Perceptions and Potential of Goat Milk for Cosmetic and Medicinal Management of Chronic Dermatoses in Africa: A Cross-Sectional Survey-Based Study

Perceptions and Potential of Goat Milk for Cosmetic and Medicinal Management of Chronic Dermatoses in Africa: A Cross-Sectional Survey-Based Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Perceptions and Potential of Goat Milk for Cosmetic and Medicinal Management of Chronic Dermatoses in Africa: A Cross-Sectional Survey-Based Study Keabetswe Tebogo Ncube, Nare Jessica Monareng, Fidele Tgizimana, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9230570/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 15 You are reading this latest preprint version Abstract Chronic dermatoses, including eczema and psoriasis, contribute substantially to morbidity in African populations, where access to dermatological care and affordable treatment remains limited. Goat milk has gained attention as a potential natural adjunct owing to its anti-inflammatory, antimicrobial, and barrier-supportive properties. To investigate perceptions, usage patterns, and acceptability of goat milk-based skincare products among African adults with chronic dermatoses, and to examine healthcare access and treatment experiences. A cross-sectional online survey was conducted among adults (≥ 18 years) residing in Africa. The structured questionnaire captured demographic characteristics, skin condition history, healthcare access, product usage, quality of life impact, and awareness of goat milk-based formulations. Descriptive and inferential analyses were performed. Among 273 respondents (68.1% female; 94.9% Black/African; predominantly South African), 15.4% reported eczema and 2.2% psoriasis, while 12.5% experienced symptoms without a formal diagnosis. Two-thirds (66.8%) had never consulted a dermatologist, and 52.4% paid for care out-of-pocket. Although only 38.9% had used goat milk cosmetics, 64.7% expressed a willingness to adopt scientifically validated, affordable formulations. Regular use was low (10.3%), but 64.7% of users rated goat milk products as effective or very effective. Interest exceeded current uptake, indicating translational and accessibility gaps. Goat milk-based skincare is perceived as a culturally acceptable and potentially beneficial adjunct for chronic dermatoses in this predominantly Black African cohort. High willingness but low regular use underscores unmet dermatological needs and highlights the importance of rigorous clinical validation, inclusive research across skin phototypes, and equitable product development strategies. Health sciences/Diseases Health sciences/Health care Health sciences/Medical research Chronic dermatoses cosmeceuticals atopic dermatitis goat milk health services psoriasis Figures Figure 1 Figure 2 Figure 3 1. Introduction Chronic dermatoses, including atopic dermatitis, psoriasis, and acne vulgaris, are highly prevalent inflammatory skin disorders that impose substantial physical, psychosocial, and economic burdens globally (WHO, 2017). In sub-Saharan Africa, their true scale remains underestimated due to limited surveillance and the prioritisation of other health conditions, despite evidence demonstrating significant impacts on quality of life and economic participation (Tiwari et al., 2022; Mthembu et al., 2023). Community-based studies report prevalence rates exceeding 60%, with a point prevalence of 62.9% (95% CI: 59.3–66.5%) documented in South Africa’s Eastern Cape, and women are disproportionately affected (Li et al., 2025; Wright et al., 2026). Dermatological conditions account for a substantial proportion of primary care visits, yet specialist access remains limited, often fewer than one dermatologist per million population, resulting in underdiagnosis, undertreatment, and widespread self-medication (Fernandez et al., 2025; Naidoo et al., 2025; Kombaté et al., 2017). Structural inequities, high treatment costs, and concerns regarding long-term use of corticosteroids, retinoids, and antibiotics have driven interest in natural and traditional therapies, with up to 80% of populations in sub-Saharan Africa relying on nature-derived remedies (WHO, 2019; WHO, 2023; Dalgard et al., 2015; Silverberg et al., 2023). Goat milk represents a culturally embedded bioresource with plausible dermatological benefits due to its lactic acid, medium-chain fatty acids, vitamins, and bioactive peptides exhibiting anti-inflammatory and antimicrobial effects (Voloshyna, 2021; ALKaisy et al., 2023; Ncube et al., 2025). Although experimental evidence is emerging, empirical data on real-world utilisation and patient perceptions remain sparse (Khowa et al., 2023; Walter & Kalicinsky, 2020). Accordingly, this study evaluates perceptions, utilisation patterns, perceived benefits, and barriers to goat milk-based skincare among individuals with chronic dermatoses in Africa, integrating biochemical plausibility with socio-cultural and health system realities. 2. Methods 2.1 Ethical Considerations This study was conducted in compliance with ethical standards governing research involving human participants. Ethical clearance was obtained from the Tshwane University of Technology (AREC202411004), and the study adhered to the university’s broader ethical guidelines for social and behavioural research involving human subjects. All participants provided informed consent before participation. They were informed of the study’s objectives, the voluntary nature of their involvement, and their right to withdraw at any point without consequence. Participation was entirely voluntary, and all responses remained confidential. Data was anonymised during collection, storage, and analysis to ensure participant privacy. No identifying information was linked to survey responses, and all procedures conformed to the principles outlined in the Declaration of Helsinki and institutional ethical regulations. 2.2 Study Design and Population A cross-sectional survey design was employed to investigate perceptions, usage patterns, and acceptability of goat milk-based skincare products in the management of chronic dermatoses among adults residing in Africa. The target population comprised men and women aged 18 years and older, including parents and caregivers of children under the age of 18. Data was collected between April and June 2025 using an online survey platform. Recruitment was conducted across the African continent to achieve broad geographic and demographic representation, encompassing urban, peri-urban, and rural contexts, with consideration of provincial or state-level diversity within participating countries. The sampling approach was inclusive, allowing participation from all African regions rather than restricting recruitment to selected countries, to capture continent-wide variation in access to dermatological care, treatment experiences, and perceptions of alternative therapies. To reflect the heterogeneity of African populations, participants represented diverse racial (Black/Africa, white, Indian, coloured/mixed race), ethnic, linguistic, cultural, and socio-economic backgrounds, with variation in education level, income bracket, and employment status, as reported in Table 1 . Responses that were incomplete were excluded before analysis. As recruitment was conducted online, participation was subject to digital access and self-selection. 2.3 Data Collection Instrument Data was collected using a structured online questionnaire administered via Google Forms. The form incorporated both closed- and open-ended questions to capture quantitative and qualitative insights. It was organised into five thematic sections: (i) demographic characteristics (e.g., age, gender, location, race/ethnicity); (ii) skin health profile (type, duration, and severity of dermatoses); (iii) skincare product use, including those containing goat milk; (iv) perceived benefits, barriers, and awareness of goat milk-based products; and (v) quality of life, access to healthcare, and financial burden associated with managing chronic skin conditions. 2.4 Sampling and Recruitment A purposive sampling strategy was employed to include both individuals with chronic dermatoses and those without diagnosed skin conditions, thereby enabling comparative insights into product usage and perceptions. This approach was deemed appropriate given the exploratory nature of the study and the need to capture experiences from those with direct exposure to skincare challenges. Recruitment was conducted online via WhatsApp, Facebook, LinkedIn, and email between April and June 2025. 