“The hidden hues”- An analysis of public perspectives regarding intimate area depigmentation and its dynamic relationship with dermatological procedures
How to cite this article: Chettyparambil Lalchand T, Joseph J. “The hidden hues” – An analysis of public perspectives regarding intimate area depigmentation and its dynamic relationship with dermatologic procedures. CosmoDerma. 2024;4:5. doi: 10.25259/CSDM_253_2023
The art of esthetic dermatology has reached its pinnacles in this generation providing treatments for almost all skin concerns. Throughout history a myriad of issues have risen, and one that is common to everyone is the pigmentation of their intimate areas. Many people, particularly women, lament that their dark underarm makes it impossible for them to wear their favorite sleeveless dress or that they must deal with their partner’s embarrassment due to this issue. Even though cosmetics have advanced and we now have answers for every issue, people are still hesitant to undergo these treatments, even though they want to get rid of these pigmentations. This study has multiple goals, it aims to determine the reasons behind people’s reluctance to undergo depigmentation procedures in intimate areas, the extent to which dermatology has advanced in society, and whether skincare is still taboo.
Material and Methods:
Using an online survey through Google Forms, we conducted a cross-sectional study dated from May 21, 2023, to July 05, 2023, collecting data from 112 people living in Tbilisi, Georgia. Most of the participants were in the 18–35 age range. Participants responded to 17 questions about their overall skincare routines, the amount of time and effort they put into skincare, and their thoughts on the depigmentation process in private areas.
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)]. In that, 62.5% (n = 70) of the population was interested in receiving treatment, but they were hesitant for a variety of reasons where 47.3% (n = 53) reasoned the high cost. About 8.9% (n = 10) were also reluctant to expose their intimate areas during procedures. About 8.9% (n = 10) of people think that they are intrusive and refuse to have them done. About 2.7% (n = 3) refuse to get the treatment due to opposition from spouses and family. Varying opinions about skincare approaches were also recorded where 33% (n = 37) stated that they have never been to a dermatologist since they have not experienced any skin problems whereas 21.4% (n = 24) use homemade skin care products, whose efficacies are debatable.
Our investigation emphasizes the blending of medical and cosmetic components of dermatology by demonstrating positive responses regarding depigmentation and dermatologic procedures. A greater demand for solutions to skin pigmentation problems in sensitive areas of the body is reflected in the growing popularity of intimate area depigmentation. Nonetheless, the choice to receive these treatments is kept private and is shaped by cultural conventions, society expectations, and individual preferences. Some desire depigmentation for greater comfort and confidence while others value natural beauty and self-acceptance. The two biggest obstacles to involvement are lack of information and financial limitations. To combat this, easily accessible skincare solutions that have been shown to work should be reasonably priced and come with easy-to-follow directions that will allay worries and promote making wise decisions.
Intimate area depigmentation
Limitations to dermatological procedures
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. 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. 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. 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. 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. 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. 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.
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.
Within the framework of this survey, a thorough analysis of participants’ skincare regimens provides insightful information. Of the participants, 28.6% (n = 32) have had skincare procedures performed whereas 71.4% (n = 80) have not.
