“The hidden hues”- An analysis of public perspectives regarding intimate area depigmentation and its dynamic relationship with dermatological procedures

INTRODUCTION

A multitude of variables can contribute to intimate area pigmentation. This may be brought on by genetic predisposition, aging of the skin or other factors such as wearing clothing that is too tight, over-waxing or hormonal changes brought on by pregnancy.^[1] There are a variety of medical depigmenting procedures such as laser therapy, topical creams, and chemical peels that are mostly used by individuals, which effectively and gradually remove spots by targeting the buildup of pigment in the skin and the underlying cause yielding a thorough and long-lasting result.^[2] One of the cons we see with these procedures is that most of them are present with aggressive chemicals like hydroquinone, which can cause severe allergic reactions to the skin.^[3] The medical-aesthetic therapies for genital whitening are based on a delicate peeling or exfoliating therapy; in essence, they take off the topmost layer of the skin, the epidermis, by carefully combining acids with other substances that encourage regeneration. The technique entails applying a specialized mixture of acids such as phytic acid, kojic acid, salicylic acid, plankton extract, niacin amide, and azeloyl glycine to the affected region.^[4] This suppresses melanin production giving the skin an even tone with a firm, supple outlook making chemical peel the most important part of the field of depigmentation.^[5] Pigmentation after treatment lightens up gradually, and benefits may often be observed as early as one week after treatment. The most favorable results are typically seen approximately four weeks after treatment.^[6] After no more than one treatment, the skin will seem even, radiant, and healthy. It is suitable for all skin types. Published research provides evidence of the efficacy of these therapies enhancing a person’s self-assurance and comfort level when dressing in a variety of ways – a factor that is crucial in expressing one’s identity. However, it poses the question of why individuals prefer not to receive these treatments. Through this study, our aim is to discover more about why people are reluctant to seek treatment for intimate area depigmentation, if they regularly consult a dermatologist for skincare advice, and whether another reason – such as personal beliefs – prevents them from obtaining both this and other dermatological treatments.

MATERIAL AND METHODS

A cross-sectional online study was carried out between May 21, 2023 and July 5, 2023 using Google Forms and shared through social media platforms among the population of Tbilisi, Georgia. Most participants were medical students from various parts of the world, primarily Indians and native Georgians between the ages of 18 and 24. There were 17 questions asked, mainly regarding gender, age, and viewpoints on dermatologist appointments, whether they have a skincare regimen or not, thoughts on treatments for intimate area depigmentation, and more. Informed consent was obtained from the participants at the beginning of the survey.

RESULTS

From a total of 112 participants, 69.6% (n = 78) were female, and 30.4% (n = 34) were male, with the majority of participants from age group 18 to 24 [83% (n = 93)], followed by people who are 25–30 [16.1% (n = 18)] and 2% from age 31 to 40 [0.9% (n = 1)]. Regarding their general opinions about undergoing dermatological treatments, 55.4% (n = 62) stated that they felt positive about them and would like to see improvements on their skin, while 24.1% (n = 27) said that they were costly and took a long time to show results on the skin. About 12.5% (n = 15) have experienced reactions while going out in the sun after a dermatological procedure, so they do not want to give it a chance once again to experience the inconvenience. A less intrusive, more superficial yet effective method like facemasks is preferred by 43.5% (n = 47) over a considerably invasive microneedling said by 7.4% (n = 8). The study has been done on a population who are ethnically constant, thus making it a limitation to access a wider range of perspectives.

DISCUSSION

Contemporary society has predominated its way onto breaking taboos that skincare was only for women by showing a considerable number of men attended our survey although women still predominate. The long-standing stigma associated with males using skincare products or makeup has been significantly altered as a result of men choosing to pursue professions in dermatology and plastic surgery, work as makeup artists, maintain their own skincare regimens, and wear makeup.^[7] Skincare products are gender-neutral and are more widely accepted in our society today than they were in the past.^[8]

In our studies, there were some common skin complaints such as acne, scars, blackheads, and sun tans, which were reported by the majority of people, and a few fractions of them really wanted to correct those problems but had different reasons not to adapt to therapeutic measures.

According to 45.5% (n = 51) of respondents, the high cost of skincare procedures and products prevents them from affording therapy, thus they give up trying to address their skin concerns. Despite their desire to solve their skin issues, 29.5% (n = 33) lack the necessary knowledge about skincare treatments and products. This is where a qualified dermatologist can help.^[9] However, 13.4% (n = 15) of respondents say that they have not been able to locate the ideal dermatologist to help them with their issues. People are always concerned about their skin, and even if they can live with tan lines and acne scars, if they are paying for a treatment – whether it be for dermatological procedures or something else entirely – they want a full recovery from their problem. A persistent financial aspect was found to be frequent among the perspectives of the individuals when they were queried about both general dermatological operations and intimate area depigmentation. Many reasons why people choose not to undergo dermatological procedures are currently related to the high cost of medications and treatments. One of the major areas we focused on is the inconvenience of dermatological procedures. As mentioned, many people think having the depigmentation treatment is invasive and can create restrictions in life. Fortunately, 81.3% (n = 91) have not experienced any unpleasant experiences after the treatment, therefore establishing the fact that most of the people, who attended the survey sought a dermatologist if they wanted to. These findings imply it is partially the people’s mindset that influences which treatment they want to get. People often misinterpret the names of procedures like microneedling to be as painful and invasive, which often leads to confusion and misunderstanding.^[10] Similarly, the mixture of kojic acid and salicylic acid, which are mostly used in the preparation of chemical peels used in the intimate area depigmentation procedure itself has “acids” named in it making the public perspective panic on the thoughts of acids over their genitals and armpits, thus more refraining from the treatment.

CONCLUSION

The subject of intimate area depigmentation is becoming a more important and relevant part of dermatological care and it has a complex interaction with general dermatological operations. Our investigation has illuminated the many facets of this topic, providing insights that connect dermatology’s medical and cosmetic dimensions. Intimate area hyperpigmentation, as its name suggests “intimate” or “supposed to be hidden” was always a trending topic of discussion. Treatments for depigmenting private areas have grown in popularity as more people look for solutions to skin pigmentation issues in private and delicate areas. However, the choice to receive these therapies remains highly discrete and based on several variables such as personal choices, cultural norms, and social influences. Natural beauty and self-acceptance may be more important to some than depigmentation, which some may choose for the purpose of increasing comfort and self-confidence. From the survey, we conducted that a wide range of opinions regarding the treatment was available ranging from its high cost, safety standards, and the mindset of individuals not to receive the treatment. When we compare the responses of the same individuals undergoing general dermatological treatments for their face and hair, we find both notable parallels and subtle variations. The most frequent reasons people refuse dermatological procedures are still the high cost, safety concerns, and the invasive nature of the procedures; however, most of the time, people would rather treat common skincare problems such as acne, blackheads, scars, and tan lines than hyperpigmentation in intimate areas. More than one’s own decision not to treat the hyperpigmentation in their intimate areas, society as well as family play a bystander role in these situations sometimes. Improper knowledge about how the procedure is done, no correct guidance as well and a minority of the population avoid visits to dermatologists if there is no visible apparent problem for their skin. Even though aesthetic dermatology has established its power on a global level, there are some regions where it could not work efficiently due to certain cultural barriers, stigmas as well as narrow mindsets of people. By providing accurate and easily accessible information about cosmetic procedures and private area depigmentation, doctors help individuals make informed decisions about their appearance and self-perception. By this, it is possible to control and reduce the likelihood of misunderstandings, excessive requests, and worries through being informed.