Abstract
BACKGROUND:
The United Arab Emirates (UAE) represents one of the fastest-growing cosmetics markets in the Middle East, yet little is known about consumer awareness of cosmetic safety and cosmetovigilance practices. This study aims to evaluate cosmetic use, safety awareness, adverse effects, and perceptions of cosmetovigilance among the general population in the northern emirates of the UAE.
MATERIALS AND METHODS:
A cross-sectional survey was conducted from December 2023 to March 2024 among 615 residents of Ras Al Khaimah, UAE. Data were collected using a validated bilingual questionnaire and analyzed using descriptive statistics, Chi-square tests, and logistic regression to examine associations between sociodemographic factors and cosmetic knowledge.
RESULTS:
Of 615 participants, 62.6% were female, and the median age was 35 years. The most frequently used products were creams (52.8%) and deodorants/perfumes (48.7%). Reported adverse effects included itching (32.0%, n = 197), headaches (19.2%, n = 118), rashes (11.5%, n = 71), and hair loss (11.5%, n = 71). Only 33.0% (n = 203) of respondents reported reading ingredient labels, and 70.0% (n = 431) had never performed an allergy test. The internet (31.9%, n = 196) and advertisements (28.4%, n = 175) were the most common information sources, while pharmacists were consulted by only 20.8% (n = 128). Logistic regression analysis identified gender and age as significant predictors of knowledge (P < 0.05).
CONCLUSION:
Cosmetic use is widespread in the UAE, but awareness of safety practices remains limited, with significant demographic influences. These findings underscore the need for improved consumer education, pharmacist-led interventions, and stronger regulatory enforcement to strengthen cosmetovigilance in the UAE.
Keywords: Cosmetics, cross-sectional studies, drug-related side effects and adverse reactions, sociodemographic factors, surveys and questionnaires
Introduction
Cosmetics are products formulated to cleanse, beautify, and enhance the appearance of the skin, hair, nails, and teeth. They include a wide range of items such as makeup, perfumes, creams, nail polishes, soaps, shampoos, and deodorants.[1,2] These products have become integral to daily routines, driven by social and personal aspirations for improved appearance and well-being. However, inappropriate or unsafe use may result in the purchase of substandard products and subsequent adverse reactions, including pigmentary disorders, irritation, urticaria, photosensitivity, and acneiform eruptions.[3,4]
The concept of cosmetovigilance, modelled after pharmacovigilance, refers to the monitoring, assessment, and prevention of adverse events associated with cosmetic products.[5] Although cosmetics are generally assumed to be safe, adverse reactions remain frequent and underreported, with incidence rates ranging from 8% to 26%.[6,7] Such reactions occur with both branded and non-branded products, largely due to gaps in consumer education, weak reporting systems, and reliance on non-professional information sources.[2,8]
Globally, cosmetic use—traditionally dominated by women—is rising among men as well.[9] Consumer choices are influenced primarily by advertising and peer networks, while consultation with professionals such as pharmacists or dermatologists remains limited.[10] Importantly, both temporary and permanent cosmetics pose risks: henna may cause dermatitis or hemolytic anemia in G6PD-deficient individuals, hair dyes are linked to itching and contact dermatitis, Botox injections can lead to inflammation and ptosis, and misuse of contact lenses may result in ocular complications.[8,11]
Pharmacists, with their expertise in product safety and consumer health, are strategically positioned to advance cosmetovigilance by promoting awareness, guiding safe practices, and facilitating adverse event reporting.[4,12,13]
The United Arab Emirates (UAE), one of the fastest-growing cosmetics markets in the Middle East, reflects global consumption trends.[14] However, this rapid expansion increases the risk of dermatological complications, compounded by limited public awareness and poor adherence to existing regulations.[15] Given its multicultural population, wide product availability, and role as a regional trade hub, examining cosmetic safety awareness in the UAE provides valuable insights for both national policy and global cosmetovigilance strategies.[16,17]
Theoretical framework
This study employs two complementary public health behavior theories, including the Knowledge, Attitude, and Practice (KAP) model, which is grounded in the Health Belief Model (HBM). These theories explain how individuals translate awareness into preventive actions.[18,19]
The KAP framework suggests that acquiring knowledge is the initial step in shaping attitudes and influencing health-related behaviors. In the context of cosmetovigilance, a consumer’s understanding of cosmetic ingredients, product labeling, and potential risks affects their attitudes toward product safety and their behaviors. This includes actions such as performing allergy tests, reading ingredient lists, or consulting pharmacists before using a product. Insufficient knowledge can lead to unsafe practices, which may result in adverse reactions to cosmetics and a lack of reporting such incidents.