The study also investigates how skincare regimens are established. A three-step skincare routine consisting of face wash, sunscreen, and moisturizer is reported by 47.3% (n = 53). Remarkably, 32.1% (n = 36) of respondents said that they do not follow any skincare regimen at all. About 21.4% (n = 24) of respondents believe that they are stepping up their skincare regimen by applying advanced active ingredients such as vitamin C and retinol to their skin. This raises concerns about the present condition of esthetic dermatology, especially among young people who seem to be ignoring skincare regimens. In addition, 31.3% (n = 35) of them are still unsure if they even have a skincare routine, which may be related to the differences in how they define a routine. This may lead us to the opinion that they either practice skincare regimentally or not at all or that using face wash and moisturizer has become a daily ritual for them and they do not regard them under skincare themselves and consider skincare as the application of active substances and undergoing dermatological procedures. The analysis of skincare product usage and satisfaction is also essential in this study to determine the relationship between the reluctance to prefer dermatological procedures and the data. While 8.9% (n = 10) claim that they do not find the regular skincare regimen effective for their skin, 36.6% (n = 41) report being content with their current skincare practice and reporting favorable changes in their skin complaints. Because they believe that it is not vital in their lives, 23.2% of people (n = 26) do not follow a skincare program. While comparing the skin concerns of people who never used skincare products or used them inconsistently to those who did, they share similar skin concerns such as acne, scars from previous breakouts, tan lines, dull skin, hyperpigmentation, black and white heads, and so forth. Here, we can see that in addition to statistics, having the will to consult a dermatologist is also essential to achieving the intended outcome. In fact, by focusing on skincare routines, we may explore these people’s diverse careers. A multistep skin regimen, which requires time and consistency to be effective, must be correlated with the person’s lifestyle to determine whether they have the time to take proper care of their skin. A number of these variables were examined to see whether a person’s lack of skincare compliance was due to lifestyle decisions or other causes. About 85.7% (n = 96) were students who participated in the survey with 12.5% (n = 14) working population and 1.8% (n = 2) non-specific. Out of this, 53.6% (n = 60) are leading a busy schedule, 41.1% (n = 46) do not have a busy lifestyle, and 5.4% (n = 6) with lots of spare time. With this data collected, we could analyze the relationship between lifestyle and skincare routines directing us to the hypothesis that majority of the people have a busy lifestyle, yet some choose to keep time aside for skincare whereas other part of the population thinks that it is a minor priority and keep it aside.
Intimate area depigmentation treatment
A question was asked to know the perspective of the general population about a treatment that can reduce hyperpigmentation in intimate areas, such as groin, armpits, and genitals, which was the major focus of our study. About 62.5% (n = 70) said that it would be a great idea and can wear sleeveless clothes without being embarrassed about their dark armpits. About 25% (n = 28) individuals said that they never even thought about undergoing such a procedure, but 8.9% (n = 10) think that it is not necessary to undergo such a treatment for themselves. It is interesting to note that 3.6% (n = 4) of individuals also strongly reject this technique, arguing it is needless and that there is no reason to change our natural hue, especially in our intimate places, and nobody is going to see it except us. These are just the individual’s thoughts as always. The findings proved that most individuals were anticipating this therapy, which is regarded as a significant improvement in esthetic gynecology. Both men and women were heavily represented in the statistics, with women’s opinions predominating.
When asked about what is restricting them from these treatments, 47.3% (n = 53) reported that it is due to the high price of these procedures that they are not interested in getting this done. About 32.1% (n = 36) say that they do not have a clear idea about these procedures, so they do not want to do them until they know what happens during the procedure. Even though these treatments are extremely gentle on your skin and created in a way to preserve your sensitive intimate areas, 8.9% (n = 10) say that they do not want methods like laser over their intimate areas. In addition, another 8.9% (n = 10) of people are opposed by their spouse, friends or family even when they do not have any of these frequent concerns like the expense or scare of procedures. These findings suggest that such variables rather than a person’s lack of interest may be responsible for the decreased prevalence of depigmentation treatments in intimate areas.
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. Skincare products are gender-neutral and are more widely accepted in our society today than they were in the past.
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. 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. 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.
The small sample size (n = 112) in our study limits the generalizability of our findings and could reduce the statistical power of our analysis, which is one of its limitations. Another limitation is the cross-sectional design of this study where no detailed investigation of the participants’ cultural and ethical background factors that may contribute to the decision-making toward this treatment approach was not performed. There are also several other factors such as ensuing body positivity among peers, personal values and beliefs, medical conditions or allergies, comfort with personal care practices, and exploration of alternate solutions to tackle their problems that were not included in our study, which might alter the findings we listed above. Beyond just the skin, intimate area depigmentation can cause a person to lose confidence in their physical appearance, experience bullying from friends, family, and spouses, feel physically and emotionally helpless when thinking about their hyperpigmentation, and stay away from intimate relationships. Therefore, it is essential to conduct additional studies on a larger sample size, which addresses the psychological effects of hyperpigmentation including encouraging self-acceptance, promoting realistic body image goals, and offering compassionate care.
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.
The Institutional Review Board approval is not required.
Declaration of patient consent
Patient’s consent is not required as patients identity is not disclosed or compromised.
Conflicts of interest
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Financial support and sponsorship
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