Changing the skin-bleaching behaviour among secondary school students in Nigeria: a scoping review

This study aimed to identify the multilevel determinants of skin-bleaching behaviour among secondary school students in Nigeria and to develop theoretically grounded intervention and policy strategies. A scoping review methodology was employed with 83 articles meeting the inclusion criteria. The findings were synthesised using the McLeroy Ecological Model and the COM-B Behaviour Change Model to map determinants and inform intervention design. Skin bleaching was found to be driven by interconnected factors across multiple levels. Intrapersonal influences include internalised beliefs shaped by post-colonial ideologies and low self-esteem. Interpersonal pressures from family, peers, and partners reinforce the desirability of lighter skin. Community-level drivers such as media representation and celebrity influence further normalise the practice. Institutional and policy-level factors, including weak regulatory enforcement and the widespread availability of bleaching products, sustain its prevalence. The study highlights that single-level interventions are insufficient to address such a complex behaviour. Instead, a comprehensive, multi-level approach is required, combining education, social norm change, regulatory enforcement, and stakeholder engagement. Early intervention through school-based programmes is identified as a critical entry point for sustainable behaviour change. Addressing skin bleaching as both a public health and social justice issue is essential for achieving long-term impact and reducing associated health risks.