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J. Cosmet. Sci., 69, 101–120 (March/April 2018) 101 Health Knowledge, Cosmetic Interests, Attitude, and the Need for Health Education Regarding the Use of Topical Bleaching Agents Among Women in West Saudi Arabia: A Cross-Sectional Study MARIAM EID ALANZI, RIYADH A. ALGHAMDI, OSAMA MOHAMMED ALSHARIF, KHALED S. ALGHAMDI, KHALID EID ALANZI, and SALAH MOHAMMED EL SAYED, Family Medicine Postgraduate Program, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia (M.E.A.), Family Medicine Postgraduate Program, Al-Madinah Al-Munawwarah, Ministry of Health, Saudi Arabia (M.E.A., R.A.A., and K.S.A.), Department of Dermatology, King Fahd Hospital, Al-Madinah Al-Munawwarah, Ministry of Health, Saudi Arabia (O.M.A.), Dermatology trainee, Alexandria Faculty of Medicine, Alexandria University, Egypt (K.E.A.), Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia (S.M.E.L.), Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag University, Egypt (S.M.E.L.) Accepted for publication January 28, 2018. Synopsis We aimed at investigating the cosmetic interests, public confi dence in cosmetic industry, health knowledge, practice, and need for health education regarding using topical bleaching agents (TPAs) among a relatively big sample size in Al-Madinah (west Saudi Arabia, a conservative eastern society that acquires its social customs from Islam). Islamic values increased women respect and esteem in this society. This is refl ected on cosmetic practices and attitude, e.g. women use face cover outdoors. This issue is vital for both women health and beauty, and is rarely discussed. TPAs use is affected by culture, social customs, and health awareness regarding TPAs chemical constituents, e.g. hydroquinone, mercury, steroids that may harm skin and general health. Ethical committee approval was done for our study that included 531 women (attending the outpatient clinics in March–April 2016) of targeted 571 (response rate was 89.8%). 43.3% (230 women) are current TPAs users. Three hundred and eight-nine women (73.3%) regularly used TPAs to heal pigmented areas like freckles (75.8%) and just to lighten skin color (58.7%). Side effects of discontinuation were restoration of normal skin color (44.3%) or even darker skin (27%), skin dryness (20%) and rash (9.6%). Mercury is recognized as harmful to human health by 30.2%, whereas cortisone was chosen by others (53.2%). Unexpectedly, minority of investigated women (10%) considered using TPAs safe and recognized harms of some ingredients as mercury whereas the majority (70.2%) does not encourage others for TPAs use although they themselves kept Address all correspondence to Salah Mohammed El Sayed at salahfazara@yahoo.com.