Knowledge, Attitude, and Practices Regarding Cosmetics Among Women in the Al-Qunfudah Governorate, Saudi Arabia
Safa H Alkalash, Rudhab A Alrizqi, Amnah M Alrashdi, Zeinab M Alanazi, Mariam J Zainab, Reham I Al-sahabi, Salma M Alshreef, Ghadeer Y Almasabi

TL;DR
This study explores how women in Al-Qunfudah, Saudi Arabia, use cosmetics and their awareness of related risks, finding gaps in safe practices and a need for better education.
Contribution
The study provides insights into cosmetic use patterns and safety awareness among women in a specific Saudi region, highlighting areas for public health improvement.
Findings
68% of participants had adequate knowledge about cosmetics, but many still lacked safe practices.
Over half of participants experienced side effects, primarily skin-related, from cosmetic use.
Only 38.7% of those with adverse reactions sought medical advice, indicating underreporting.
Abstract
Background: Cosmetic product use has notably increased among women due to social trends and the growing emphasis on physical appearance. Although cosmetics improve appearance and confidence, they can cause adverse effects ranging from skin irritation to potential systemic harm. Despite these risks, many reactions go unreported. Objective: This study aimed to assess the knowledge, attitudes, and practices related to cosmetic use and its adverse effects among women in Al-Qunfudah, Saudi Arabia. Methods: A cross-sectional descriptive study was conducted among 425 women living in Al-Qunfudah. Data were collected over three months, from the first of January 2025 to the end of March 2025, through an online Arabic questionnaire covering demographics, knowledge, attitudes, and cosmetic practices. Knowledge scores were classified as good (≥60%) or poor (<60%). Data analysis was done using IBM…
Genes, proteins, chemicals, diseases, species, mutations and cell lines named across the full text — each resolved to its canonical identifier and authoritative record.
| Data | N. | % |
| Age in years (Mean ± SD) | 29.7 ± 10.6 | |
| 18-24 | 193 | 45.4 |
| 25-30 | 90 | 21.2 |
| 31-40 | 51 | 12.0 |
| > 40 | 91 | 21.4 |
| Educational level | ||
| Basic education | 10 | 2.4 |
| Secondary education | 85 | 20.0 |
| Diploma | 38 | 8.9 |
| University/above | 292 | 68.7 |
| Having a profession | ||
| Yes | 143 | 33.6 |
| No | 282 | 66.4 |
| Monthly income | ||
| < 5000 SR | 307 | 72.2 |
| 5000-10000 SR | 59 | 13.9 |
| >10000-15000 SR | 30 | 7.1 |
| > 15000 SR | 29 | 6.8 |
| Item | N. | % |
| What is the first step for cleaning the skin? | ||
| Cleansing milk | 131 | 30.8 |
| Oil | 133 | 31.3 |
| Do not know | 161 | 37.9 |
| What is the most prevalent cause of skin allergy? | ||
| Perfumes | 307 | 72.2 |
| Jewelry | 57 | 13.4 |
| Do not know | 61 | 14.4 |
| What is the most harmful type of mascara for eyelashes? | ||
| Waterproof mascaras | 345 | 81.2 |
| Simple | 19 | 4.5 |
| Do not know | 61 | 14.4 |
| What is the advantage of using sunscreens? | ||
| Skin cancer prevention | 361 | 84.9 |
| Prevention of dust | 31 | 7.3 |
| Do not know | 33 | 7.8 |
| What is the most prevalent side effect of chemical dyes? | ||
| Skin dandruff | 217 | 51.1 |
| Oiliness | 60 | 14.1 |
| Do not know | 148 | 34.8 |
| What is the most important reason for the harmful effects of hair dyes? | ||
| Using oxidants | 358 | 84.2 |
| Using color | 14 | 3.3 |