The HBM provides a more comprehensive explanation for these behaviors. It suggests that the actions of cosmetic users are influenced by their perceived susceptibility to adverse effects, the perceived severity of those effects, the perceived benefits of preventive measures (such as reading labels or consulting pharmacists), and perceived barriers (such as insufficient information or accessibility). Cues to action, such as educational campaigns or regulatory enforcement, further encourage the adoption of safety-oriented practices. Thus, the HBM contextualizes cosmetic safety awareness as being shaped by both cognitive and motivational factors influenced by sociodemographic characteristics.
By integrating the KAP and HBM perspectives, the theoretical model, represented in Figure 1, establishes a link between sociodemographic variables (age, gender, education, and occupation) and KAP. These essentials, in turn, influence safety outcomes and risk perceptions. The model assumes that enhanced knowledge leads to more positive attitudes and safer practices, ultimately reducing the incidence of cosmetic-related adverse events and strengthening national cosmetovigilance efforts.[20]
Figure 1.
Theoretical Framework of Consumer-Driven Cosmetovigilance Based on KAP and HBM
To date, limited research has examined cosmetovigilance practices and consumer risk perceptions in the UAE. This study is the first to comprehensively assess cosmetic safety awareness, adverse event experiences, and sociodemographic predictors among the general population in the northern emirates. By addressing this gap, the research contributes novel evidence to support national policies, enhance pharmacist-led education, and serve as a model for cosmetovigilance strategies in other emerging markets.
Materials and Methods
Study design and setting
This was a prospective cross-sectional survey-based study conducted in accordance with institutional and national ethical standards. All procedures involving human participants adhered to the principles outlined in the Declaration of Helsinki. The study received ethical approval from the Institutional Research and Ethics Committee of RAK College of Pharmacy, RAK Medical and Health Sciences University (Approval No. RAKCOP-REC-01-2023/24-UG), and the Ministry of Health and Prevention Research Ethics Committee (Approval No. MOHAP/REC/2024/2-2024-UG-P). The research was carried out between 1 December 2023 and 31 March 2024, following all applicable regulations and legal frameworks to ensure participant safety, confidentiality, and voluntary informed consent.
Study participants and sampling
The study participants were members of the general population residing in Ras Al Khaimah, United Arab Emirates (UAE), encompassing diverse nationalities and demographics. The sample size was estimated using Raosoft® calculator with a 95% confidence level, 50% response distribution, and a 3.9% margin of error, resulting in a required sample of 613 respondents.[21] A margin of error of 3.9% was selected to maximize the precision of the estimates while remaining feasible for the study duration and available resources.
Although the study initially aimed to achieve stratification by age, gender, and social class, in practice, participants were recruited through educational institutions, shopping complexes, social enterprises, social media, and e-mail. Thus, the approach is best described as convenience sampling with stratification considerations, which may limit the representativeness of the findings.
The study participants were members of the general population residing in the northern emirates of the UAE, 18 years or older, who had used cosmetic products over the past year and provided informed consent. Individuals with hearing impairment or those unable to speak or comprehend English or Arabic were excluded, as were those with mental disabilities.
Data collection tool and technique
A self-administered or interviewer-assisted questionnaire was developed to examine the participants’ level of awareness and safe use of cosmetics. The questionnaire consisted of sixteen multiple-choice questions in English and Arabic, the target group’s languages.
The process of questionnaire development employed a literature search and discussion. The panel, consisting of ten people and representatives from healthcare, pharmacovigilance, epidemiological research, and linguistics, evaluated and improved the formulated questions to make them valid and reliable. A two-step procedure for content validation of the questionnaire was carried out based on the method developed by Lynn M.[22] Additional data were also taken from a pre-test of 20 general population members to test the face validity and rectify any areas of the instrument that appeared ambiguous or confusing. Finally, for the determination of the reliability of the instrument, the internal consistency construct was used as measured by Cronbach’s alpha. The instrument had a reliability score of 0.78. The first questionnaire was designed completely with 21 questions, and after the validation stage, only 16 questions were left for the operational stage.
