioeconomic reasons for non-use. Implications of these findings are discussed in light of growing public health concerns about the use of fairness products, and the potential for advocacy and public health interventions to address the use of skin fairness products.

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david.deng@wecistanche.com / WhatApp:86 13632399501

Ievads

Studies have documented the use of skin fairness products, sometimes referred to as "skin whitening products," "skin bleaching products," or "depigmenting agents," in Africa, Europe, North America, and Asia, with the prevalence of use ranging from 27 to 77 percent among community samples (1). Skin fairness products include whitening and skin-lightening creams, face washes, deodorants, and lotions. This industry is one of the fastest-growing segments of the global beauty industry, particularly in Asia and Africa, with marketing forecasters predicting it will be worth an estimated $US 31.2 billion by 2024 (2). Historically marketed to women, companies have recently expanded their offerings to include products designed and marketed specifically for men. Advertisements and packaging overtly claim that products will make consumers' skin fairer and more even-toned, while product names and the use of well-known models and actors in advertisements imply that they will enhance consumers' cultural capital via improvements in attractiveness, youthfulness, confidence, and success (3, 4). Cultural capital refers to social and cultural assets (e.g., education, style of speech and dress, intellect, and appearance) that can enhance an individual's social mobility in stratified societies (5).

The widespread use of skin fairness products is increasingly recognized as a public health, environmental justice, and social justice issue due to the deleterious health side effects and the potential reinforcement of racial and social inequalities (6, 7). Despite this, empirical research into skin fairness product use is limited to the prevalence and medical side effect investigations, especially among samples in Asia (1). This is particularly the case for research conducted in India, one of the fastest growing markets with an annual spend of $US 450 million on skin fairness products (8). Recognizing the social and public health implications of fairness product use, this study presents an examination of women's and men's use of skin fairness products and their beliefs about fairness in a metropolitan area in India.

atbilstība no āda taisnīgums produkti to sabiedrība veselība ir izcelts ar joma of the industry, the widespread use of these products, and the potenciālais veselība riski saistīti ar to lietošana. Veids un apjoms puse ietekme atkarība atkarīgs no daba un koncentrācija of produkts sastāvdaļas (9). Kamēr daži kosmētikas produkti ir saistīti ar zemāks risks, citi produkti satur ļoti aktīvi un potenciāli bīstami sastāvdaļas, piemēram kā hidrohinons, dzīvsudrabs, un balināšana aģenti tādi as ūdeņradis peroksīds (10, 11). Agarwal et al. (12) tested 23 āda godīgums sejas krēmi pieejami in Indija un atrasts tas gandrīz 50 procenti no šiem krēmiem (n = 11) saturoši steroīdi tas var būt kaitīgs to āda. A turpmākais pētījums atrasts ka līmenis no dzīvsudrabs daudzi populāri sejas krēmi ir pieaug pār laiks (13).

Blakusparādības efekti no āda taisnīgums produkti satur hidrohinons, steroīdi, or dzīvsudrabs var iekļaut kairinājums, iekaisums, retināšana of āda, rētas, anomālijas starp jaundzimušie zīdaiņi if lietots grūtniecība grūtniecība un zīdīšana, un nieres, aknas, or nervs bojājums (14, 15). Ādas balināšana līdzekļi arī palielinājums uzņēmība pret infekcijām tai skaitā baktērijas, sēnītes, parazīti, un vīrusi (16). Daži valstis (piem. , Gana, Ziloņkauls Piekraste, Nigērija, Dienvidāfrika Āfrika, un Zimbabve) ir aizlieguši imports of taisnīgums produkti kas satur hidrohinonu un dzīvsudrabu (17). Tomēr, daudzas valstis, ieskaitot divas lielākās tirgus, Indija un Ķīna, do not ir noteikumi on sastāvdaļas ietverts in šie produkti. Plaši izplatīta izmantošana āda taisnīgums produkti dāvanas a aug sabiedrība veselība bažas , jo īpaši Āzijā.

In several Asian countries and cultures, white or fair skin is perceived to be more attractive and desirable due to its social advantages for marital and career prospects (1, 18). This is particularly relevant in Asian countries, including India, Japan, Korea, China, and Thailand, where skin fairness has been understood to be a cultural marker of class, wealth, and social status for centuries (1). The advertising industry, in particular, is argued to play a significant role in reinforcing and capitalizing on stereotypical notions of caste, age, race, and beauty. Shankar et al. (19) assert that the advertising of fairness products is akin to "disease mongering," not necessarily creating a market where there is not one, but playing on people's insecurities about appearance and making huge profits from them. A content analysis of advertisements for skin-related products in women's magazines in India, Japan, Korea, and Hong Kong found that "good skin" was depicted as "smooth, young, pore-less, line-free, bright, transparent, white, full and fine" and advert narratives suggested enhanced cultural capital through the use of products advertised to achieve fairer skin (4). Thus, fairer skin may be assumed to improve career and marital prospects and increase cultural capital in societies that value fair skin.