2.5 Data Analysis Quantitative data was analysed descriptively using SPSS v30. Frequencies and percentages were calculated for categorical variables. Open-ended responses were subjected to inductive thematic analysis to identify recurring patterns in user perceptions and experiences. For categorical variables, percentages and frequencies were calculated. To identify recurring patterns in user perceptions and experiences, inductive thematic analysis was applied to open-ended responses. The data collected from 273 participants were summarised using descriptive statistics. Measures of central tendency (mean, median) and dispersion (standard deviation, skewness) were used to describe continuous variables, including age and Likert scale items (e.g., satisfaction levels with goat milk products). Frequencies and percentages were employed to analyse categorical variables, such as gender, race, province, skin conditions, types of goat milk products used, and opinions regarding the medicinal and cosmetic benefits of goat milk. To examine the relationships between variables, bivariate and inferential analyses were conducted. Associations between categorical variables, such as age group and the presence of skin conditions, were evaluated using chi-square tests. One-way ANOVA (with post-hoc tests when appropriate) assessed differences among more than two groups, while independent samples t-tests compared the mean satisfaction levels between two groups. The relationship between age and satisfaction levels was explored using Pearson correlation. Finally, variables like age, gender, race, and previous product exposure were included in a binary logistic regression to identify predictors of goat milk cosmetic usage. 3. Results 3.1 Participant Demographics The majority of respondents were female (68.1%), and in the racial context, most were Black/African (94.9%; n = 258 of 273). Among Black/African respondents, the largest proportion resided in South Africa, particularly in Gauteng Province (n = 133; 50.2%), followed by North West (n = 31; 11.7%) and Limpopo (n = 18; 6.8%). Overall, 17.7% (n = 47) of participants were distributed across other African countries and selected locations, reflecting broader continental representation. Malawi (6.6%), Zimbabwe (3.3%), and Djibouti (1.5%) were reported individually due to comparatively higher response frequencies, while countries contributing smaller numbers—including Botswana, Lesotho (Mohale’s Hoek), Ghana (Greater Accra), Kenya (Nairobi), Nigeria (Osun), Ethiopia (Addis Ababa), Eswatini (Manzini Region), and Benin (Abomey-Calavi), were aggregated for reporting consistency (Table 1 ). Most respondents were aged 25–34 years (35.1%), followed by 18–24 years (32.5%). Population distribution across different geographical areas was analysed as shown in Fig. 1 . The majority of the respondents lived in urban areas (70.6%), with fewer in rural (15.8%) or peri-urban (13.6%) settings. Table 1 Demographic profile of participants (N = 273). Variable Category n (%) Gender Male 87 (31.9) Female 186 (68.1) Race Black/African 258 (94.9) White 4 (1.5) Indian 3 (1.1) Coloured 7 (2.6) Age group (years) 18–24 88 (32.5) 25–34 95 (35.1) 35–44 38 (14.0) 45–54 10 (3.7) ≤ 17 / ≥55 40 (14.8) Region Gauteng - SA 133 (50.2) North West - SA 31 (11.7) Limpopo - SA 18 (6.8) Other SA Provinces 36 (13.6) Other African Countries 47 (17.7) 3.2 Prevalence and Impact of Skin Conditions The most frequently reported diagnosed condition was eczema/atopic dermatitis (15.4%), followed by seborrheic dermatitis (4.8%) and psoriasis (2.2%) (Table 2 ). Rare conditions (< 2%) included stasis dermatitis, rosacea, and lichen planus. Additionally, 12.5% reported symptoms without a formal diagnosis, suggesting under-recognition of dermatological morbidity. Table 2 Prevalence of Chronic Dermatoses and Symptoms Condition No (%) Yes (%) Eczema/Atopic Dermatitis 231 (84.6) 42 (15.4) Seborrheic Dermatitis 260 (95.2) 13 (4.8) Stasis Dermatitis 269 (98.5) 4 (1.5) Psoriasis 267 (97.8) 6 (2.2) Rosacea 271 (99.3) 2 (0.7) Lichen Planus 271 (99.3) 2 (0.7) Symptoms Only 239 (87.5) 34 (12.5) 3.3 Management of Skin Health Conditions Topical products dominated treatment practices. Creams/lotions (27.3%), ointments (20.1%), and soaps (13.5%) were the most used (Table 3 ). Natural/home remedies (12.5%) and herbal treatments (11.3%) also featured prominently, reflecting the role of traditional practices. Fewer participants reported serums (8.9%) or pharmaceutical products (3.7%). Table 3 Skin Health Condition Management: Product Usage Frequency Product Type Percent Using (%) Creams/Lotions 27.3 Ointments 20.1 Soaps 13.5 Natural/Home Remedies 12.5 Herbs 11.3 Serums 8.9 Pharmaceutical Products 3.7 Other 2.7 3.4 Access to Healthcare and Affordability Access to medical care among participants varied notably in terms of frequency of healthcare visits, type of facility utilised, and perceived accessibility. As shown in Fig. 2 A, the majority of respondents (66.8%) reported never visiting a dermatologist or healthcare professional for their skin health condition, while 22.1% visited rarely (once a year or less), 9.6% visited occasionally (one to three times per year), and only 1.5% reported regular visits (once a month or more). Figure 2 B illustrates the types of healthcare facilities primarily accessed by participants. The most frequently used were private clinics or hospitals (44.1%) and self-medication (26.4%), followed by public clinics or hospitals (15.7%). Smaller proportions utilised traditional or alternative medicine (8.5%), health centres (4.1%), or skincare companies. Notably, some participants indicated no healthcare use for their skin condition. Regarding perceived accessibility (Fig. 2 C), 43.0% rated their access to medical care as good, meaning care was accessible but somewhat expensive. A combined 34.3% rated access as moderate (22.7%) or poor (11.6%), indicating challenges such as limited availability or affordability. Only 13.6% of participants described their access as excellent, highlighting a potential gap in equitable healthcare provision for skin health conditions within the population. Figure 2 presents crucial insights into participants’ engagement with medical care for their skin health conditions. Figure 3 A illustrates that 38.5% of respondents never purchased prescription or self-medication for their condition, while 23.7% did so rarely (once a year or less). Purchases made occasionally (one to three times yearly) accounted for 23.0%, and 14.8% purchased medications regularly (once a month or more). Figure 3 B shows that payment for medical expenses was predominantly out-of-pocket (52.4%), followed by medical aid or insurance (37.3%). Other payment methods included family support, employer-sponsored plans, social grants, charity, or no payment reported by smaller percentages. This indicates economic burden and potential barriers to consistent access to care. Affordability was a concern for 62% of participants, reflecting financial challenges in managing skin conditions (Fig. 3 , Table 4 ). Mean accessibility scores, rated on a scale from 1 (poor) to 4 (excellent), indicated moderate access to medical care (Mean = 2.50, SD = 0.97). Table 4 Access to Medical Care and Affordability Variable Mean SD Access to Medical Care (1–4)* 2.50 0.97 Affordability (0–1)** 0.62 0.49 *1 = Poor, 4 = Excellent; 0 = No, 1 = Yes 3.5 Quality of Life Impact of Chronic Skin Conditions On a scale of 1 (not at all) to 5 (very much), participants rated the impact of their skin health conditions on multiple life domains. Respondents reported that skin conditions had the greatest negative effect on self-esteem/confidence (Mean = 2.59, SD = 1.51), followed by emotional wellbeing (Mean = 2.37, SD = 1.32), social life (Mean = 2.25, SD = 1.38), overall quality of life (Mean = 2.22, SD = 1.28), and physical health (Mean = 2.10, SD = 1.24) (Table 5 ). Table 5 Impact of chronic skin conditions on well-being. Scores were measured on a 5-point Likert scale (1 = no impact, 5 = severe impact). Domain Mean ± SD Median (IQR) Physical health 2.10 ± 1.24 2 (1–3) Emotional wellbeing 2.37 ± 1.32 2 (1–3) Social life 2.25 ± 1.38 2 (1–3) Self-esteem/confidence 2.59 ± 1.51 2 (1–4) Overall quality of life 2.22 ± 1.28 2 (1–3) 3.6 Awareness, Use, and Perceived Effectiveness of Goat Milk in Skincare and Medicinal Products Belief in the benefits of goat milk products was varied, with a mean score of 1.05 (on a scale where higher values indicate stronger belief in superiority). Approximately 43% of participants reported using goat milk cosmetics, and 64.7% expressed interest or occasional use of skincare containing goat milk, as shown in Table 6 . Perception charts revealed mixed opinions on whether goat milk products were superior, about the same, or less beneficial compared to alternatives. Table 6 Awareness and Perception of Goat Milk Products Variable Frequency Percent (%) Goat Milk Cosmetics Use Yes: 118 38.9 No: 155 51.2 Skincare Containing Goat Milk Yes (regular or occasional): 37 14.5 Interested but not tried: 196 64.7 Not Interested: 22 7.3 Regarding willingness to use goat milk products, the majority of respondents had either tried these products (mean tried products coded = 0.87) or expressed interest in trying them. Usage