Scoring of knowledge
Each correct knowledge response was awarded 1 point, while incorrect or “don’t know” responses were scored as 0. Scores were summed to a maximum of 5 in the knowledge section. Respondents scoring ≥ 3 out of 5 were classified as having “good knowledge,” while those scoring < 3 were considered to have “poor knowledge.” This cut-off was based on scoring practices used in similar KAP (Knowledge, Attitude, and Practice) studies.
Data collection took about four months. Participants were engaged through various means, such as educational institutions, shopping complexes, social enterprises, social media, and e-mails. The survey was distributed using multiple methods, including online and offline approaches. For online use, it was posted via a Google form link, email, and social media to reach a wider audience. Hard copies of the questionnaires were distributed in person by the research investigators.
A follow-up and reminder strategy was implemented to optimize the number of responses obtained and ensure accurate data collection. Participants were first invited to complete the questionnaire via email or in person as they preferred. A follow-up email reminder was sent to online participants automatically a week after the date of the first invitation. Where the questionnaire was not completed, a second reminder was sent two weeks after the first. Study investigators also provided follow-up visits or phone calls to participants who had been initially contacted in person.
After participants completed the survey, an educational information leaflet was distributed to promote safe cosmetic usage patterns. The leaflet included safety guidelines and recommendations for the systematic use of cosmetics, aiming to reduce adverse effects and encourage informed use.
Ethical consideration
All the subjects were given detailed information regarding the study, including its rationale, any relevant procedures, and the significance of the study. An informed written consent was obtained from all participants to ensure no breaches of ethical standards. Participants’ responses were anonymous, which encouraged honest reporting without fear of repercussions. Only researchers who participated in the study were privy to the participants’ data, ensuring security and confidentiality. All participants’ identities were adequately protected, and identifying characteristics were securely stored to safeguard privacy.
Statistical analysis method
The data were processed with IBM’s Statistical Package for Social Sciences (SPSS) version 28.0. Descriptive and inferential statistics were employed to assess the mean and variance of continuous variables and the proportions and frequencies of categorical variables to describe demographic features. Knowledge and practice scores were compared to demographic characteristics using an independent sample t-test and one-way analysis of variance (ANOVA). The relationship between cosmetic use frequency and sociodemographic factors was investigated using Chi-square and Fisher’s exact test. The Chi-square test also examined associations between knowledge, perception, and demographic characteristics. Binary logistic regression analysis was used to identify the demographic factors that predict good and poor knowledge and practices. A P value of < 0.05 was considered statistically significant.
Results
Demographic and socio-economic factors
The questionnaire was distributed to 650 participants. Of these, 615 individuals (94.61%) completed and returned the study questionnaire. Among the remaining 35 participants, 17 (2.6%) provided partial responses that were excluded from the analysis. Of the 650 individuals approached, 615 (94.6%) completed the questionnaire, although the questionnaire was distributed through both online and offline methods, no complete responses were received through the online mode. Therefore, all responses included in the final analysis were collected through face-to-face interviews. Most participants were female (62.6%), with a median age of 35 years, and the majority were in the 21–40 age group (65.4%). Over two-thirds held a bachelor’s degree (66.8%), and the majority were non-UAE nationals (80.0%). The largest occupational groups were students (42.1%) and employed individuals (38.5%) [Table 1].
Table 1.
Sociodemographic characteristics of the study participants (n=615)
| Sociodemographics | Frequency (n=615) (%) | 95% CI | ||
|---|---|---|---|---|
| Gender | ||||
| Male | 230 (37.39) | 33.8–41.5 | ||
| Female | 385 (62.60) | 58.5–66.2 | ||
| Age category | ||||
| ≤20 | 195 (31.70) | 28.0–35.3 | ||
| 21–40 | 228 (37.07) | 33.0–41 | ||
| 41–60 | 182 (29.59) | 26.2–33.5 | ||
| ≥61 | 10 (1.62) | 0.8–2.8 | ||
| Mean Age (years) | 32.48±5.67 | |||
| Level of education | ||||
| School level | 24 (3.90) | 2.4–5.5 | ||
| Secondary | 120 (19.51) | 16.6–22.8 | ||
| Diploma | 14 (2.27) | 1.3–3.6 | ||
| Bachelor | 411 (66.82) | 63.1–70.4 | ||
| Masters | 46 (7.47) | 5.5–9.6 | ||
| Nationality | ||||
| Non- Local | 514 (83.57) | 80.7–86.5 | ||
| Local | 101 (16.42) | 13.5–19.3 | ||
| Work experience | ||||
| Working | 237 (38.53) | 34.8–42.3 | ||
| Not working | 47 (7.64) | 5.5–9.8 | ||
| Student | 259 (42.11) | 38.2–45.7 | ||
| Homemaker | 72 (11.70) | 9.3–14.3 | ||
Study participants respondents towards cosmetic products related to knowledge, attitude, and practice
Only 55 participants (8.9%) reported allergic reactions to cosmetics, and most (431, 70.0%) had never performed an allergy test. About one-third (203, 33.0%) read ingredient labels, while only 123 (20.0%) sought advice before using hair dye. More than three-quarters (461, 75.0%) supported educational guidance on cosmetics.