Indija dāvanas a īpaši interesants gadījums piemērs dēļ tā tā liela tirgus daļa in the skin fairness industry and its senie kultūras priekšstati of beauty and fairness, kas ir stipras saites ar kastu un kopienu aizspriedumiem, kurpju taisnīgāks āda is vēlams (20). Indijā, the tirgus bija liberalizēts uz priekšu beigas of divdesmitais gadsimts, kas noveda a pārspriegums in the the fairability products. At present, there are many fairness creams, face washes, and losions for men and women wide available, including products marketed by local and international brands. The skin fairness industry currently represents 50 percent of India's whole skincare market, with estimates of its worth variing between $US 450–535 million (8, 21).

Indian consumers are led to believe that fairer skin will provide them with higher status, and advertisements serve to reinforce this notion (21, 22). Phillips (23) describes the societal equation of fairness with beauty and the accompanying negative connotation of lack of beauty associated with darker skin color in India. She also discussed the associated moral and behavioral qualities linked with skin color, highlighting the far-reaching impact fair skin may have on an individual's life and cultural capital within the Indian context. Individuals with darker skin in India are often assumed to be blue-collar or manual workers, required to spend time outdoors where their skin becomes darker. Furthermore, darker skin color has been associated with adverse moral and behavioral qualities (4, 23). These factors are compounded by two centuries of colonial "white" rule (20). Consequently, there are strong ties between caste, economic class, marital prospects, occupation status, colonialism, and skin color in India.

Although theoretical critiques have examined the marketing and use of skin fairness products in India, empirical quantitative research on skin fairness product use and the social and psychological factors driving this is sparse. Most quantitative studies [e.g., Ref. (24)] investigating the prevalence of, and reasons for, using skin fairness products have been conducted in Sub-Saharan Africa (1). Nonetheless, a few studies indicate that the use of these products is prevalent and associated with social disadvantage and poor health correlates among Indian consumers. Indian women and men were included in a 26-country study that investigated the prevalence and correlates of using skin fairness products among undergraduate students (16). In their study, the authors found that 18.9 percent of 799 Indian undergraduate students sampled reported using skin fairness products, and their use was associated with depression, risky sexual behaviors, lack of personal control, and low social support. Furthermore, a recent experimental online study found that women in India who were primed temporarily to feel disempowered were likely to indicate a stronger preference for medically risky skin fairness products (i.e., those containing more active and potentially harmful ingredients) as compared to less risky cosmetic products, in addition to finding the products more relevant and useful (25).

To inform future research, advocacy, and public health intervention efforts, the current study was undertaken to explore the use the use and non-use of skin fairness products in a large, educated, community sample of women and men in Mumbai, India. Among self-identified current users and non-users, reasons for use or non-use were assessment and beliefs about the benefits of skin fairness were also izpētīts. Dzimumu atšķirības in iemesli par un pret lietošana taisnīgums produkti bija arī izpētīti. Dots ka skaistums produkti ir vēsturiski bijis tirgots sievietēm un ka sievietēm tend to būt vairāk iespējams būt tiesāts balstīts uz viņu izskatu, pieredze sliktāks ķermenis attēls, un ir mazāk sociālais kapitāls nekā vīrieši (4, 7), it bija hipotēze ka sievietes būtu vairāk iespējams ziņotu lietošana lietošana ādas godīgums produkti nekā vīrieši un būtu vairāk iespējams būtu vairāk iespējams apstiprināt , nozīme āda taisnīgums par pievilcība un kultūras kapitāls nekā vīrieši.

Materiāli un Metodes

Dalībniekiem

The sample consisted of 1,992 adults (62 percent women) from Mumbai, India. The mean age of the entire sample was 24.69 years (SD=9.06; range 16–60 years). The distribution of occupations was such that 1,217 (61 percent ) were students, 172 (8.6 percent ) were professionals, 257 (12.9 percent ) were employed (other than professionals), 225 (11.3 percent ) were homemakers, 65 (3.3 percent ) were involved in business, and the rest (2.9 percent ) did not provide data on their occupation. There were 748 participants (542 women, 206 men, and 6 did not report gender) who reported that they had used skin fairness products in the past 30 days (current users). The mean age among current users was 24.73 (SD=9.12). The remaining 1,238 participants (696 women, 540 men, and 2 had not specified gender) had not used fairness products in the past 30 days (non-users). The mean age of non-users was 24.67 years (SD=9.03). See Table 1 for more demographic information.