frequency varied by demographic factors and was higher in urban and peri-urban regions compared to rural areas. Despite limited awareness, the willingness to adopt goat milk–based skincare products was high. Among participants who had not previously used such products, 76.9% expressed interest, while only 8.6% reported no interest. Regular users accounted for 3.5%, suggesting substantial potential for market growth and adoption if awareness and access are improved. As shown in Table 7 , 82.1% respondents reported some level of use or interest in skincare or medicinal products containing goat milk. Most (71.8%) used these products occasionally, while 10.3% used them regularly. A small portion (8.1%) expressed interest but had not yet tried goat milk products, and 6.6% were not interested. Table 7 Usage of Skincare or Medicinal Products Containing Goat Milk Usage Category Frequency Percent (%) No, and I am not interested 18 6.6 No, but I am interested in trying 22 8.1 Yes, occasionally 196 71.8 Yes, regularly 28 10.3 Among users, the majority (64.7%) rated goat milk skincare as “effective” or “very effective” in managing their skin condition, while 21.6% perceived it as “neutral,” and 13.7% as “ineffective.” There were no statistically significant differences in perceived effectiveness across different age groups (p = 0.184) or gender ( p = 0.452). 3.8 Associations Between Age and Dermatoses, Impact of Skin Health Conditions Chi-square tests examined the association between age groups and the presence of chronic dermatoses. No significant associations were found for eczema (χ²(4) = 5.15, p = 0.272), seborrheic dermatitis (χ²(4) = 1.22, p = 0.876), stasis dermatitis (χ²(4) = 3.70, p = 0.449), psoriasis (χ²(4) = 3.63, p = 0.459), lichen planus (χ²(4) = 2.95, p = 0.566), or symptoms only (χ²(4) = .968, p = .915). Rosacea prevalence, however, demonstrated a significant association with age (χ²(4) = 12.35, p = 0.015), indicating that the distribution of rosacea cases varies across age groups, with higher prevalence in some age categories (Table 8 ). Table 8 Chi-Square Tests for Association Between Age Group and Chronic Dermatoses Skin Condition χ² (df) p-value Eczema/Atopic Dermatitis 5.15 (4) 0.272 Seborrheic Dermatitis 1.22 (4) 0.876 Stasis Dermatitis 3.70 (4) 0.449 Psoriasis 3.63 (4) 0.459 Rosacea 12.35 (4) 0.015* Lichen Planus 2.95 (4) 0.566 Symptoms Only 0.968 (4) 0.915 *Significant at p < .05 Participants rated the impact of their skin health condition on physical, emotional, social, self-esteem, and overall well-being on a scale from 1 (no impact) to 5 (severe impact). There were significant differences across age groups in emotional (F(4,244) = 3.15, p = .015), social (F(4,248) = 4.42, p = 0.013), and self-esteem impacts (F(4,245) = 4.88, p = 0.008), but not in physical impact (F(4,246) = 1.00, p = .407) or overall impact (F(4,247) = 1.68, p = 0.189). 3.10 Correlations Among Key Variables Spearman's rho correlations showed a significant negative association between spending on skincare products and perceived product affordability (rho = -0.189, p = .002) (Table 9 ), indicating that higher spending is associated with lower perceived affordability. Frequency of prescription or self-medication was positively correlated with visits to dermatology healthcare professionals (r = 0.310, p < .001), suggesting that increased medical visits relate to more frequent medication use. Access to medical care was also positively correlated with paying for medical expenses (rho = .282, p < .001). Table 9 Spearman’s Correlations Among Key Variables Variables Correlation (rho) p -value Spend on Skincare & Product Affordability -0.189 .002 Dermatology Visits & Prescription Frequency 0.310 < .001 Access to Medical Care & Medical Expenses 0.282 < .001 4. Discussion Insights into the perceptions, usage patterns, and acceptability of goat milk-based skincare products among predominantly South African adults reveal high interest and perceived therapeutic value; however, interpretation is contextualised within the demographic distribution of the sample population. Although respondents resided across multiple African countries, over 80% were based in South Africa, and more than half (50.2%) in Gauteng Province. Consequently, the findings more strongly reflect perceptions within an urbanised South African context rather than continent-wide variation. Africa comprises highly heterogeneous populations with substantial genetic, climatic, and socio-cultural diversity, including differences in skin phototypes, barrier function, sebum production, and environmental exposures, which may influence both disease expression and treatment responses (Taylor, 2002; Iwuala & Taylor, 2022; Wright et al., 2026). Participants reported perceived benefits of goat milk products, including hydration, soothing of irritation, and improvement in barrier function. These perceptions align with established biochemical properties of goat milk. It contains lactic acid (an α-hydroxy acid), medium-chain fatty acids, vitamins A and D, and bioactive proteins such as lactoferrin and α-lactalbumin, which exhibit antimicrobial, antioxidant, and anti-inflammatory activity (Ncube et al., 2025; Park, 2017; Silanikove et al., 2010). (Kim et al., 2025; Legrand, 2016) (Legrand, 2016). These mechanisms provide biological plausibility for the user-reported outcomes. The epidemiological profile observed mirrors broader patterns in skin disease burden. Eczema or atopic dermatitis was the most frequently reported condition (15.4%), consistent with global adult prevalence estimates ranging between 2–10% and paediatric prevalence of 15–20% (Nutten, 2015; Silverberg, 2017). Importantly, 12.5% reported persistent symptoms without formal diagnosis, reflecting under-recognition of dermatological disease. Population-based data from rural South Africa demonstrate point prevalences of any skin disease exceeding 60% (Naidoo et al., 2025; Wright et al., 2026), while Global Burden of Disease analyses show that sub-Saharan Africa carries one of the highest age-standardised burdens of skin and subcutaneous diseases globally in terms of DALYs (Guo & Zheng, 2025; Yakupu et al., 2023). These findings reinforce that chronic dermatoses represent a substantive public health concern rather than a cosmetic issue. Access barriers were substantial. Approximately two-thirds of respondents had never consulted a dermatologist, and over half reported out-of-pocket care expenditure. This aligns with documented shortages of dermatologists in sub-Saharan Africa, where specialist density may be fewer than one dermatologist per million population in several countries (Tiwari et al., 2022b). Financial constraints are known determinants of delayed care and suboptimal adherence in chronic inflammatory skin disease (Drucker et al., 2017). Psychosocial burden was evident, with the greatest impact reported in self-esteem and emotional well-being, consistent with evidence that dermatological disorders significantly impair quality of life and may confer psychiatric comorbidity risks comparable to other chronic diseases (Dalgard et al., 2015). Despite this burden, openness to goat milk-based skincare was high (82.1% expressed interest), with only 10.3% reported regular use. The discrepancy between interest and sustained utilisation likely reflects limited availability of standardised medical-grade formulations, affordability constraints, and regulatory ambiguity rather than lack of acceptability. Notably, racial subgroup analyses were constrained by sample composition (94.9% Black/African; <10% White, Indian and Coloured racial categories), limiting robust comparison of perceptions or usage across racial groups. Given established differences in skin structure, transepidermal water loss, pigmentation biology, and inflammatory response across skin phototypes (Wilson et al., 1988; Del Bino et al., 2018), future studies with more balanced representation are warranted to explore whether therapeutic perceptions or responses differ by racial or ethnic background. Comparisons with other nature-derived products commonly used in Africa, such as shea butter and aloe vera, demonstrate similar patterns of cultural acceptability but limited high-quality clinical standardisation (Surjushe et al., 2008). Goat milk appears to occupy a comparable translational space: culturally familiar and biologically plausible, yet insufficiently integrated into evidence-based dermatological practice. Structured formulation development, stability testing, and controlled clinical evaluation are therefore essential. Economic and socio-cultural considerations further contextualise these findings. Smallholder goat farming is widespread across Southern and Eastern Africa, presenting opportunities for localised value chains (Kahi & Wasike, 2019). However, equitable integration would require regulatory oversight, quality control, and avoidance of therapeutic