Regarding safety, 225 participants (36.58%) believed cosmetics on the market are generally safe, but only 32 (5.2%) thought they were safe for all age groups. A majority (431, 70.0%) were unaware of hazardous chemicals, and 280 participants (45.52%) reported insufficient information at purchase, highlighting the need for pharmacist involvement [Table 2].
Table 2.
Knowledge, attitudes, and practices related to cosmetic products (n=615)
| Questions |
n=615 (%) |
|||||
|---|---|---|---|---|---|---|
| Yes (%) | No (%) | I don’t know (%) | ||||
| Have you ever experienced any allergic reaction to the use of any cosmetic product | 55 (8.94) | 462 (75.12) | 98 (15.93) | |||
| Have you ever performed an allergy test before using a cosmetic product | 124 (20.16) | 431 (70.08) | 50 (8.13) | |||
| Do you usually read/check the list of ingredients present in the cosmetics | 203 (33.0) | 171 (27.80) | 241 (39.18) | |||
| Do you seek any advice or suggestions before you buy your cosmetic product | 127 (20.65) | 300 (48.78) | 188 (30.56) | |||
| Do you think educational advice regarding your cosmetics would be beneficial for you | 473 (76.91) | 54 (8.78) | 88 (14.30) | |||
| Do you think that all the available cosmetics in the market are safe | 225 (36.58) | 343 (55.77) | 47 (7.64) | |||
| Is it safe to use all available cosmetics in all age groups | 32 (5.20) | 501 (81.46) | 82 (13.33) | |||
| Are you aware of any hazardous chemicals/toxic ingredients present in the cosmetics | 168 (27.31) | 432 (70.24) | 15 (2.43) | |||
| Did you ever consult or receive pharmacist advice while buying your cosmetic product | 128 (20.81) | 253 (41.13) | 234 (38.04) | |||
| Do you think you get enough information when you are buying your product | 123 (20.0) | 280 (45.52) | 205 (33.33) | |||
Types of cosmetic products
Creams emerged as the most commonly used cosmetic product (325, 52.8%), followed by deodorants/perfumes (300, 48.7%) and nail polish (259, 42.1%). Hair dye was used by 175 participants (28.5%), while contact lenses (96, 15.6%) and powders (44, 7.1%) were less frequently reported.
Awareness of adverse effects of cosmetics
The study findings indicate that participants reported various adverse effects associated with cosmetic use, with 197 (32.0%) reporting itching as the most common. 64 participants (10.4%) experienced acne or pimples, while 74 (12.1%) noted facial redness, and 104 (17.0%) reported rashes over the face and forehead. A total of 341 participants (55.4%) reported no adverse effects. [Figure 2]
Figure 2.
Distribution of self -reported adverse reactions associated with cosmetic product use among study participants
Use of cosmetics in special populations
The survey results indicate that most respondents believed cosmetic selection for vulnerable populations should be approached with caution. Specifically, 194 participants (31.6%) emphasized careful cosmetic use in children, 116 (18.8%) expressed concern for individuals with serious health issues, 97 (15.8%) highlighted the elderly as a group requiring attention, and 73 (11.8%) indicated precautions during pregnancy. Notably, 134 respondents (21.7%) were uncertain about the safety of cosmetics in these special populations.
Source of information about cosmetics
The study revealed that the most common information source regarding cosmetics was the Internet (31.9%, n = 196), followed by advertisements (28.4%, n = 175). Other sources included beauticians (14.9%, n = 92), family/friends (12.6%, n = 77), pharmacists (9.4%, n = 58), and product promoters (2.6%, n = 16) [Figure 3].
