The word “cosmeceutical” came into being in 1984 when a dermatologist known as Dr. Albert Kligman introduced it. [1] Another record showed that in 1961 the term cosmeceutical was conceived by Raymond Reed, a pioneer member of the United States Society of Cosmetic Chemists (USSCC). [2] [3] Dr. Albert Kligman described as the father of cosmeceuticals actually popularized the term cosmeceuticals when he described it in 1984. The cosmeceutical products made an appearance in the world market in 1996. The term “cosmeceutical” has been evolving and most people were confused with cosmetics generally. Some felt that the term cosmeceuticals lack proper definition and its difference from individual cosmetics and pharmaceutical agents seems to be incomplete. The definition of cosmeceutical has always been controversial. [1] There are regulatory issues around the products because the term cosmeceutical is not in existence in the United States Food and Drug Administration records. [4] Cosmeceuticals are agents that combine the properties of cosmetics as well as pharmaceutical drugs. They can affect skin function as well as modify the appearance and the feel of the skin to promote both looks and health conditions. Currently, cosmeceuticals have dominated over any other personal care products across the globe. [1] The anti-aging cosmeceutical (a one group of cosmeceuticals) was valued at USD38.6 billion in 2021. Its value will increase to about USD 60.3 billion in 6 years’ time. [5] A study in 2019 showed that awareness about cosmeceuticals was not adequate, even among community pharmacists in Saudi Arabia let alone ordinary people. [6] A study in Seoul, South Korea, 2017, revealed that total customers’ awareness of cosmeceuticals was described as low, therefore, promotion of awareness was considered necessary. [7] Nowadays, toiletries and skin lightening (bleaching) agents are used the world over, especially in Africa and Asia without public awareness about the correct use of topical creams and their adverse effects on the skin. [8]

This study seeks to demonstrate the awareness of the term cosmeceutical as well as the use of these products among students of tertiary institutions in Northeast Nigeria amidst regulatory issues.

Study design―It was a cross-sectional descriptive study.

Study locale―The study was conducted in Ramat Polytechnic, one of the tertiary institutes of learning located in Maiduguri, the capital city of the state in northeastern Nigeria. It was established in January 1973 by the government of the defunct North-Eastern State as Technical College. Currently, the institute has one Campus with six Schools, and 34 departments offering 52 different programs.

The Polytechnic offers full and part-time courses of instruction and training leading to National Diploma (ND), Higher National Diploma (HND), Nigeria Certificate in Education (NCE Tech and Bus) and other Certificates of distinctions in Scientific, Technological, Management and Engineering courses to cater for the manpower requirements of the State and the nation. The students run through their programs by staying on or off campus. The Polytechnic offers Post Graduate Diploma through the Consultancy Unit in Management, Finance, Agronomy and Farm Management, Health Education and Hygiene and Education since 2003 in affiliation to the University of Maiduguri.

Study population―The study population was all female students of the institution.

Study samples―Participants were drawn from the institution’s female students for homogeneity and to enhance the maximum flow of information.

The majority of the respondents were within the age groups of 15 to 19 (18.6%) and 20 to 24 years (64.3%). The mean age was 22.8 ± 10.1 years. Almost all (97.1%) respondents were single. Most (64.3%) of the respondents were Muslims (belonging to the religion of Islam) from different tribal groups. (Table 1)

The study showed that none of the respondents ever heard or knew about cosmeceuticals. However, all of them knew about cosmetics. All of them were using cosmetics in form of body creams or lotions at the time of the discussions

and all refuted use of cosmeceuticals. However, it was found in this study that Forty-Six (65.7%) of the 70 respondents were found to be using cosmeceuticals through examination of the ingredients of the products they were using which they described as cosmetics. Twenty-Two (31.4%) of the respondents were actually using body cosmetics creams or lotions as they mentioned while 2 (2.9%) were not using any form of product for cosmetic reasons. (Table 2)

Figure 1 shows a range of cosmeceuticals in body creams or lotions used by participants. The majority (18.0%) of respondents use cocoa butter body cream. Six (about 12.5%) persons were using pharmaceutical drugs (Funbact, Epiderm, Nixoderm, Libya and Silva creams in their body creams as cosmetics. Two of the respondents were using two different body creams at the time of the study. One of the respondents was using a combination of cocoa butter and skineal and the other was using cocoa butter and paw paw lotion.