overstatement. Regulatory harmonisation for cosmeceuticals remains variable across African jurisdictions, which may affect consumer confidence and product standardisation. Several limitations warrant emphasis. The sampling strategy was continent-wide in intent but respondent distribution was uneven, with strong concentration in South Africa, particularly Gauteng Province. Thus, perceptions may reflect an urban South African context rather than pan-African heterogeneity. The online design may have favoured participants with digital access and higher educational attainment. Self-reported diagnoses were not clinically verified. The cross-sectional design precludes inference regarding clinical efficacy. Overall, goat milk is perceived as a culturally acceptable and potentially beneficial adjunctive skincare ingredient within this predominantly South African cohort. High expressed willingness coupled with limited regular use highlights translational barriers rather than a lack of acceptability. While mechanistic plausibility is supported by biochemical evidence, rigorous dermatological trials across diverse African populations are required before continent-wide generalisation. Strategic interventions encompassing clinical trials, formulation standardisation, regulatory oversight, and community engagement could transform goat milk from a traditional remedy into a scalable, science-backed option for managing chronic dermatoses across the continent. 5. Conclusion Goat milk-based skincare products are widely perceived as effective, culturally familiar, and desirable among African adults affected by chronic dermatoses within this predominantly Black/African cohort. Reported benefits, including enhanced hydration, anti-inflammatory effects, and improved skin comfort, are supported by emerging biochemical evidence, reinforcing goat milk’s potential as a safe and culturally acceptable dermatological intervention. However, interpretation of perceived effectiveness is contextualised within the racial composition of the sample (94.9% Black/African). The study was not sufficiently powered to conduct meaningful race-stratified comparisons, and it remains unclear whether perceptions, tolerability, or therapeutic responses may differ across racial or skin phototype groups. Given known variations in epidermal structure, barrier function, pigmentation biology, and inflammatory responses across skin types, further research, including more balanced racial and ethnic representation, is warranted to determine whether goat milk formulations demonstrate comparable acceptability and performance across diverse populations. The findings highlight both the therapeutic promise and the barriers to uptake, including limited awareness, product availability, cost, and regulatory ambiguity. Addressing these challenges will require rigorous clinical evaluation across multiple skin phototypes, formulation standardisation, clear regulatory frameworks, and community education to ensure safe, effective, and equitable access. Localised production and value addition present further opportunities to support rural micro-enterprises and generate socio-economic benefits alongside public health impact. Despite study limitations, particularly the predominance of South African respondents, concentration within Gauteng Province, limited racial heterogeneity, reliance on self-reported data, and the cross-sectional design, these findings provide actionable insights into culturally informed, evidence-based approaches for chronic dermatoses management within the sampled population. Broader continental generalisation should be undertaken cautiously until multi-country, demographically balanced studies are conducted. Goat milk has the potential to evolve from a traditional remedy into a scientifically validated, culturally embraced, and policy-supported intervention. Translating perception into practice through dermatologically rigorous, inclusive, and phototype-conscious research offers a pathway to transform an indigenous bioresource into a sustainable dermatological solution with both therapeutic and socio-economic significance. Declarations 6. Acknowledgements The authors gratefully acknowledge the Tshwane University of Technology (TUT) for institutional support and for providing access to analytical tools utilised in this study. Sincere appreciation is extended to Prof Mtileni (TUT) for academic guidance, methodological support in study design, and assistance with manuscript development. The authors further acknowledge the University of Johannesburg and The Tugizimana Lab for their institutional support. Special thanks are extended to the host (Dr Tugizimana) at The Tugizimana Lab for scholarly input, writing assistance, critical proofreading of the manuscript, and support during the publication process. 7. Conflict of Interest The authors declare that there is no conflict of interest. 8. Funding This study was funded by the National Research Foundation (NRF) under the Scarce Skills NRF Postdoctoral Grant (Grand ID: PSTD240327211078). 9. Data Availability The datasets generated and/or analysed during the current study are not publicly available due to ethical restrictions and the need to protect participant confidentiality, as the data contain potentially identifiable information, but are available from the corresponding author upon reasonable request. References Abad, I., Bellés, A., Rodríguez-Largo, A., Luján, L., de Blas, I., Graikini, D., Grasa, L., & Sánchez, L. (2025). 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Cleaner and Responsible Consumption , 13 , 100190. https://doi.org/10.1016/j.clrc.2024.100190 Drucker, A. M., Wang, A. R., Li, W.-Q., Sevetson, E., Block, J. K., & Qureshi, A. A. (2017). The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. Journal of Investigative Dermatology , 137 (1), 26–30. https://doi.org/10.1016/j.jid.2016.07.012 Duniphin, D. (2023). Limited Access to Dermatology Specialty Care: Barriers and Teledermatology. Dermatology Practical & Conceptual , e2023031. https://doi.org/10.5826/dpc.1301a31 Elhabal, S. F., Faheem, A. M., Hababeh, S., Nelson, J., Elzohairy, N. A., AbdelGhany Morsy, S. A., Ewedah, T. M., Mousa, I. S., Fouad, M. A., & Hamdan, A. M. E. (2025). Dissolving Microneedles Containing Lactoferrin Nanosuspension for Enhancement of Antimicrobial and Anti-Inflammatory Effects in the Treatment of Dry Eye Disease. Pharmaceutics , 17 (5), 653. https://doi.org/10.3390/pharmaceutics17050653 Fernandez, J. M., Kaderbhai, H., Adams, J. L., Adam, M. B., & Adam, R. D. (2025). Current management of skin conditions in Kenya: exploring teledermatology preferences and perspectives among providers. International Journal of Women’s Dermatology , 11 (1), e196. https://doi.org/10.1097/JW9.0000000000000196 Guo, H., & Zheng, P. (2025). Epidemiological trends and disparities in the global burden of bacterial skin diseases among children and adolescents from 1990 to 2021: an analysis based on GBD 2021. BMC Pediatrics , 25 (1), 467. https://doi.org/10.1186/s12887-025-05825-z Iwuala, C., & Taylor, S. C. (2022). Structural and functional differences in skin of colour. Clinical and Experimental Dermatology , 47 (2), 247–250. https://doi.org/10.1111/ced.14892 Johnson, M. C., Patel, P., Ayers, A., & Spears, K. M. (2025). Resource Management Challenges in Rural Dermatological Care: A Mapping Review. Cureus . https://doi.org/10.7759/cureus.77544 Kahi, A. K., & Wasike, C. B. (2019). Dairy goat production in sub-Saharan Africa: current status, constraints and prospects for research and development. Asian-Australasian Journal of Animal Sciences , 32 (8), 1266–1274. https://doi.org/10.5713/ajas.19.0377 Khowa, A. A., Tsvuura, Z., Slotow, R., & Kraai, M. (2023). The utilisation of domestic goats in rural and peri-urban areas of KwaZulu-Natal, South Africa. Tropical Animal Health and Production , 55 (3), 204. https://doi.org/10.1007/s11250-023-03587-3 Kim, J. W., Lee, J. S., Choi, Y. J., & Kim, C. (2025). The Multifaceted Functions of Lactoferrin in Antimicrobial Defense and Inflammation. Biomolecules , 15 (8), 1174. https://doi.org/10.3390/biom15081174 Kombaté, K., Técléssou, J. N., Saka, B., Akakpo, A. S., Tchangai, K. O., Mouhari-Toure, A., Mahamadou, G., Gnassingbé, W., Abilogun-Chokki, A., & Pitché, P. (2017). Prevalence and Factors Associated with Self-Medication in Dermatology in Togo. Dermatology Research and Practice , 2017 , 1–5. https://doi.org/10.1155/2017/7521831 Legrand, D. (2016). Overview of Lactoferrin as a Natural Immune Modulator. The Journal of Pediatrics , 173 , S10–S15. https://doi.org/10.1016/j.jpeds.2016.02.071 Li, A. W., Yin, E. S., & Antaya, R. J. (2017). Topical Corticosteroid Phobia in Atopic Dermatitis. JAMA Dermatology , 153 (10), 1036. https://doi.org/10.1001/jamadermatol.2017.2437 Li, D., Fan, S., Zhao, H., Song, J., Li, W., & Xu, X. (2025). Global, regional and national burden of skin and subcutaneous diseases: a systematic analysis of the Global Burden of Disease Study 2021. International Health . https://doi.org/10.1093/inthealth/ihaf070 Mahomoodally, M. F. (2013). Traditional Medicines in Africa: An Appraisal of Ten Potent African Medicinal Plants. Evidence-Based Complementary and Alternative Medicine , 2013 , 1–14. https://doi.org/10.1155/2013/617459 Mthembu, L., Masuka, J. T., Duze, K., & Mosam, A. (2023). The characteristics of dermatology inpatients seen at the quaternary Inkosi Albert Luthuli Central Hospital in Durban, South Africa, over a 5-year period – 2015 - 2020. South African Medical Journal , 114 (1), 33–38. https://doi.org/10.7196/SAMJ.2024.v114i1.1098 Naidoo, N., Maruma, F., Ngwenya, E., & Mazibuko, M. N. (2025). Assessment of dermatological life quality in patients with cutaneous diseases at Universitas Academic Hospital. Journal of the Colleges of Medicine of South Africa , 3 (1). https://doi.org/10.4102/jcmsa.v3i1.160 Ncube, K. T., Modiba, M. C., Mpofu, T. J., Nephawe, K. A., & Mtileni, B. (2025). Genomic Tools for Medicinal Properties of Goat Milk for Cosmetic and Health Benefits: A Narrative Review. International Journal of Molecular Sciences , 26 (3), 893. https://doi.org/10.3390/ijms26030893 Nutten, S. (2015). Atopic Dermatitis: Global Epidemiology and Risk Factors. Annals of Nutrition and Metabolism , 66 (Suppl. 