Steroid driven skin lightening, a public health concern and its impact on Somali women in Kenya: An integrative review

Background: Steroid misuse among Somali women in Kenya continues to pose a serious public health challenge. Recent findings indicate that approximately 66% of women in this community have either used skin-lightening steroids themselves or know someone who has, often in pursuit of socially constructed beauty ideals. Despite being aware of the dermatologic side effects, many users persist frequently without knowledge of the products’ actual ingredients or long-term risks. This study seeks to unpack the underlying drivers of steroid misuse, identify key influencers and distribution channels, and examine the systemic health consequences. Our ultimate goal is to inform targeted public awareness strategies that can help curb the prevalence of unsafe steroid use.

Methodology: This research adopts an integrative review approach, synthesizing findings from previously published literature across varied methodologies. The included studies span retrospective and prospective analyses, laboratory-based investigations, and existing systematic reviews. Using targeted search terms “Steroids,” “Abuse,” and “Steroids AND Somali” a total of 24 articles were retrieved, with 11 meeting the inclusion criteria after screening for relevance and duplication.

In addition to the systematic review, the study incorporates primary data collected via a Google Form designed with Somali-language translations to ensure participant comprehension. This tool explored the underlying drivers of steroid misuse, including social motivators, enabling factors, and potential strategies for prevention and public health intervention.

Expected outcome and Significance: We aim to explore the cultural and social norms within the Somali community that shape prevailing beauty standards particularly the perception that lighter skin is more desirable. These norms appear to be key drivers behind the use of steroid-containing products, often without users knowing the ingredients or understanding the potential health risks. Through this research, we also intend to design a targeted awareness campaign that addresses these misconceptions and promotes safer, informed choices, with the broader goal of reducing steroid misuse.

Awareness campaign: in this study we have highlighted multiple mechanisms which can enable the population to be aware of the effects of these steroids. These mechanisms include an informative health poster.

Conclusion: In conclusion, the use of skin-lightening products containing steroids and harmful substances such as hydroquinone and mercury remains widespread. Many women who use these products are unaware of their ingredients and the potential health risks, driven instead by societal pressures to conform to narrow beauty standards. Encouragingly, a significant number of users have expressed willingness to discontinue use if properly informed. This study therefore aims to bridge that knowledge gap by fostering awareness, promoting safer choices, and ultimately reducing the prevalence of steroid misuse.