Table 1

Characteristic	Category	n	%
Age (years)	18–25	33	60
Age (years)	>25	22	40
Mean age (years)	—	30	—
Educational attainment	Form Two or below	9	15.8
	Certificate level	36	65
	Diploma level and above	7	12
	Form Four	4	7.2
Occupation	Drinking den attendants/service staff	30	55
	Salon workers	10	18
	Not clearly specified	8	15
	Casual hotel workers	2	4
	Registered clerical workers	2	3
	Indoor/domestic workers	2	3
	Well-paying jobs	1	2
Monthly income (TZS)	≤ 100,000	25	45
	> 100,000	30	55

Table 1: Below Showing Socio-Demographic Charcterstics of Study Participants (N=55)

Table 2

Characteristic	Category	n	%
Age (years)	18–25	33	60
	>25	22	40
Mean age (years)	—	30	—
Educational attainment	Form Two or below	9	15.8
	Certificate level	36	65
	Diploma level and above	7	12
	Form Four	4	7.2
Occupation	Hospitality & personal services	40	72.7
	Informal/unstable employment	8	14.5
	Formal employment	3	5.5
	Domestic/indoor work	2	3.6
Monthly income (TZS)	≤ 100,000	25	45
	> 100,000	30	55

Table 2: Socio-Demographic Characteristics of Study Participants (Simplified Occupational Categories) (N = 55)

Table 3

Characteristic	Category	N	%
Age group (years)	18–29	37	67.5
	≥30	18	32.5
Skin-bleaching status	Ever users	49	89.6
	Non-users	6	10.4

Table 3: Sociodemographic Characteristics of Respondents (N = 55)

Table 5

Variable	Category	N	%
Skin-bleaching practice	Current users	35	71.4
	Former users	6	12.5
Duration of use	< 1 year	12	24.7
	> 3 years	36	72.5
Frequency of application	Once or twice daily	31	64.2
	Multiple times daily	12	25

Table 4: Prevalence and Patterns of Skin-Bleaching Practices Among Users (n = 55)

Percentages are based on skin-bleaching users only (N = 55). Minor discrepancies may reflect rounding or non-response.

Table 6

Body area	N	%
Face	48	98.2
Arms	41	83.5
Legs	19	38.4
Entire body	14	28.5

Table 5: Body Areas Commonly Bleached by Participants (Multiple Responses Allowed) (n = 55) Body Areas Commonly Bleached by Participants (Multiple Responses Allowed) (n = 55)

Multiple responses were permitted; percentages exceed 100%.

Table 7

Product type	n	%
Soaps	47	95.5
Creams	47	95
Lotions	46	93.4
Serums	41	84.2
Tablets (oral products)	3	6
Concurrent use of multiple products	34	68.4

Table 6: Types of Skin-Bleaching Products Used and Usage Patterns (N = 55)

Table 8

Dermatological symptom	N	%
Any dermatological effect	33	67.2
Skin thinning	44	89.4
Hyperpigmentation/dark spots	28	56.5
Acne or rashes	11	23.3
Skin irritation	4	8.7

Table 7: Self-Reported Dermatological Health Effects among Skin-Bleaching Users (n = 55)

Symptoms are self-reported; multiple responses were allowed.

Table 9

Systemic symptom	N	%
Any systemic symptom	43	87
Headaches	45	92
Fatigue	44	90.4
Menstrual irregularities	33	67.5
Urinary/kidney-related complaints	17	35.2

Table 8: Self-Reported Systemic Health Symptoms Among Skin-Bleaching Users (N = 55)

Table 10

Sample	Product	Hg	Hg Risk	Pb	Pb Risk	Cd	Cd Risk
Code	Type	(µg/g)	Category	(µg/g)	Category	(µg/g)	Category
C1	Cream	2.3	Moderate	1.1	Safe	0.05	Safe
C2	Cream	0.8	Safe	0.3	Safe	0.01	Safe
C3	Cream	4.5	High	1.8	Moderate	0.12	Moderate
L1	Lotion	1.2	Safe	0.9	Safe	0.02	Safe
L2	Lotion	3.1	Moderate	2.5	Moderate	0.08	Moderate
S1	Soap	0.5	Safe	0.2	Safe	0.01	Safe
S2	Soap	1.9	Moderate	0.7	Safe	0.03	Safe
SR1	Serum	5.2	High	3	High	0.15	High
SR2	Serum	2	Moderate	1.2	Safe	0.05	Safe

Table 9: shows Quantitative and Risk-Coded Results of Cosmetic Samples

From the table Hg limit: 1 µg/g; Pb limit: 1.5 µg/g; Cd limit: 0.1 µg/g (WHO/FDA), and in risk categories: Safe ≤ limit; Moderate > limit but ≤ 2× limit; High > 2× limit.

Table 11

Chemical	Samples Tested	Samples Above Limit	% Exceedance
Hg	9	6	0.667
Pb	9	3	0.333
Cd	9	3	0.333

Table 10: showing Percent Exceedance of Toxic Metals in Samples

Table 12

Chemical/Active Ingredient	Reported Use in Study	Common Body Areas	Associated Health Risks	References
		Applied
Corticosteroids	Frequently used in creams, lotions, serums	Face (98.2%),	Skin thinning (89.4%), stretch marks, acne/rashes (23.3%), delayed wound healing, systemic endocrine disruption, Cushing-like symptoms	WHO, 2023;
		arms (83.5%),		FDA, 2022
		legs (38.4%),
		entire body (28.5%)
Hydroquinone	Common in creams, soaps, serums	Face (98.2%),	Hyperpigmentation/dark spots (56.5%), paradoxical reactions (exogenous ochronosis), skin	Mahé et al., 2003; WHO,
		arms (83.5%)	irritation (8.7%), potential DNA damage	2023
Mercury	Occasionally present in unregulated products	Face, arms, legs, full body (28.5%)	Neurological symptoms (headaches 92%, fatigue	FDA, 2022;
			90.4%), renal/urinary	WHO, 2023
			complaints (35.2%), immunotoxicity, systemic
			toxicity
Combination/Multi- product Use	68.4% using ≥2 products concurrently	Mainly face and arms	Cumulative exposure increases risk of dermatologic reactions, systemic toxicity, and	Mahé et al., 2003; WHO,
			interaction effects	2023
Oral tablets	6% of participants	Systemic	Potential internal toxicity,	WHO, 2023
			kidney damage, endocrine effects

Table 11: Summary of Health Risks Associated with Skin-Bleaching Practices (N = 55)

Table 13

Donabedian Domain	Quantitative	Toxicological	Qualitative
Structure	Health access gaps	Illegal product content	Regulatory failures
Process	Usage prevalence	Exposure intensity	Social pressure
Outcome	Health risks	Toxicity linkage	Psychosocial harm

Table 12: Showing the Data Integration (Triangulation) On System Weaknesses and Societal Pressures Drive Toxic Exposure and Health Harm Based On Donabedian Framework

Tables at a glance