Figure 3.
Sources of information about cosmetic products among study participants
Relationship between the sociodemographic factors and frequent use of cosmetic procedures
The analysis of the relationship between sociodemographic factors and the frequency of cosmetic use revealed significant associations with gender, nationality, and employment status (P < 0.05). Female participants reported more frequent cosmetic use compared to males. Non-UAE nationals reported higher usage than UAE nationals, and employed individuals reported greater cosmetic use than students or unemployed participants. These findings underscore the influence of sociodemographic characteristics on cosmetic behavior among respondents [Table 3].
Table 3.
Association between frequency of cosmetic use and sociodemographic characteristics (n=615)
| Variables | Frequency of cosmetics use |
P | ||||||
|---|---|---|---|---|---|---|---|---|
| 1 – 2 times/day | More than 2 times/day | Once per week | ||||||
| Gender | ||||||||
| Female | 217 | 21 | 70 | <0.001* | ||||
| Male | 139 | 11 | 157 | |||||
| Age group (in years) | ||||||||
| ≤20 | 116 | 10 | 69 | 0.135** | ||||
| 21–40 | 136 | 17 | 75 | |||||
| 41–60 | 97 | 5 | 80 | |||||
| ≥61 | 7 | 0 | 3 | |||||
| Nationality | ||||||||
| Local | 47 | 3 | 51 | 0.007* | ||||
| Non-Local | 309 | 29 | 176 | |||||
| Level of education | ||||||||
| School level | 11 | 1 | 12 | 0.299** | ||||
| Secondary | 63 | 7 | 50 | |||||
| Diploma | 6 | 1 | 7 | |||||
| Bachelor | 243 | 21 | 147 | |||||
| Masters | 33 | 2 | 11 | |||||
| Employment | ||||||||
| Working | 153 | 17 | 67 | <0.001* | ||||
| Not working | 24 | 1 | 22 | |||||
| Student | 152 | 13 | 94 | |||||
| Homemaker | 27 | 1 | 44 | |||||
*Chi-squared test; **Fisher’s exact test P<0.05 is statistically significant
Relationship between respondents’ mean knowledge score and sociodemographic Features of the study respondents
The analysis of the association between respondents’ mean knowledge scores and sociodemographic characteristics revealed a statistically significant correlation between age and mean knowledge scores (P < 0.001), with older participants demonstrating higher knowledge levels than younger participants. A significant association was also observed between employment status and mean knowledge scores (P < 0.001), as employed individuals had higher knowledge levels compared to unemployed participants. No significant associations were found with other sociodemographic variables [Table 4].
Table 4.
Mean knowledge scores across sociodemographic characteristics (n=615)
| Variable | Mean score | df | F/t | p | ||||
|---|---|---|---|---|---|---|---|---|
| Gender | ||||||||
| Male | 3.56±2.29 | 613 | -1.69* | 0.092 | ||||
| Female | 3.88±2.28 | |||||||
| Age | ||||||||
| ≤20 | 3.22±2.32 | 614 | 6.77** | <0.001 | ||||
| 21–40 | 3.84±2.22 | |||||||
| 41–60 | 4.20±2.25 | |||||||
| ≥61 | 4.70±1.70 | |||||||
| Level of education | ||||||||
| School level | 4.08±2.39 | 614 | 0.703** | 0.590 | ||||
| Secondary | 3.96±2.32 | |||||||
| Diploma | 4.00±1.96 | |||||||
| Bachelor | 3.65±2.30 | |||||||
| Masters | 3.98±2.13 | |||||||
| Employment | ||||||||
| Working | 3.92±2.18 | 614 | 7.93** | <0.001 | ||||
| Not working | 4.55±2.12 | |||||||
| Student | 3.30±2.35 | |||||||
| Homemaker | 4.40±2.20 | |||||||
| Nationality | ||||||||
| Local | 3.77±2.48 | 613 | 0.046* | 0.963 | ||||
| Non-local | 3.76±2.25 |
**ANOVA, *t-test, P<0.05 is statistically significant
Relationship between sociodemographic factors and attitudes about using cosmetics
The analysis showed that gender, age, level of education, and employment status were significantly associated with perceptions related to cosmetic use (P < 0.05). Female participants, younger individuals, those with higher education levels, and employed respondents were more likely to seek advice, consider cosmetics as safe, find educational guidance beneficial, and report reading ingredient lists [Table 5].
