The Use of Over-the-Counter (OTC) Skin-Lightening Agents and Their Side Effects Among the Residents of Saudi Arabia: A Cross-Sectional Study.

Introduction: Over-the-counter (OTC) skin-lightening agents are topical products in the form of lotions, creams, oils, soaps, and serums designed to alter skin pigmentation primarily for cosmetic purposes. The growing misuse and overuse of these products has become a serious public health concern due to their potential adverse effects on human health and their quality of life.

Methods: This study was cross-sectional in nature, adopting a convenience sampling technique utilizing data from a sample of 408 residents of Arar, Northern Saudi Arabia. The participants completed online questionnaires, distributed through social media means like Telegram, WhatsApp, and Facebook ensuring anonymity. Data was analyzed using SPSS Version 27 to obtain important insights.

Results: The sample of the study had a predominance of females 304 (74.5%) while only 104 (25.5%) were males. A substantial proportion of 170 (41.7%) of the participants were aged between 20 and 35 years with more than half (229 (56.2%)) being single and the majority (266 (65.2%)) having university and above level of education. More than half (259 (63.5%)) of them indicated that they had bought skin-lightening products without a doctor's prescription. Twenty-eight (10.8%) of the participants had been diagnosed with a condition that increased skin pigmentation before with a substantial proportion (11 (39.3%)) noting that the product contained hydroquinone cream ingredients. The overall prevalence of OTC skin-lightening agents among the participants of Arar, Northern Saudi Arabia was 63.5% (259/408). The study found a significantly high prevalence of use of OTC skin-lightening agents among participants aged 20-35 years (87 (71.3%)) (p=0.031) as well as those who had a university level of education and above (129 (71.3%)) (p=0.001). The findings show that 39 (40.6%) of the female respondents and eight (30.8%) of the male participants experienced adverse effects associated with irritation and redness.

Conclusion: Overall, the study found a considerably high prevalence of the use of OTC skin-lightening agents among the participants of Arar, Northern Saudi Arabia. The use of OTC skin-lightening agents was significantly greater among female participants than male participants. The commonly used products contained hydroquinone cream ingredients, which presented adverse effects and complications associated with irritation, redness, and darkening of the skin. It is imperative to launch targeted public awareness campaigns to educate the community, especially women, about the risks associated with OTC skin-lightening agents, promote safer alternatives, and advocate for stricter regulation and control over the sale and distribution of skin-lightening products containing harmful ingredients.