1), 8–16. https://doi.org/10.1159/000370220 Park, Y. W. (2017). Goat Milk – Chemistry and Nutrition. In Handbook of Milk of Non‐Bovine Mammals (pp. 42–83). Wiley. https://doi.org/10.1002/9781119110316.ch2.2 Ponikowska, M., Vellone, E., Czapla, M., & Uchmanowicz, I. (2025). Challenges Psoriasis and Its Impact on Quality of Life: Challenges in Treatment and Management. Psoriasis: Targets and Therapy , Volume 15 , 175–183. https://doi.org/10.2147/PTT.S519420 Silanikove, N., Leitner, G., Merin, U., & Prosser, C. G. (2010). Recent advances in exploiting goat’s milk: Quality, safety and production aspects. Small Ruminant Research , 89 (2–3), 110–124. https://doi.org/10.1016/j.smallrumres.2009.12.033 Silverberg, J. I. (2017). Public Health Burden and Epidemiology of Atopic Dermatitis. Dermatologic Clinics , 35 (3), 283–289. https://doi.org/10.1016/j.det.2017.02.002 Silverberg, J. I., Mohawk, J. A., Cirulli, J., Nograles, K., Punzalan, J. C., Kelly, K. M., Kim, B. S., Guttman-Yassky, E., & Lebwohl, M. (2023). Burden of Disease and Unmet Needs in Atopic Dermatitis: Results From a Patient Survey. Dermatitis® , 34 (2), 135–144. https://doi.org/10.1089/derm.2022.29015.jsi Surjushe, A., Vasani, R., & Saple, D. (2008). Aloe vera: A short review. Indian Journal of Dermatology , 53 (4), 163. https://doi.org/10.4103/0019-5154.44785 Taylor, S. C. (2002). Skin of color: Biology, structure, function, and implications for dermatologic disease. Journal of the American Academy of Dermatology , 46 (2), S41–S62. https://doi.org/10.1067/mjd.2002.120790 Tiwari, R., Amien, A., Visser, W. I., & Chikte, U. (2022a). Counting dermatologists in South Africa: number, distribution and requirement. British Journal of Dermatology , 187 (2), 248–250. https://doi.org/10.1111/bjd.21036 Tiwari, R., Amien, A., Visser, W. I., & Chikte, U. (2022b). Counting dermatologists in South Africa: number, distribution and requirement. British Journal of Dermatology , 187 (2), 248–250. https://doi.org/10.1111/bjd.21036 Tuckman, A. (2017). The Potential Psychological Impact of Skin Conditions. Dermatology and Therapy , 7 (S1), 53–57. https://doi.org/10.1007/s13555-016-0169-7 Turreira-García, N. (2025). West African Shea Processors in a Changing Global Market: Effects of Market Integration on Traditional Knowledge Resilience. Economic Botany . https://doi.org/10.1007/s12231-025-09646-0 Vieira, D., Duarte, J., Vieira, P., Gonçalves, M. B. S., Figueiras, A., Lohani, A., Veiga, F., & Mascarenhas-Melo, F. (2024). Regulation and Safety of Cosmetics: Pre- and Post-Market Considerations for Adverse Events and Environmental Impacts. Cosmetics , 11 (6), 184. https://doi.org/10.3390/cosmetics11060184 Voloshyna, I. M. (2021). PRACTICAL USE OF GOAT MILK AND COLOSTRUM. Biotechnologia Acta , 14 (5), 38–48. https://doi.org/10.15407/biotech14.05.038 Walter, G., & Kalicinsky, C. (2020). Adult-onset IgE-mediated food allergy at a Winnipeg allergy clinic: a case series. Allergy, Asthma & Clinical Immunology , 16 (1), 85. https://doi.org/10.1186/s13223-020-00483-5 WILSON, D., BERARDESCA, E., & MAIBACH, H. I. (1988). In vitro transepidermal water loss: differences between black and white human skin. British Journal of Dermatology , 119 (5), 647–652. https://doi.org/10.1111/j.1365-2133.1988.tb03478.x Wright, A. K., Swan, R., Xu, J., Lwin, S. M., Azrielant, S., Chateau, A., Ede, C., Sons, J., Gxolo, Z., Skenjana, A., Mankahla, A., Drusinsky, S., Kannenberg, S. M., Mhlanga, S., Luthuli, M., Topping, L., Taicher, E., Flohr, C., Dlova, N. C., … Griffiths, C. E. M. (2026). Skin disease in the Eastern Cape (SKINSCAPE): a Global Psoriasis Atlas point prevalence study in rural South Africa. British Journal of Dermatology , 194 (1), 125–134. https://doi.org/10.1093/bjd/ljaf386 Yakupu, A., Aimaier, R., Yuan, B., Chen, B., Cheng, J., Zhao, Y., Peng, Y., Dong, J., & Lu, S. (2023). The burden of skin and subcutaneous diseases: findings from the global burden of disease study 2019. Frontiers in Public Health , 11 . https://doi.org/10.3389/fpubh.2023.1145513 Yaldo M, M. M. P. G. (2025). Increased Popularity of Goat Milk Soap: Analyzing Five Years of Google Trends: Google searches for ‘goat milk soap’ nearly doubled from 2018 to 2023, reflecting growing public interest in natural cleansers marketed for eczema and sensitive skin despite limited scientific evidence. Journal of Integrative Dermatology , 1 , 1–4. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9230570","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":625885850,"identity":"f6f728e1-a298-41b4-a38b-5cee4b6785a9","order_by":0,"name":"Keabetswe Tebogo Ncube","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAsUlEQVRIiWNgGAWjYHACNgaGAzYMjA0kakkjXcthEtSbs58xe/DhzPnE5gbmhx8Y/tgR1mLZk2NuOOPG7cTGBjZjCQaeZMJaDG7wmEnzfABpYTBjYJBgJlLLnw/ngFrYvwG59URqYbhxAKiFB2hLAhHhYHAmrdyw50yycWMzT7FEwoHjRGg5fnjbgx/H7GQ3trdv/PDhTzVhLXBg2AwkEkjQwMAgT5LqUTAKRsEoGFEAAF+VOZrehOEqAAAAAElFTkSuQmCC","orcid":"","institution":"University of Johannesburg","correspondingAuthor":true,"prefix":"","firstName":"Keabetswe","middleName":"Tebogo","lastName":"Ncube","suffix":""},{"id":625885851,"identity":"55ae2697-16ac-4c9e-a85c-6eaf02ad4aff","order_by":1,"name":"Nare Jessica Monareng","email":"","orcid":"","institution":"Tshwane University of Technology","correspondingAuthor":false,"prefix":"","firstName":"Nare","middleName":"Jessica","lastName":"Monareng","suffix":""},{"id":625885852,"identity":"a68073d2-e2e2-4e12-b780-3106b04127fd","order_by":2,"name":"Fidele Tgizimana","email":"","orcid":"","institution":"University of Johannesburg","correspondingAuthor":false,"prefix":"","firstName":"Fidele","middleName":"","lastName":"Tgizimana","suffix":""},{"id":625885853,"identity":"2c778b1f-7703-4aa4-82aa-a30e222f10ba","order_by":3,"name":"Bohani Mtileni","email":"","orcid":"","institution":"Tshwane University of Technology","correspondingAuthor":false,"prefix":"","firstName":"Bohani","middleName":"","lastName":"Mtileni","suffix":""}],"badges":[],"createdAt":"2026-03-26 07:23:36","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9230570/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9230570/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107489824,"identity":"ca83ea64-9fd3-4713-b67f-86ffc2d7a22a","added_by":"auto","created_at":"2026-04-22 02:49:04","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":60517,"visible":true,"origin":"","legend":"\u003cp\u003eIllustration of the distribution of a population across different geographical areas: Urban, Rural, and Peri-urban\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-9230570/v1/5d3cfbca79c050bb3f40650f.png"},{"id":107476259,"identity":"a38dee97-7f34-4fa6-b3a7-1a40d8272e88","added_by":"auto","created_at":"2026-04-21 22:59:01","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":113041,"visible":true,"origin":"","legend":"\u003cp\u003eIllustrates the Access to Medical Care for Skin Health Conditions. A) Frequency of visits to dermatologists or healthcare professionals, categorised as regularly (once a month or more), occasionally (one to three times a year), rarely (once a year or less), or never. B) Primary types of healthcare facilities utilised, including public clinics/hospitals, private clinics/hospitals, health centres, traditional/alternative medicine, self-medication, no care, or skincare companies. C) Participant perceptions of medical care accessibility, rated as excellent (easily accessible and affordable), good (accessible but somewhat expensive), moderate (limited availability or long waiting times), or poor (difficult to access or unaffordable)\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-9230570/v1/34af1c4c266bb75f3743c341.png"},{"id":107704462,"identity":"89f2b984-4f89-40cb-b25e-1d6d9807794f","added_by":"auto","created_at":"2026-04-24 08:45:29","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":102976,"visible":true,"origin":"","legend":"\u003cp\u003eFrequency and Method of Payment. A) Frequency of purchasing prescription or self-medication for skin health conditions, categorised as regularly (once a month or more), occasionally (one to three times a year), rarely (once a year or less), or never. B) Methods of payment for medical expenses related to skin health treatment, including consultation, treatment, and medication, such as medical aid/insurance, employer-sponsored health plans, out-of-pocket cash payments, social grants, family support, charity, or no payment\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-9230570/v1/13a7c0f5197fb9566f19fcde.png"},{"id":107708455,"identity":"35e8613a-9814-434b-9c12-11df1d70720e","added_by":"auto","created_at":"2026-04-24 09:27:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":671366,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9230570/v1/ac2dd98b-87a7-471a-84f0-daa73d6e7d98.