Table 5.
Association of sociodemographics with perception of cosmetics (n=615)
| Association of demographics with perception | Yes | No | I don’t know | P | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Do you seek any advice or suggestions before you buy your cosmetic product | Gender | Male | 95 | 67 | 68 | <0.001* | ||||||
| Female | 205 | 60 | 120 | |||||||||
| Is it safe to use all available cosmetics in all age groups? | Age (Years) | ≤20 | 10 | 162 | 23 | 0.003* | ||||||
| 21–40 | 10 | 184 | 34 | |||||||||
| 41–60 | 11 | 152 | 19 | |||||||||
| ≥61 | 01 | 03 | 06 | |||||||||
| Would educational advice regarding your cosmetics be beneficial for you? | Level of Pharmacy Education | School level | 16 | 3 | 5 | 0.009** | ||||||
| Secondary | 80 | 13 | 27 | |||||||||
| Diploma | 8 | 1 | 5 | |||||||||
| Bachelor | 329 | 35 | 47 | |||||||||
| Masters | 40 | 2 | 4 | |||||||||
| Do you usually read/check the list of ingredients present in cosmetics? | Work experience | Working | 98 | 57 | 82 | 0.001* | ||||||
| Not working | 22 | 12 | 13 | |||||||||
| Student | 63 | 85 | 111 | |||||||||
| Homemaker | 20 | 17 | 35 | |||||||||
| Are you aware of any hazardous chemicals/toxic ingredients present in the cosmetics | Nationality | Non – Local | 22 | 78 | 01 | 0.217 | ||||||
| Local | 146 | 354 | 14 | |||||||||
*Chi-squared test; **Fisher’s exact test; P<0.05 is statistically significant
Sociodemographic factors linked to sufficient knowledge score using binary logistic regression
Binary logistic regression analysis, adjusted for all other variables, showed that gender and age were significantly associated with adequate knowledge scores (P < 0.05). Female participants were more likely to have sufficient knowledge compared to males (OR = 0.596, P = 0.013). Older individuals also had higher odds of adequate knowledge compared to younger participants (OR = 0.235, P = 0.048) [Table 6].
Table 6.
Logistic regression analysis of sociodemographic predictors of adequate knowledge (n=615)
| The beta coefficient of predictor variables | Standard error | Wald | P | Exp(B) | Odds ratio (95% CI) | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Gender (male v/s female) | 0.510 | 0.200 | 6.476 | 0.011 | 1.665 | 1.124–2.466 | ||||||
| Age groups (≤40 v/s >40) | 0.600 | 0.190 | 10.007 | 0.002 | 1.822 | 1.256–2.642 | ||||||
| Nationality (local v/s non-local) | -0.015 | 0.230 | 0.004 | 0.948 | 0.985 | 0.628–1.546 | ||||||
| Education (Secondary school v/s diploma & above) | -0.209 | 0.198 | 1.113 | 0.291 | 0.812 | 0.551–1.196 | ||||||
| Employment (employ v/s non-employee) | -0.172 | 0.203 | 0.713 | 0.398 | 0.842 | 0.566–1.254 | ||||||
| Constant | -1.488 | 0.765 | 3.786 | 0.052 | 0.226 |
P<0.05 is statistically significant
Discussion
Cosmetics are widely recognized as an essential part of personal grooming and self-expression, and their use is expanding globally in both men and women.[23] The present study explored cosmetovigilance and cosmetic safety awareness among the general public in the northern emirates of the UAE, highlighting knowledge gaps, adverse reactions, and sociodemographic influences.
Our findings revealed a predominance of female users (62.6%), consistent with earlier studies reporting female prevalence rates between 61% and 76.6%.[24,25,26] This gender trend reflects societal and cultural norms in the region, as also noted in Saudi Arabia, where women spend significant amounts annually on cosmetic products.[16] The median age of participants (35 years) aligns with international studies reporting strong engagement in cosmetics among young to middle-aged groups.[27,28,29] These data reinforce that cosmetic use is not merely a lifestyle preference but a public health matter, as widespread use increases the potential for adverse events and the burden on healthcare systems.
