Skin ‘Bleaching’ Practices and Associated Adverse Health Effects in Zimbabwe: A Canonical Correlational Study of Harare

The study aimed to identify the ingredients, processes and practitioners involved in the skin lightening practices in Zimbabwe and to identify the associated, adverse health effects as well as to establish the user demographics. A technical field survey was carried out in Harare, Zimbabwe from October 2022 to March 2023. Out of a total of 450 potential participants, 382 individuals in 3 broad groups were successfully interviewed; these included 150 skin lightening practitioners and traders, 118 skin lightening products users and 114 individuals who have never practiced skin bleaching. A semi structured technical questionnaire was used for each group of participants and the collected data were analysed qualitatively and quantitatively. The study observed that both sexes are involved in skin lightening in Zimbabwe, the majority (52%) being women aged between 31-45 years. The established industry, is divers, including registered healthcare providers, commercial trade, informal markets and others. The majority of practitioners (65%) have less than 5 practising years. There are over 30 different skin lightening products available either as prescription medications, OTC treatments, commercial products, network marketing products as well as illegal bootleg concoctions. The products extends from creams, lotions and serums, to oral and injectable dosage forms. The most prevalent products being corticosteroid creams. 75% of users reported both reversible and non-reversible adverse health side effects and outcomes including skin irritations, inflammation, rashes, erythema, oedemas, ochronosis, dermal atrophy, photophobia, insomnia and unexplained weight gain. The most prevalent side effect being pruritus and irritations. It was observed that there is no formal registration, regulation or legislation covering the products, processes and practice of skin lightening in Zimbabwe.