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Perceptions and Potential of Goat Milk for Cosmetic and Medicinal Management of Chronic Dermatoses in Africa: A Cross-Sectional Survey-Based Study","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eChronic dermatoses, including atopic dermatitis, psoriasis, and acne vulgaris, are highly prevalent inflammatory skin disorders that impose substantial physical, psychosocial, and economic burdens globally (WHO, 2017). In sub-Saharan Africa, their true scale remains underestimated due to limited surveillance and the prioritisation of other health conditions, despite evidence demonstrating significant impacts on quality of life and economic participation (Tiwari et al., 2022; Mthembu et al., 2023). Community-based studies report prevalence rates exceeding 60%, with a point prevalence of 62.9% (95% CI: 59.3\u0026ndash;66.5%) documented in South Africa\u0026rsquo;s Eastern Cape, and women are disproportionately affected (Li et al., 2025; Wright et al., 2026). Dermatological conditions account for a substantial proportion of primary care visits, yet specialist access remains limited, often fewer than one dermatologist per million population, resulting in underdiagnosis, undertreatment, and widespread self-medication (Fernandez et al., 2025; Naidoo et al., 2025; Kombat\u0026eacute; et al., 2017).\u003c/p\u003e \u003cp\u003eStructural inequities, high treatment costs, and concerns regarding long-term use of corticosteroids, retinoids, and antibiotics have driven interest in natural and traditional therapies, with up to 80% of populations in sub-Saharan Africa relying on nature-derived remedies (WHO, 2019; WHO, 2023; Dalgard et al., 2015; Silverberg et al., 2023). Goat milk represents a culturally embedded bioresource with plausible dermatological benefits due to its lactic acid, medium-chain fatty acids, vitamins, and bioactive peptides exhibiting anti-inflammatory and antimicrobial effects (Voloshyna, 2021; ALKaisy et al., 2023; Ncube et al., 2025). Although experimental evidence is emerging, empirical data on real-world utilisation and patient perceptions remain sparse (Khowa et al., 2023; Walter \u0026amp; Kalicinsky, 2020).\u003c/p\u003e \u003cp\u003eAccordingly, this study evaluates perceptions, utilisation patterns, perceived benefits, and barriers to goat milk-based skincare among individuals with chronic dermatoses in Africa, integrating biochemical plausibility with socio-cultural and health system realities.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Ethical Considerations\u003c/h2\u003e \u003cp\u003eThis study was conducted in compliance with ethical standards governing research involving human participants. Ethical clearance was obtained from the Tshwane University of Technology (AREC202411004), and the study adhered to the university\u0026rsquo;s broader ethical guidelines for social and behavioural research involving human subjects. All participants provided informed consent before participation. They were informed of the study\u0026rsquo;s objectives, the voluntary nature of their involvement, and their right to withdraw at any point without consequence. Participation was entirely voluntary, and all responses remained confidential. Data was anonymised during collection, storage, and analysis to ensure participant privacy. No identifying information was linked to survey responses, and all procedures conformed to the principles outlined in the Declaration of Helsinki and institutional ethical regulations.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Study Design and Population\u003c/h2\u003e \u003cp\u003eA cross-sectional survey design was employed to investigate perceptions, usage patterns, and acceptability of goat milk-based skincare products in the management of chronic dermatoses among adults residing in Africa. The target population comprised men and women aged 18 years and older, including parents and caregivers of children under the age of 18. Data was collected between April and June 2025 using an online survey platform.\u003c/p\u003e \u003cp\u003eRecruitment was conducted across the African continent to achieve broad geographic and demographic representation, encompassing urban, peri-urban, and rural contexts, with consideration of provincial or state-level diversity within participating countries. The sampling approach was inclusive, allowing participation from all African regions rather than restricting recruitment to selected countries, to capture continent-wide variation in access to dermatological care, treatment experiences, and perceptions of alternative therapies.\u003c/p\u003e \u003cp\u003eTo reflect the heterogeneity of African populations, participants represented diverse racial (Black/Africa, white, Indian, coloured/mixed race), ethnic, linguistic, cultural, and socio-economic backgrounds, with variation in education level, income bracket, and employment status, as reported in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Responses that were incomplete were excluded before analysis.\u003c/p\u003e \u003cp\u003eAs recruitment was conducted online, participation was subject to digital access and self-selection.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Data Collection Instrument\u003c/h2\u003e \u003cp\u003eData was collected using a structured online questionnaire administered via Google Forms. The form incorporated both closed- and open-ended questions to capture quantitative and qualitative insights.\u003c/p\u003e \u003cp\u003eIt was organised into five thematic sections: (i) demographic characteristics (e.g., age, gender, location, race/ethnicity); (ii) skin health profile (type, duration, and severity of dermatoses); (iii) skincare product use, including those containing goat milk; (iv) perceived benefits, barriers, and awareness of goat milk-based products; and (v) quality of life, access to healthcare, and financial burden associated with managing chronic skin conditions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Sampling and Recruitment\u003c/h2\u003e \u003cp\u003eA purposive sampling strategy was employed to include both individuals with chronic dermatoses and those without diagnosed skin conditions, thereby enabling comparative insights into product usage and perceptions. This approach was deemed appropriate given the exploratory nature of the study and the need to capture experiences from those with direct exposure to skincare challenges.\u003c/p\u003e \u003cp\u003eRecruitment was conducted online via WhatsApp, Facebook, LinkedIn, and email between April and June 2025.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Data Analysis\u003c/h2\u003e \u003cp\u003eQuantitative data was analysed descriptively using SPSS v30. Frequencies and percentages were calculated for categorical variables. Open-ended responses were subjected to inductive thematic analysis to identify recurring patterns in user perceptions and experiences. For categorical variables, percentages and frequencies were calculated. To identify recurring patterns in user perceptions and experiences, inductive thematic analysis was applied to open-ended responses. The data collected from 273 participants were summarised using descriptive statistics. Measures of central tendency (mean, median) and dispersion (standard deviation, skewness) were used to describe continuous variables, including age and Likert scale items (e.g., satisfaction levels with goat milk products). Frequencies and percentages were employed to analyse categorical variables, such as gender, race, province, skin conditions, types of goat milk products used, and opinions regarding the medicinal and cosmetic benefits of goat milk.