| Do not know | 53 | 12.5 |
| What is the appropriate shampoo after hair dyeing? | ||
| Promoters | 357 | 84.0 |
| Any shampoo | 24 | 5.6 |
| Do not know | 44 | 10.4 |
| What is the most common side effect of cosmetics and pharmaceuticals on skin? | ||
| Skin irritation and sensitivity | 340 | 80.0 |
| Dryness | 53 | 12.5 |
| Do not know | 32 | 7.5 |
| What is appropriate skin for using cosmetic powders? | ||
| Dry skin | 50 | 11.8 |
| Wet skin | 302 | 71.1 |
| Do not know | 73 | 17.2 |
| What is the cosmetics group that had the most side effects on skin? | ||
| Oily cosmetics | 260 | 61.2 |
| Powders | 67 | 15.8 |
| Do not know | 98 | 23.1 |
| What is the common side effect of nail polish? | ||
| Discoloration of nails | 284 | 66.8 |
| Itching | 20 | 4.7 |
| Do not know | 121 | 28.5 |
| Overall knowledge score | ||
| Good | 289 | 68.0 |
| Poor | 136 | 32.0 |
| Attitude | Strongly disagree | Disagree | Neutral | Agree | Strongly agree | |||||
| N. | % | N. | % | N. | % | N. | % | N. | % | |
| Inappropriate use of cosmetics causes rashes, skin darkening, and wrinkles | 1 | .2 | 8 | 1.9 | 61 | 14.4 | 182 | 42.8 | 173 | 40.7 |
| The quality of cosmetics is more important than their price | 0 | 0.0 | 10 | 2.4 | 27 | 6.4 | 135 | 31.8 | 253 | 59.5 |
| Tattoo causes cancer | 0 | 0.0 | 19 | 4.5 | 155 | 36.5 | 127 | 29.9 | 124 | 29.2 |
| Laser therapy is carcinogenic | 25 | 5.9 | 121 | 28.5 | 223 | 52.5 | 39 | 9.2 | 17 | 4.0 |
| Hair dyeing has harmful effects on pregnant and breastfeeding women | 4 | 0.9 | 30 | 7.1 | 104 | 24.5 | 159 | 37.4 | 128 | 30.1 |
| Using sunscreens should start from an earlier age | 7 | 1.6 | 27 | 6.4 | 52 | 12.2 | 142 | 33.4 | 197 | 46.4 |
| I usually prefer to use water for cleaning cosmetics | 50 | 11.8 | 148 | 34.8 | 55 | 12.9 | 121 | 28.5 | 51 | 12.0 |
| Practice | Yes | No | ||
| N. | % | N. | % | |
| Do you use cosmetics? | 133 | 31.3 | 292 | 68.7 |
| Do you use sunscreens? | 281 | 66.1 | 144 | 33.9 |
| Do you consult pharmacists for selecting cosmetics? | 142 | 33.4 | 283 | 66.6 |
| Do you pay attention to the following factors in the selection of dyes for your hair? | ||||
| Continuity of color effects on hair | 282 | 66.4 | 143 | 33.6 |
| Manufacturing company | 311 | 73.2 | 114 | 26.8 |
| Harmlessness | 302 | 71.1 | 123 | 28.9 |
| Expiration date | 335 | 78.8 | 90 | 21.2 |
| Doing a sensitivity test before hair dying | 252 | 59.3 | 173 | 40.7 |
| Do you pay attention to the following factors when selecting face cosmetics? | ||||
| Production and consumption data | 338 | 79.5 | 87 | 20.5 |
| Production license | 218 | 51.3 | 207 | 48.7 |
| Brand credibility | 348 | 81.9 | 77 | 18.1 |
| Do you use nail polishes? | 297 | 69.9 | 128 | 30.1 |
| Do you use acetone for cleaning nail polishes? | 339 | 79.8 | 86 | 20.2 |
| Side effects | N. | % |
| Did you previously experience side effects of cosmetics use? (n= 425) | ||
| Yes | 214 | 50.4 |
| No | 211 | 49.6 |
| What was the type of cosmetic product used? (n= 214) | ||
| Skincare | 37 | 17.3 |
| Haircare | 177 | 82.7 |
| What was the duration of the reaction that occurred? (n= 214) | ||
| Within 1 month | 166 | 77.6 |
| Within 1 year | 48 | 22.4 |
| What was the type of reaction? (n= 214) | ||
| Skin reaction only | 184 | 86.0 |
| Systemic reaction only | 21 | 9.8 |
| Skin and systemic reactions | 9 | 4.2 |
| What was the affected body area? (n= 214) | ||