Funbact, Epiderm and skineal contain steroids, antifungal and antibacterial agents as part of their ingredients as can be seen in Table 3 which also shows Libya cream to contain an antifungal agent. Silva cream contains antibiotics to prevent and treat bacterial infections while Nixoderm contains Salicylic Acid 2 g in 100 g, Benzoic acid, Zinc Oxide, and Sulphur.

Source: Labels of products, internet.

The discussants (100.0%) purchased cosmeceuticals over the counter at markets. Four discussants (8.3%) obtain the products from pharmacies. About 58.3% of the respondents felt the products were easy to get and have never experienced any form of regulation at the point of buying. About 29.2% and 4.2% either had difficulty in obtaining the product due to financial and supply issues respectively while the remaining 8.3% had a combination of both financial and supply issues.

Table 4 shows that beautification accounted for the most (53.0%) reasons for cosmeceuticals use by respondents followed by skin lightening accounting for 15.7%. Skin lightening was also mentioned by some of the respondents to account for 10.4% of the unwanted effects of cosmeceuticals. The table shows

excessive sweating as one of the most frequently mentioned unwanted effects accounting for 22.9%. The attitudes of the respondent as shown in Table 4 include feelings of stigmatization due to the use of body creams and lotions as beautifying agents or for any of the reasons shown in Table 4. The respondents generally felt that the products are good (41.8%) though they felt that the beautifying agents take over the natural beauty a lady has as mentioned by some (10.9%). This means that the user will have to always rely on the product to maintain her beauty. Many pieces of advice were given to users of cosmeceuticals. The advice includes encouragement of all girls to start using cosmeceuticals (46.2%). However, girls were advised not to use skin bleaching agents (23.1%).

In the KII the informant the State Chief Regulation Officer of the National Agency for Food and Drug Administration and Control (NAFDAC) showed an incomplete understanding of the term cosmeceuticals. However, he affirmed that there is a policy regulation for cosmetics and other related products in the country. The regulation is aimed at controlling manufacturing practices to ensure standards and contents testing, labels, supplies, and adverts. He feels that the policy needs to be reviewed because of the advancement in the field of cosmetics. He advised that the review should be done more frequently by the government. He also advised users ensure using genuine unexpired products by carefully selecting what they buy. The Staff of NAFDAC occasionally visit retailing points to ensure quality and check against forgery and expired products. Defaulters are held to account for their shortcomings.

The majority of the respondents fell into the age group 15 to 19 and 20 to 24 years contributing to 18.6% and 64.3% respectively as in Table 1. These groups were the ones that like enhancing their beauty and appearance more than the other groups as stated in research on cosmetics usage and its relation to sex, age and marital status which mentions that the age range of 19 - 23 like cosmetics more than the other age groups. [21] Single females like cosmetics more than married ones. Almost all (97.1%) were singles belonging to the group that liked cosmetics more but decrease that tendency after marriage. [21] Most (64.3%) of the respondents were Muslims compared to the Christians (35.7%).

The awareness of cosmeceuticals was zero among the respondents. This was worse than the findings of the studies the researcher came across. In Seoul, Korea in 2017 which revealed that total customers’ awareness of cosmeceuticals was described as low. [7] The awareness about cosmeceuticals was described as inadequate even among community pharmacists in Saudi Arabia according to a study conducted in 2020. [6] Among the community pharmacist 53% knew about sunscreens, 62% knew about moisturizers while the rest of them were not aware. Another study among tertiary students in Saudi Arabia showed poor knowledge of hazards about cosmeceuticals. A study in Sudan among students showed 16%, 52% and 32% had excellent, average and poor knowledge about cosmeceuticals respectively. [11]