\u003c/p\u003e \u003cp\u003eTo examine the relationships between variables, bivariate and inferential analyses were conducted. Associations between categorical variables, such as age group and the presence of skin conditions, were evaluated using chi-square tests. One-way ANOVA (with post-hoc tests when appropriate) assessed differences among more than two groups, while independent samples t-tests compared the mean satisfaction levels between two groups. The relationship between age and satisfaction levels was explored using Pearson correlation. Finally, variables like age, gender, race, and previous product exposure were included in a binary logistic regression to identify predictors of goat milk cosmetic usage.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Participant Demographics\u003c/h2\u003e \u003cp\u003eThe majority of respondents were female (68.1%), and in the racial context, most were Black/African (94.9%; n\u0026thinsp;=\u0026thinsp;258 of 273). Among Black/African respondents, the largest proportion resided in South Africa, particularly in Gauteng Province (n\u0026thinsp;=\u0026thinsp;133; 50.2%), followed by North West (n\u0026thinsp;=\u0026thinsp;31; 11.7%) and Limpopo (n\u0026thinsp;=\u0026thinsp;18; 6.8%). Overall, 17.7% (n\u0026thinsp;=\u0026thinsp;47) of participants were distributed across other African countries and selected locations, reflecting broader continental representation. Malawi (6.6%), Zimbabwe (3.3%), and Djibouti (1.5%) were reported individually due to comparatively higher response frequencies, while countries contributing smaller numbers\u0026mdash;including Botswana, Lesotho (Mohale\u0026rsquo;s Hoek), Ghana (Greater Accra), Kenya (Nairobi), Nigeria (Osun), Ethiopia (Addis Ababa), Eswatini (Manzini Region), and Benin (Abomey-Calavi), were aggregated for reporting consistency (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Most respondents were aged 25\u0026ndash;34 years (35.1%), followed by 18\u0026ndash;24 years (32.5%). Population distribution across different geographical areas was analysed as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The majority of the respondents lived in urban areas (70.6%), with fewer in rural (15.8%) or peri-urban (13.6%) settings.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic profile of participants (N\u0026thinsp;=\u0026thinsp;273).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87 (31.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e186 (68.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRace\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBlack/African\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e258 (94.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (1.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (1.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eColoured\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (2.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge group (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e88 (32.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95 (35.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38 (14.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u0026ndash;54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (3.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;17 / \u0026ge;55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40 (14.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGauteng - SA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e133 (50.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNorth West - SA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31 (11.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLimpopo - SA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18 (6.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther SA Provinces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (13.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther African Countries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47 (17.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Prevalence and Impact of Skin Conditions\u003c/h2\u003e \u003cp\u003eThe most frequently reported diagnosed condition was eczema/atopic dermatitis (15.4%), followed by seborrheic dermatitis (4.8%) and psoriasis (2.2%) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Rare conditions (\u0026lt;\u0026thinsp;2%) included stasis dermatitis, rosacea, and lichen planus. Additionally, 12.5% reported symptoms without a formal diagnosis, suggesting under-recognition of dermatological morbidity.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence of Chronic Dermatoses and Symptoms\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCondition\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEczema/Atopic Dermatitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e231 (84.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42 (15.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeborrheic Dermatitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e260 (95.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (4.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStasis Dermatitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e269 (98.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (1.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsoriasis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e267 (97.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (2.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRosacea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e271 (99.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (0.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLichen Planus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e271 (99.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (0.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSymptoms Only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e239 (87.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34 (12.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Management of Skin Health Conditions\u003c/h2\u003e \u003cp\u003eTopical products dominated treatment practices. Creams/lotions (27.3%), ointments (20.1%), and soaps (13.5%) were the most used (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Natural/home remedies (12.5%) and herbal treatments (11.3%) also featured prominently, reflecting the role of traditional practices. Fewer participants reported serums (8.9%) or pharmaceutical products (3.7%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSkin Health Condition Management: Product Usage Frequency\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProduct Type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePercent Using (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreams/Lotions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOintments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSoaps\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNatural/Home Remedies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHerbs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerums\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePharmaceutical Products\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Access to Healthcare and Affordability\u003c/h2\u003e \u003cp\u003eAccess to medical care among participants varied notably in terms of frequency of healthcare visits, type of facility utilised, and perceived accessibility. As shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eA, the majority of respondents (66.8%) reported never visiting a dermatologist or healthcare professional for their skin health condition, while 22.1% visited rarely (once a year or less), 9.6% visited occasionally (one to three times per year), and only 1.5% reported regular visits (once a month or more).\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eB illustrates the types of healthcare facilities primarily accessed by participants. The most frequently used were private clinics or hospitals (44.1%) and self-medication (26.4%), followed by public clinics or hospitals (15.7%). Smaller proportions utilised traditional or alternative medicine (8.5%), health centres (4.1%), or skincare companies. Notably, some participants indicated no healthcare use for their skin condition. Regarding perceived accessibility (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eC), 43.0% rated their access to medical care as good, meaning care was accessible but somewhat expensive. A combined 34.3% rated access as moderate (22.7%) or poor (11.6%), indicating challenges such as limited availability or affordability. Only 13.6% of participants described their access as excellent, highlighting a potential gap in equitable healthcare provision for skin health conditions within the population.