| Face | 165 | 80.9 |
| Hair | 25 | 12.3 |
| Eyes | 25 | 12.3 |
| Hand | 24 | 11.8 |
| Scalp | 17 | 8.3 |
| Lips | 15 | 7.4 |
| Nose | 14 | 6.9 |
| Legs | 9 | 4.4 |
| Upper limbs | 3 | 1.5 |
| Lower limbs | 1 | 0.5 |
| What was the type of consultation adopted? (n= 214) | ||
| Dermatologist | 65 | 38.7 |
| Pharmacist | 16 | 9.5 |
| Started self-medication | 78 | 46.4 |
| Beautician | 9 | 5.4 |
| What was the nature of management adopted? | ||
| Product withdrawal | 12 | 6.1 |
| Product change | 41 | 20.7 |
| Drug treatment | 36 | 18.2 |
| Stopped using the product until adverse events disappeared | 109 | 55.1 |
| Did the side effects completely subside after treatment? | ||
| Yes | 185 | 86.4 |
| No | 29 | 13.6 |
| How long did it take for the side effect to subside? | ||
| Within 1-2 weeks | 116 | 68.6 |
| Within 3-4 weeks | 30 | 17.8 |
| More than 1 month | 23 | 13.6 |
| Factors | Overall knowledge level | Test | p-value | |||
| Poor | Good | |||||
| N. | % | N. | % | |||
| Age, in years | 6.138 | 0.105 | ||||
| 18-24 | 60 | 31.1 | 133 | 68.9 | ||
| 25-30 | 26 | 28.9 | 64 | 71.1 | ||
| 31-40 | 12 | 23.5 | 39 | 76.5 | ||
| > 40 | 38 | 41.8 | 53 | 58.2 | ||
| Educational level | 5.113 | 0.164^ | ||||
| Basic education | 5 | 50.0 | 5 | 50.0 | ||
| Secondary education | 34 | 40.0 | 51 | 60.0 | ||
| Diploma | 12 | 31.6 | 26 | 68.4 | ||
| University / above | 85 | 29.1 | 207 | 70.9 | ||
| Having a profession | 0.075 | 0.785 | ||||
| Yes | 47 | 32.9 | 96 | 67.1 | ||
| No | 89 | 31.6 | 193 | 68.4 | ||
| Monthly income | 2.160 | 0.540^ | ||||
| < 5000 SR | 103 | 33.6 | 204 | 66.4 | ||
| 5000-10000 SR | 18 | 30.5 | 41 | 69.5 | ||
| >10000-15000 SR | 9 | 30.0 | 21 | 70.0 | ||
| > 15000 SR | 6 | 20.7 | 23 | 79.3 | ||
| Do you use cosmetics? | 3.583 | 0.049 | ||||
| Yes | 51 | 38.3 | 82 | 61.7 | ||
| No | 85 | 29.1 | 207 | 70.9 | ||
| Do you use sunscreens? | 8.057 | 0.005 | ||||
| Yes | 77 | 27.4 | 204 | 72.6 | ||
| No | 59 | 41.0 | 85 | 59.0 | ||
| Do you consult pharmacists for selecting cosmetics? | 6.361 | 0.012 | ||||
| Yes | 34 | 23.9 | 108 | 76.1 | ||
| No | 102 | 36.0 | 181 | 64.0 | ||
| Factors | Do you use cosmetics? | Test | p-value | |||
| Yes | No | |||||
| N. | % | N. | % | |||
| Age, in years | 8.185 | 0.042 | ||||
| 18-24 | 73 | 37.8 | 120 | 62.2 | ||
| 25-30 | 27 | 30.0 | 63 | 70.0 | ||
| 31-40 | 12 | 23.5 | 39 | 76.5 | ||
| > 40 | 21 | 23.1 | 70 | 76.9 | ||
| Educational level | 3.267 | 0.352^ | ||||
| Basic education | 3 | 30.0 | 7 | 70.0 | ||
| Secondary education | 33 | 38.8 | 52 | 61.2 | ||
| Diploma | 13 | 34.2 | 25 | 65.8 | ||
| University/above | 84 | 28.8 | 208 | 71.2 | ||
| Having a profession | 0.371 | 0.543 | ||||
| Yes | 42 | 29.4 | 101 | 70.6 | ||
| No | 91 | 32.3 | 191 | 67.7 | ||
| Monthly income | 2.317 | 0.509^ | ||||
| < 5000 SR | 101 | 32.9 | 206 | 67.1 | ||
| 5000-10000 SR | 17 | 28.8 | 42 | 71.2 | ||
| >10000-15000 SR | 6 | 20.0 | 24 | 80.0 | ||
| > 15000 SR | 9 | 31.0 | 20 | 69.0 | ||
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Taxonomy
TopicsSkin Protection and Aging · Contact Dermatitis and Allergies · Effects and risks of endocrine disrupting chemicals
Introduction
Cosmetic products have become an essential part of daily life for both men and women due to modernization and the increasing emphasis on appearance. This trend has contributed to the significant annual growth of the global beauty market [1].