The types of cosmetics used also reflect regional preferences. In our study, creams (52.8%) were most frequently reported, followed by deodorants/perfumes (48.7%) and nail polish (42.1%). These findings align with Sri Lanka, where 55% reported cream use, and with Middle Eastern markets, where creams and perfumes dominate consumption patterns.[29,30,31] Similar to studies in India and Pakistan, knowledge about safe cosmetic practices was limited, with only one-third of respondents reading ingredient labels and over 70% never performing an allergy test.[3,32] These results support our hypothesis that cosmetic safety awareness is suboptimal, particularly in populations with high product use but weak regulatory enforcement.
Although the majority of respondents reported no adverse effects, reactions such as itching (32%), acne (10.4%), and rashes (17.0%) were noted. These figures are comparable to Malaysia (35.2%), China (31%) and India (76%), where cosmetic-related dermatological complications were reported.[4,33,34] Comparable frequencies (20–30%) have also been described in other Asian countries.[35,36,37] The slightly lower prevalence in our study may be attributable to underreporting or recall bias, a well-documented limitation in self-reported surveys. Nonetheless, even mild adverse effects can significantly impact quality of life and escalate into costly dermatological interventions if not addressed.
An important finding was that most participants relied on the internet (31.9%) and advertisements (28.4%) as their primary information sources, while only 20.8% consulted pharmacists. While this highlights the underutilization of pharmacists, it also presents an opportunity for targeted interventions. Strategies such as integrating cosmetic counselling into community pharmacy practice, pharmacist-led awareness campaigns, and mobile health platforms could enhance their role in promoting safe cosmetic use. Similar approaches have been effective in other Middle Eastern contexts.[38,39,40,41,42]
Sociodemographic factors also played a significant role. Age and gender were predictors of knowledge, with females and older individuals demonstrating higher awareness. These results are consistent with earlier work in Lebanon and Saudi Arabia (where females had 1.5 times higher knowledge scores than males), which also found significant associations between education, age, and awareness.[5,31] These associations confirm our hypothesis that demographic variables strongly influence cosmetic safety practices and awareness, and they suggest that public health interventions should be tailored to subgroups most at risk of poor knowledge.
This study also highlighted awareness of vulnerable populations, including children, pregnant women, and the elderly. A significant proportion of respondents emphasized caution in these groups, reflecting increasing consumer recognition of cosmetic safety risks. However, uncertainty among others underscores the need for public health campaigns that address special populations explicitly.[43,44]
Overall, these findings have important implications for public health, regulation, and policy. As the UAE is one of the largest cosmetic markets in the region and a hub for cosmetic trade and re-export, its consumer safety policies have implications beyond national borders. Weaknesses in local reporting may extend risks across neighboring markets, reinforcing the urgency of building robust systems. The UAE is well-positioned to pioneer cosmetovigilance frameworks aligned with international best practices by adapting international models such as the EU Cosmetic Products Notification Portal (CPNP), the U.S. FDA MedWatch program, and the WHO Global Benchmarking Tool. Strengthening consumer awareness, mandating standardized labeling with allergen warnings and ingredient disclosure, empowering pharmacists through structured education programs, and establishing mandatory adverse event reporting systems are crucial steps.[45] In addition, leveraging digital health and AI technologies could enhance adverse event detection, real-time surveillance, and consumer awareness, while monitoring cosmetic spending patterns would provide insights into risk behaviors and the economic burden of cosmetic use. While findings from this study cannot be directly generalized to all emerging economies due to cultural and regulatory differences, they may offer useful lessons for countries with similar market dynamics.
This study has several strengths. It is one of the first to comprehensively examine cosmetovigilance and cosmetic safety awareness in the northern emirates of the UAE, a region where cosmetic use is rapidly growing. The study benefited from a relatively large and diverse sample size, use of a validated and reliable instrument, and coverage of multiple domains, including knowledge, practices, adverse effects, and perceptions.
However, some limitations should be acknowledged. As a cross-sectional survey, the design restricts the ability to establish causal relationships between sociodemographic factors and cosmetic knowledge or practices. Reliance on self-reported data introduces risks of recall bias and social desirability bias, potentially leading to underreporting of adverse effects or overestimation of safe practices. Recruitment was concentrated in urban areas, which may not fully represent rural populations. In addition, the perspectives of healthcare providers, such as pharmacists and dermatologists, were not included, which could have enriched the findings. Although the sample had a predominance of female participants, this reflects actual global and regional cosmetic usage patterns and therefore strengthens, rather than limits, representativeness. Another limitation is that spending patterns on cosmetics were not assessed, despite their potential influence on consumer safety and public health.