Pasākumi

Dalībnieki aizpildīts a pašziņojums anketa in viņu home, classroom, or workplace.

Demogrāfijas

Dalībnieki paši ziņojuši viņu dzimums, vecums, un nodarbošanās ietvaros anketā.

Lietošana of Āda Godīgums Produkti

Participants were asked if they had ever used skin fairness products in their lifetime ("How often in your life have you used fairness products?"). The response format was 0="Not at all," 1="Less than one month," 2="1–3 months," 3="4–6 months," 4="more than six months." They were also asked about their frequency of use in the last 30 days ("On how many occasions in the past thirty days have you used fairness products?"). The response format for this question was 0="Not at all," 1="1–2 times a week," 2="3–4 times a week," 3="Everyday," 4="More than once a day." For subsequent analyses, non-users were defined as those who reported that they had used fairness products "Not at all" in the last 30 days. Current users were defined as those who reported any use of fairness products in the past 30 days.

For current users, further items asked the respondents about who had introduced them to fairness products (open-ended response format), the age at which they first started using fairness products, and their main reason for using fairness products (open-ended response format). They were also asked if they had experienced any adverse side effects after using fairness creams and whether they had consulted a health professional either before or after use ("Yes" or "No" response formats).

Ticējumi par Taisnīgums

Ticējumi par taisnīgums bija novērtēti ar a mērķtiecīgi-veidots mērogs, as tur bija nebija plaši izmantots standartizēts mērogs pieejams. The first author (Hemal Shroff) radīts the scale with feedback from doctors, academics, and statistical consultants. Items were pilot tested with a sample of 10 individuals to ensure comprhension of the items. No changes were needed based on the pilot testing. Skaitļošana of nozīmē un SDs bija izdarīts par demogrāfija vienumi, biežums of use, and the user and non-user scales.

Dalībnieki kas ziņoja strāva (ietvaros pagātne 30 dienas) lietošana of godīgums krēmi bija jautāja pabeigt a 15-}item scale (The Usage of Fairness Products Scale; see Table 2). Three subscales assessed beliefs about "body image and attractiveness" (piemēram, , "The fairer I am, the more attractive I feel"), "family and peer influence" (piemēram, , "I try to look fair because my family members say it is attractive"), and "media and celebrity influence" (piemēram,, "I wish I was as the people (aktieri) on TV and in ads"). Subscales were developed conceptally based on prior body image research and theory [e.g., Ref. (26)]. Principal components analysis revealed three factors congruent with these subscales, with satisfactory factor loadings (item coefficients <0.50) for statements onto their respective subscales. Participants were asked to rate on a Likert scale the extent to which they agreed with the statements (1 = strongly disagree; 5 = strongly agree) contained within each subscale. Mean total subscale scores were calculated with higher scores indicating greater endorsement of the beliefs about fairness. Internal consistencies for the subscales were good among women and men (Cronbach's α = 0.77–92). Mean and SD scores for items for the male and female users on each subscale are included in Table 2.

Participants who reported they had not used fairness products in the last 30 days (i.e., non-users) were asked to complete an 8-item scale (The Non-Usage of Fairness Products Scale; see Table 3). Two subscales assessed beliefs about "product efficacy and side effects" (e.g., "I don't use fairness products because they are harmful to my skin") and "socio-economic factors" (e.g., "I don't use fairness products because I cannot afford them"). Principal components analysis revealed two factors congruent with these subscales. However, while the factor loading for the first subscale "product efficacy and side effects" was satisfactory (item coefficients <0.55), the results were poor for the "socio-economic factors" subscale (item coefficients <0.35). Participants were asked to rate the extent to which they agreed with the statements within each subscale on a Likert scale (1 = strongly disagree; 5 = strongly agree). Mean subscale total scale scores were calculated with higher scores indicating greater endorsement of reasons for not using fairness creams. Internal consistency values for the "product efficacy and side effects" subscale were satisfactory among women and men (Cronbach's α = 0.69–0.71), although they were inadequate for the "socio-economic factors subscale" (Cronbach's α = 0.44–0.48). Mean and SD scores for items for the men and women non-users are included in Table 3.

Procedūru

For more info: david.deng@wecistanche.com / WhatApp:86 13632399501