Cosmetics are materials designed to be rubbed, poured, sprinkled, sprayed, or injected into any part of the human body in order to clean, beautify, enhance attractiveness, or change the look of that area without changing the structure or function of the body [2]. Based on this definition, cosmetics include products such as soaps, shampoos, skin creams, lotions, perfumes, lipsticks, nail polishes, eye and facial makeup, permanent waves, hair dyes, toothpaste, and deodorants [3]. While cosmetics enhance beauty and boost confidence, they also pose potential risks. Adverse effects may result from individual sensitivity to ingredients, microbial contamination, improper labeling, violations of color additive regulations, or the presence of harmful substances such as preservatives and fragrances [4].
Clinical manifestations of adverse reactions to cosmetics vary and may include itching, corrosive scalp injuries, acute hair loss, cosmetic acne, conjunctivitis, photo-allergic or toxic contact dermatitis, hypo- or hyperpigmentation, and oral mucosal irritation [5-7]. In addition to dermatological concerns, long-term exposure to certain cosmetic ingredients has been linked to potential systemic health effects. Research suggests that some chemical components, such as parabens and phthalates, may act as endocrine disruptors, interfering with hormonal balance and posing potential reproductive health risks [8]. Furthermore, prolonged use of cosmetics containing heavy metals, such as lead in lipsticks and mercury in skin-lightening creams, has been associated with neurotoxicity and other serious health effects [9].
Despite these risks, documented cases of adverse reactions to cosmetics remain limited. This may be due to the tendency of consumers to self-medicate for mild to moderate reactions rather than seek medical attention [10-11]. A 2006 survey examined 3,474 cosmetic users, of whom 848 reported experiencing adverse reactions to the products. The findings revealed that more than half of the women who experienced negative reactions did not seek medical advice or consult a pharmacist [12].
According to Poranki and Perwej, the use of cosmetics in Saudi Arabia is increasing as income levels rise, which is a noteworthy development and an important factor for marketers looking to enter this market with modern marketing strategies [13]. Recent reports from Saudi Arabia indicate an inadequate level of awareness regarding the adverse effects of cosmetics [14]. Although earlier Saudi research evaluated the general public's understanding of cosmetics, no such studies have been conducted in the Al-Qunfudah governorate, a distant region with little access to medical care. Therefore, the aim of this study was to assess knowledge, attitudes, and practices related to cosmetics and their adverse effects among women in Al-Qunfudah, Saudi Arabia.
Materials and methods
Study design
A cross-sectional descriptive study was conducted in Al-Qunfudah governorate, Saudi Arabia, and data were collected over three months, from the first of January 2025 to the end of March 2025.
Inclusion Criteria
The study participants had to possess all the following criteria to be recruited in this study: All women 18 years old and older, living in Al-Qunfudah governorate, who gave informed consent to participate in the study.