Future research should address these limitations by adopting longitudinal and mixed-method designs to establish causal relationships and capture nuanced consumer perceptions. Expanding studies to rural populations and including healthcare professionals would provide a more comprehensive understanding of cosmetovigilance practices. Interventional research evaluating pharmacist-led education, consumer awareness campaigns, and regulatory strategies is recommended. In addition, the integration of artificial intelligence (AI) into cosmetovigilance systems could improve adverse reaction monitoring, early signal detection, and public outreach. Finally, future work should explore cosmetic spending patterns, as expenditure behaviors are closely tied to consumer risk exposure and carry significant implications for policy development.
Conclusion
This study identifies key policy-relevant insights for enhancing cosmetic safety in the UAE. Notable knowledge gaps persist regarding allergy testing, ingredient risks, and reliance on non-professional information sources. Sociodemographic determinants, particularly age and gender, significantly influence cosmetic knowledge and use, underscoring the need for targeted and equitable awareness initiatives. Strengthening the national cosmetovigilance framework is imperative to safeguard consumers and ensure regulatory accountability. Establishing a centralized adverse event reporting system under the Ministry of Health and aligning national policies with the WHO Global Benchmarking Tool, EU Cosmetic Regulation (EC No. 1223/2009), and GCC unified cosmetic guidelines will promote harmonization and transparency. Integrating pharmacist-led consumer education into these efforts can further advance public health outcomes. By adopting these international policy benchmarks, the UAE can position itself as a regional leader in evidence-based cosmetovigilance and consumer safety.
AI policy statement
No generative artificial intelligence tools were used in the data collection, analysis, or interpretation of results in this study. AI assistance (ChatGPT, OpenAI GPT-5) was utilized solely for language editing, formatting, and structural refinement of the manuscript in accordance with ethical academic writing practices. All scientific content, analysis, and conclusions remain entirely the authors’ original work.
Abbreviations
AI: Artificial Intelligence; ANOVA: Analysis of Variance; CI: Confidence Interval; CPNP: Cosmetic Products Notification Portal (EU); df: Degrees of Freedom; EU: European Union; FDA: U.S. Food and Drug Administration; G6PD: Glucose-6-Phosphate Dehydrogenase; GCC: Gulf Cooperation Council; GBT: Global Benchmarking Tool (WHO); JEHP: Journal of Education and Health Promotion; KAP: Knowledge, Attitude, and Practice; MOHAP: Ministry of Health and Prevention (UAE); OR: Odds Ratio; RAKCOP: RAK College of Pharmacy; RAKMHSU: RAK Medical and Health Sciences University; REC: Research Ethics Committee; SPSS: Statistical Package for the Social Sciences; UAE: United Arab Emirates; WHO: World Health Organization
Ethical approval
The study received ethical approval from the Institutional Research and Ethics Committee of RAK College of Pharmacy, RAK Medical and Health Sciences University (Approval No. RAKCOP-REC-01-2023/24-UG) and the Ministry of Health and Prevention Research Ethics Committee (Approval No. MOHAP/REC/2024/2-2024-UG-P).
Author’s contributions
HAA: Investigation, data collection, methodology, and writing – original draft. HAJ: Investigation, data collection, data curation, and writing – original draft. SBS: Conceptualization, methodology, supervision, validation, and writing – review and editing. JS: Conceptualization, methodology, formal analysis, supervision, validation, and writing. SAR: Supervision, formal analysis, validation, and writing – review and editing.
Data availability statement
The data that support the findings of this study are available from the corresponding author upon reasonable request. The data is not publicly available due to privacy and confidentiality considerations.
Conflicts of interest
There are no conflicts of interest.
Acknowledgment
We would like to express our sincere gratitude to the President of RAK Medical and Health Sciences University, Ras Al Khaimah, and the Dean of RAK College of Pharmacy for their continuous support during the research period. We also extend our appreciation to the Institutional Research and Ethics Committee of RAK College of Pharmacy and the Ministry of Health and Prevention Research Ethics Committee for granting ethical approval to conduct this study.
Funding Statement
Nil.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request. The data is not publicly available due to privacy and confidentiality considerations.