About 68.6% of the respondents were using cosmeceuticals without being aware. They thought they were using ordinary cosmetics. A prevalence study of the usage of cosmeceuticals among University students in Saudi Arabia showed a usage rate of 81%. [10] That was much higher than the 68.6% usage rate found in this study. Some of the respondents used medicines (Epiderm, Funbact, Nixoderm, Skineal, Silva and Libya cream) as cosmetics to enhance their appearance and skin condition (see in Figure 1). About 16.6% of the cosmetics mentioned by the respondents contained steroid out of which 6.2% (carowhite, carofresh and CT+) contain hydroquinone (Figure 1 and Table 2). It was obvious that the discussants were using products they do not know much about to enhance their skin conditions. The main reason for the use of cosmeceutical products was to enhance their beauty (53.0%) followed by skin lightening (15.7%). Other reasons given for the use of cosmeceuticals include treatment of pimples/acne (3.6%), rashes (10.8%), deodorant (9.6%), skin softening (4.8%) and reduce sweating (1.2%). The unwanted side effects mentioned by the discussants related to the products they were using include excessive sweating (22.9%), sun burn (16.7%) body odor (14.6%) and skin discoloration (6.3%). It was testified that about 30% of the adverse effects are termed as serious or severe, while the remaining 70 percent were considered mild. [22] Some (10.4%) actually viewed skin lightening as an unwanted effect. After discontinuing the beauty product, the gains in the skin quality will be lost leading to the return of poor skin quality (8.3%). That may lead to getting addicted to the product as believed by some in a study conducted in northeastern Nigeria which mentioned that about 50.5% believe that addiction to use of skin whitening agents can occur. [23] About 10.9% of the respondents asserted that the use of beauty products may lead to stigmatization. This is similar to previous findings in the same region which stated that about 24.7% of respondents thought that stigmatization was an issue in the use of skin whitening agents. [23] However, the discussants in this study felt that cosmetics or cosmeceuticals were good (41.8%) and while some (10.9%) thought that the products were very useful and helpful. Many (46.2%) of the discussants advised all girls to start using cosmeceuticals but to avoid the use of skin whitening agents (23.1%) and other pieces of advice as in Table 2.

There was no indication of regulatory policy and implementation in the manufacturing process, content testing, labeling, advertisements and supply of the cosmeceuticals as well as retail in the state where the study was conducted as mentioned by the key informant. The same thing happens in Pakistan where the Ministry of Science and Technology has promulgated laws to regulate skin-enhancing creams through the PSQCA. A special task force checks manufacturing units, markets, and stores to ensure standards and takes legal measures against defaulters was the case in the study locale. In the European Union cosmetics are subjected to expert safety assessment before being cleared for marketing. [22] However, in the U.S., the FDA only investigate product that has evidence of harm or complaint after being introduced to the market. The EU considers cosmeceuticals as cosmetics with the same laws applied for both, in the US, the FDA considers cosmeceuticals as drugs but not fully recognized, while in Japan cosmeceuticals are considered as quasi-drugs. [3] However, A legally accepted definition of cosmeceutical unlike in the case of ordinary cosmetics is currently inexistent the world over. So far, respondents in this study buy a range of products OTC all forms of cosmeceuticals without any form of restriction.

Inappropriate use of cosmeceuticals due to poor knowledge in the northeastern region of Nigeria was noted among students and staff of regulatory agencies while regulation of cosmeceuticals was specifically not addressed.

Organize an enlightenment program to empower the students in the tertiary institution to enable them to take informed decisions concerning such products as cosmeceuticals. Similar empowerment program should be extended to the students of other levels within the region. All the stakeholders relevant to the regulation of such cosmeceuticals should be educated on these agents. The government of Nigeria formulates policies with the aim of regulating the use of cosmeceuticals.

The authors declare no conflicts of interest.

Bolori, M.T., Bolori, B.U., Kuchichi, A.B., Ngoshe, I.M., Bukar, F.L., Amodu, M.O., Arshad, S., Mohamed, S.G.S. and Ahmed, H.R.M. (2023) Awareness and Use of Cosmeceuticals among Female Students of Tertiary Institutions in Northeastern Nigeria. Open Access Library Journal, 10: e9717. https://doi.org/10.4236/oalib.1109717