Exclusion Criteria
Men, and women less than 18 years old living outside Al-Qunfudah governorate were excluded from the study.
The sample size of 425 was determined through the Raosoft calculator (Raosoft Inc., Seattle, WA) [14], based on the Al-Qunfudah governorate's population size of 300,516, with a 5% marginal error and a 95% confidence interval, and the expected response rate is 50% [15].
Data collection
An online Arabic questionnaire was designed using Google Forms (Google Inc., Mountain View, CA), where participants received electronic links through different electronic platforms, such as Telegram (Telegram FZ‑LLC, Dubai, United Arab Emirates) and X (X Corp., Bastrop, TX) applications, with a brief explanation of the study objectives, the target population, and a request to participate voluntarily.
The questionnaire (Appendix A) was created by the study researchers after conducting a literature review [1, 4, 10, 16]. It included items to collect data about participants’ demographic characteristics (six items) and knowledge (11 items), attitudes (seven items), and seven items to evaluate their practice, as well as nine items about adverse reactions after cosmetic use. This questionnaire's validity was pre-tested in a pilot study that included 40 responses, which were collected to test the tool. The data from the pilot study were excluded from the main study results. A Cronbach factor was 0.80 for the overall questionnaire and 0.81, 0.78, 0.79, and 0.80 for knowledge, attitudes, practice, and side effect items, respectively.
Statistical analysis
The data analysis for this study was conducted using IBM SPSS Statistics software, version 27 (IBM Corp., Armonk, NY). Descriptive statistics, including frequencies and percentages, were used for presenting the qualitative data, while quantitative data were presented as the mean and standard deviation (mean ± SD). For the analysis of knowledge and attitudes, the knowledge score was calculated by assigning one point for each correct answer. The knowledge level was categorized into two groups: poor and adequate knowledge, with a cutoff of 60%. Participants who scored below 60% were classified as having poor knowledge, while those scoring 60% or above were categorized as having adequate knowledge. To assess associations between various demographic factors and knowledge, the chi-square (χ²) test was used for categorical variables. In cases where the expected frequency count was low, the exact probability test was employed. Additionally, to compare the differences between groups, the p-value was calculated, and a p-value less than 0.05 was considered statistically significant.
Ethics
Helsinki's 1964 Declaration of the World Medical Association, most recently updated in 2008, was followed in this study. Permission was obtained from Umm Al-Qura University's (UQU) Institutional Review Board; ethical permission was acquired in September 2024 under the number HAPO-02-K-012-2024-10-2269. All participants were asked to provide informed consent for the study before they could answer the questionnaire, guaranteeing that all information would be shared anonymously.
Results
Out of the 425 respondents, age distribution reveals that 193 participants (45.4%) were in the 18-24 age range, with a mean age of 29.7 years. Just 10 (2.4%) of women had only a basic education, whereas 292 (68.7%) had a university degree or above. Regarding employment, 143 (33.6%) of the women had a job. A total of 307 (72.2%) claimed to have a monthly salary of less than 5000 Saudi riyal (SR), and 29 (6.8%) reported earning more than 15000 (Table 1).
There was a split in the responses about the first stage in skin cleaning: 133 (31.3%) selected oil, 131 (30.8%) opted for cleansing milk, and 161 (37.9%) were unsure. Most respondents (307, 72.2%) said that perfumes are the main source of skin allergies, followed by jewelry (57, 13.4%) and uncertainty (61, 14.4%). Waterproof mascara was identified by 345 (81.2%) of responders as the most detrimental to eyelashes. A resounding 361 (84.9%) of respondents accurately said that sunscreen prevents skin cancer. Nearly half of the respondents said that the most common negative reaction to chemical dyes is skin dandruff. A total of 358 (84.2%) of respondents accurately identified the usage of oxidants as the main cause of hair dyes' negative effects. For shampoo use after hair dyeing, 357 (84.0%) recommended promoters. Among the participants, 340 (80.0%) correctly identified skin irritation and sensitivity, while 53 (12.5%) chose dryness as the most common side effect of cosmetics and pharmaceuticals on the skin. Regarding the appropriate skin for using cosmetic powders, 302 (71.1%) correctly chose wet skin. 260 (61.2%) mentioned oily cosmetics as being the cosmetic group with the most side effects on the skin; 284 (66.8%) correctly identified discoloration of nails as the common side effect of nail polish. The vast majority (89, 68.0%) had a good level of knowledge about cosmetics, while 136 (32.0%) of the participants had poor knowledge (Table 2).
Regarding the attitudes towards cosmetics among women in the Al-Qunfudah governorate, a majority of participants (355, 83.5%) believed that improper use of cosmetics has harmful effects on the skin. There was a strong consensus that quality outweighs cost, as 253 (59.5%) strongly agreed and 135 (31.8%) agreed about this issue; 124 (29.2%) strongly agreed, and 127 (29.9%) agreed that tattoos cause cancer. Only 39 (9.2%) agreed, and 17 (4.0%) strongly agreed that laser therapy is carcinogenic. In contrast, 121 (28.5%) disagreed, and 25 (5.9%) strongly disagreed; 159 (37.4%) agreed, while 128 (30.1%) strongly agreed that hair coloring is dangerous to pregnant and breastfeeding mothers; 197 women (46.4%) and 142 (33.4%) strongly agreed that sunscreen use should begin at a young age, suggesting a strong understanding of the necessity of sun protection. Finally, 148 (34.8%) disagreed, with 50 (11.8%) strongly opposing the use of water to clean cosmetics (Table 3).
A total of 133 women (31.3%) reported using cosmetics, while 281 (66.1%) reported using sunscreens. Only 142 (33.4%) consult pharmacists for selecting cosmetics, while 283 (66.6%) do not. Regarding hair dyeing, 282 (66.4%) considered the continuity of color effects on hair, and 311 (73.2%) focused on the manufacturer's company. Additionally, 302 (71.1%) prioritized the harmlessness of the product, while 335 (78.8%) considered the expiration date. However, only 252 (59.3%) did a sensitivity test before hair dyeing. When choosing face cosmetics, the majority of women were concerned about factors such as manufacturing and consumption data (338, 79.5%) and brand credibility (348, 81.9%). In contrast, 218 (51.3%) paid attention to the production license, while 207 (48.7%) didn't. Around 297 (69.9%) applied nail polish, whereas 339 (79.8%) used acetone to clean it. However, 128 (30.1%) did not use nail polish, and 86 (20.2%) did not use acetone (Table 4).
A total of 214 study subjects (50.4%) experienced cosmetic side effects. Of them, 177 (82.7%) attributed side effects to haircare products, while 37 (17.3%) identified skincare products as the source of their reactions; 166 (77.6%) reported that their reactions occurred within one month, while 48 (22.4%) experienced side effects within a year of cosmetics usage. The most prevalent form of reaction was a skin reaction alone, which affected 184 women (86.0%), followed by systemic reactions in 21 (9.8%), and a combination of skin and systemic reactions in nine (4.2%). The affected body areas were predominantly the face, by 165 (80.9%), followed by the hair and eyes (12.3% each), and the hands (11.8%). For those who sought consultation for the side effects, 65 (38.7%) consulted a dermatologist, while 16 (9.5%) consulted a pharmacist, and 78 (46.4%) chose to self-medicate. A smaller number, 9 (5.4%), sought advice from a beautician. 109 (55.1%) stopped using the product until the adverse events disappeared, 41 women (20.7%) changed the product, and 36 (18.2%) used drug treatment. A smaller group, 12 (6.1%), withdrew the product entirely. In terms of recovery, 185 (86.4%) reported that the side effects completely subsided after treatment, while 29 (13.6%) did not experience full recovery (Table 5).
A higher proportion of non-cosmetic users, 207 (70.9%), had good knowledge, suggesting that those who used cosmetics had slightly lower knowledge levels, with a p-value of 0.049. Sunscreen use was also significantly associated with better knowledge. Among sunscreen users, 204 (72.6%) had good knowledge, while only 59 (59.0%) of non-sunscreen users reported good knowledge. Additionally, 59 (41.0%) of non-users had poor knowledge, compared to 77 (27.4%) of sunscreen users, and the p-value was 0.005. Another significant factor was consulting pharmacists for selecting cosmetics. Among those who consulted pharmacists, 108 (76.1%) had good knowledge, compared to 181 (64.0%) among those who did not. The p-value is 0.012. Other factors, such as age, educational level, having a profession, and monthly income, did not show significant associations with overall knowledge, as their p-values were greater than 0.05 (Table 6).
Table 6: Factors associated with the participants' knowledge about cosmetics (N=425)P: Pearson X2 test; ^: Exact probability test; P < 0.05 (significant); SR: Saudi Riyal
Age is the only significant factor associated with the use of cosmetics among women in the Al-Qunfudah governorate, with a p-value of 0.042. Among women aged 18-24, 73 (37.8%) used cosmetics, while 120 (62.2%) did not. No significant associations were found between cosmetic use and other factors, such as educational level (p = 0.352), having a profession (p = 0.543), or monthly income (p = 0.509) (Table 7).
Table 7: Distribution of cosmetic use according to the demographic characteristics of the study participantsP: Pearson X2 test; ^: Exact probability test; P < 0.05 (significant); SR: Saudi Riyal
Discussion
The results of the current study, which evaluated the level of cosmetics knowledge among Saudi Arabian women in Al-Qunfudah, are quite intriguing. Many women are aware that skin allergies can be brought on by perfumes, a phenomenon that is also observed in other regions of the world. For example, according to a Canadian study [17], perfumes are a major cause of skin allergies worldwide. To concentrate on giving women greater knowledge, doctors are becoming more aware of what they already know about cosmetics. Similarly, the recognition of waterproof mascaras as the most harmful type for eyelashes reflects a growing global awareness of the damaging effects of certain cosmetic products, as noted in a 2020 study in the United States [18]. However, the relatively high percentage of participants who were unsure about the first step in skin cleaning or the side effects of chemical dyes suggests a need for targeted educational campaigns, a finding reported in a 2018 study in the west of Saudi Arabia, which emphasized the lack of public awareness about cosmetic ingredients and their potential risks [19].
The awareness of the role of sunscreens in preventing skin cancer is particularly notable, as it reflects a positive trend in public health knowledge. This matches with global efforts to promote sunscreen use, such as the World Health Organization’s campaigns on UV radiation protection [20]. However, the small but significant percentage of women who believed sunscreens prevent dust or were unsure about their benefits indicates lingering misconceptions. These findings are consistent with a 2024 study in Aseer, Saudi Arabia, which found that while most women understood the importance of sunscreens, a subset held incorrect beliefs about their primary function [15]. Similarly, a study by Nohynek et al. [21] identified oxidants as the main hazardous component in hair dyes. However, the lack of knowledge about the right shampoo to use after dyeing one's hair reveals a lack of practical cosmetic education, which was previously identified in a 2015 study carried out in Dubai [22].
The high level of awareness regarding skin irritation and sensitivity as the most common side effect of cosmetics and pharmaceuticals is promising, as it reflects a growing understanding of skin health. This finding is supported by a 2019 study in Egypt, which reported similar levels of awareness among women in Cairo [23]. However, the misconceptions about the appropriate skin type for cosmetic powders and the side effects of nail polish highlight areas where knowledge is lacking. For example, the belief that dry skin is suitable for cosmetic powders contradicts dermatological recommendations, which emphasize the importance of matching products to skin type [24]. This discrepancy is also noted in a 2011 study in Kuwait, where similar misconceptions were observed [25]. Overall, while most women in Al-Qunfudah demonstrated good knowledge of cosmetics, the persistent gaps in understanding suggest a need for more comprehensive and accessible educational resources, particularly in regions with limited access to dermatological expertise.
The results from Al-Qunfudah governorate reveal a pattern of knowledge that is both consistent with and divergent from findings in other regions. The high levels of awareness in certain areas, such as sunscreen use and the harmful effects of waterproof mascaras, reflect global trends in cosmetic education. However, the gaps in knowledge, particularly regarding skin cleaning steps and the side effects of chemical dyes, highlight the need for targeted interventions. These findings underscore the importance of culturally tailored public health campaigns to address misconceptions and improve cosmetic literacy, not only in Saudi Arabia but also in other regions with similar demographic and educational profiles.
In line with reported worldwide concerns, a significant proportion of women are aware that inappropriate cosmetic use can have adverse consequences such as rashes, skin darkening, and wrinkles [26, 27]. In addition, there is a definite preference for quality over pricing, which is indicative of a larger movement to put product efficacy and safety first. Uncertainty surrounds the health risks associated with tattoos, and there are different opinions about the carcinogenicity of laser therapy, indicating a need for improved public education. Conversely, there's a strong consensus regarding the harmful effects of hair dye during pregnancy and breastfeeding, and a high level of awareness regarding the importance of sunscreen use. Nevertheless, varying preferences for water as a cosmetic cleaning method suggest a need for clearer guidelines on effective cosmetic removal practices. While women demonstrate a general understanding of cosmetic risks and prioritize safety, misconceptions persist regarding specific treatments and basic cosmetic practices, highlighting the importance of targeted educational initiatives.
Considering practice, both positive behaviors and areas requiring improvement were also reported. A significant proportion of women use sunscreens. However, the limited consultation with pharmacists for cosmetic selection suggests a tendency to rely on personal preferences rather than professional advice. When choosing hair dyes, women prioritize factors like color continuity and product safety, consistent with observations in many studies [28-29]. Yet, a concerning number do not perform sensitivity tests before utilizing hair dye. Similarly, while brand credibility and production data are considered for face cosmetics, the focus on production licenses is relatively low, indicating a need for greater awareness of regulatory standards. Furthermore, the prevalent use of nail polish and acetone for removal, while common, raises concerns about potential health risks, such as nail brittleness and skin irritation, augmenting the need for safer alternatives to acetone, as noted in a U.S. study [30].
In brief, the findings reveal that cosmetic use, sunscreen use, and consulting pharmacists significantly influence women's cosmetic knowledge in Al-Qunfudah. Notably, cosmetic users demonstrated slightly lower knowledge levels compared to non-users, while sunscreen users and those who consulted pharmacists exhibited significantly better knowledge. Age was the only demographic factor significantly associated with cosmetic use, with younger women more likely to use cosmetics than older women. Other demographic factors like education, profession, and income did not show significant associations with either knowledge or cosmetic use. Essentially, practical behaviors like sunscreen use and seeking professional advice correlated with better knowledge, while age influenced cosmetic usage patterns.
Strengths and limitations
This study has several strengths, including being conducted in an underexplored population (Saudi women in Al-Qunfudah) and employing a validated questionnaire that is simple and clear and enhances accessibility. The second strength of this study is that it was conducted on a large sample size, and its topic has strong community relevance. However, several restrictions need to be mentioned. The cross-sectional study limits causal inferences, and the dependence on self-reported data raises concerns about bias. The study included women 18 and older, but cosmetics may also be used by adolescent females. It was more appropriate to include men, as their knowledge is important because some of them can use materials like sunscreen, and their awareness could influence female relatives. Furthermore, the study's geographical focus may limit generalizability, highlighting the importance of including a more diversified sample.
Conclusions
In conclusion, this study revealed a mix of moderate women's knowledge and variable attitudes and practices regarding cosmetics in Al-Qunfudah, Saudi Arabia. While there's strong awareness of sunscreen and quality product selection, gaps exist in professional consultation, sensitivity testing, and understanding regulatory standards. Also, women in Al-Qunfudah prioritize safe and high-quality cosmetics; gaps in consulting professionals, performing sensitivity tests, and understanding regulatory standards emphasize the necessity of focused educational initiatives to encourage safer cosmetic procedures. To improve, targeted education campaigns are crucial, emphasizing professional guidance, safety practices, and safer product alternatives. By addressing these gaps, women can make informed choices for safer cosmetic use.
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