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents crucial insights into participants\u0026rsquo; engagement with medical care for their skin health conditions. Figure\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eA illustrates that 38.5% of respondents never purchased prescription or self-medication for their condition, while 23.7% did so rarely (once a year or less). Purchases made occasionally (one to three times yearly) accounted for 23.0%, and 14.8% purchased medications regularly (once a month or more). Figure\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eB shows that payment for medical expenses was predominantly out-of-pocket (52.4%), followed by medical aid or insurance (37.3%). Other payment methods included family support, employer-sponsored plans, social grants, charity, or no payment reported by smaller percentages. This indicates economic burden and potential barriers to consistent access to care. Affordability was a concern for 62% of participants, reflecting financial challenges in managing skin conditions (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e Mean accessibility scores, rated on a scale from 1 (poor) to 4 (excellent), indicated moderate access to medical care (Mean\u0026thinsp;=\u0026thinsp;2.50, SD\u0026thinsp;=\u0026thinsp;0.97).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAccess to Medical Care and Affordability\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccess to Medical Care (1\u0026ndash;4)*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAffordability (0\u0026ndash;1)**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003e*1\u0026thinsp;=\u0026thinsp;Poor, 4\u0026thinsp;=\u0026thinsp;Excellent; 0\u0026thinsp;=\u0026thinsp;No, 1\u0026thinsp;=\u0026thinsp;Yes\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Quality of Life Impact of Chronic Skin Conditions\u003c/h2\u003e \u003cp\u003eOn a scale of 1 (not at all) to 5 (very much), participants rated the impact of their skin health conditions on multiple life domains. Respondents reported that skin conditions had the greatest negative effect on self-esteem/confidence (Mean\u0026thinsp;=\u0026thinsp;2.59, SD\u0026thinsp;=\u0026thinsp;1.51), followed by emotional wellbeing (Mean\u0026thinsp;=\u0026thinsp;2.37, SD\u0026thinsp;=\u0026thinsp;1.32), social life (Mean\u0026thinsp;=\u0026thinsp;2.25, SD\u0026thinsp;=\u0026thinsp;1.38), overall quality of life (Mean\u0026thinsp;=\u0026thinsp;2.22, SD\u0026thinsp;=\u0026thinsp;1.28), and physical health (Mean\u0026thinsp;=\u0026thinsp;2.10, SD\u0026thinsp;=\u0026thinsp;1.24) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eImpact of chronic skin conditions on well-being. Scores were measured on a 5-point Likert scale (1\u0026thinsp;=\u0026thinsp;no impact, 5\u0026thinsp;=\u0026thinsp;severe impact).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDomain\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMedian (IQR)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.10\u0026thinsp;\u0026plusmn;\u0026thinsp;1.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1\u0026ndash;3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional wellbeing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.37\u0026thinsp;\u0026plusmn;\u0026thinsp;1.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1\u0026ndash;3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial life\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.25\u0026thinsp;\u0026plusmn;\u0026thinsp;1.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1\u0026ndash;3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-esteem/confidence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.59\u0026thinsp;\u0026plusmn;\u0026thinsp;1.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1\u0026ndash;4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverall quality of life\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1\u0026ndash;3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.6 Awareness, Use, and Perceived Effectiveness of Goat Milk in Skincare and Medicinal Products\u003c/h2\u003e \u003cp\u003eBelief in the benefits of goat milk products was varied, with a mean score of 1.05 (on a scale where higher values indicate stronger belief in superiority). Approximately 43% of participants reported using goat milk cosmetics, and 64.7% expressed interest or occasional use of skincare containing goat milk, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e. Perception charts revealed mixed opinions on whether goat milk products were superior, about the same, or less beneficial compared to alternatives.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAwareness and Perception of Goat Milk Products\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGoat Milk Cosmetics Use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes: 118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo: 155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkincare Containing Goat Milk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes (regular or occasional): 37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInterested but not tried: 196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot Interested: 22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eRegarding willingness to use goat milk products, the majority of respondents had either tried these products (mean tried products coded\u0026thinsp;=\u0026thinsp;0.87) or expressed interest in trying them. Usage frequency varied by demographic factors and was higher in urban and peri-urban regions compared to rural areas. Despite limited awareness, the willingness to adopt goat milk\u0026ndash;based skincare products was high. Among participants who had not previously used such products, 76.9% expressed interest, while only 8.6% reported no interest. Regular users accounted for 3.5%, suggesting substantial potential for market growth and adoption if awareness and access are improved.\u003c/p\u003e \u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e, 82.1% respondents reported some level of use or interest in skincare or medicinal products containing goat milk. Most (71.8%) used these products occasionally, while 10.3% used them regularly. A small portion (8.1%) expressed interest but had not yet tried goat milk products, and 6.6% were not interested.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUsage of Skincare or Medicinal Products Containing Goat Milk\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUsage Category\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo, and I am not interested\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo, but I am interested in trying\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes, occasionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e71.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes, regularly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAmong users, the majority (64.7%) rated goat milk skincare as \u0026ldquo;effective\u0026rdquo; or \u0026ldquo;very effective\u0026rdquo; in managing their skin condition, while 21.6% perceived it as \u0026ldquo;neutral,\u0026rdquo; and 13.7% as \u0026ldquo;ineffective.\u0026rdquo; There were no statistically significant differences in perceived effectiveness across different age groups (p\u0026thinsp;=\u0026thinsp;0.184) or gender (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.452).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3.8 Associations Between Age and Dermatoses, Impact of Skin Health Conditions\u003c/h2\u003e \u003cp\u003eChi-square tests examined the association between age groups and the presence of chronic dermatoses. No significant associations were found for eczema (χ\u0026sup2;(4)\u0026thinsp;=\u0026thinsp;5.15, p\u0026thinsp;=\u0026thinsp;0.272), seborrheic dermatitis (χ\u0026sup2;(4)\u0026thinsp;=\u0026thinsp;1.22, p\u0026thinsp;=\u0026thinsp;0.876), stasis dermatitis (χ\u0026sup2;(4)\u0026thinsp;=\u0026thinsp;3.70, p\u0026thinsp;=\u0026thinsp;0.449), psoriasis (χ\u0026sup2;(4)\u0026thinsp;=\u0026thinsp;3.63, p\u0026thinsp;=\u0026thinsp;0.459), lichen planus (χ\u0026sup2;(4)\u0026thinsp;=\u0026thinsp;2.95, p\u0026thinsp;=\u0026thinsp;0.566), or symptoms only (χ\u0026sup2;(4) = .968, p = .915). Rosacea prevalence, however, demonstrated a significant association with age (χ\u0026sup2;(4)\u0026thinsp;=\u0026thinsp;12.35, p\u0026thinsp;=\u0026thinsp;0.015), indicating that the distribution of rosacea cases varies across age groups, with higher prevalence in some age categories (Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eChi-Square Tests for Association Between Age Group and Chronic Dermatoses\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkin Condition\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eχ\u0026sup2; (df)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEczema/Atopic Dermatitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.15 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.272\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeborrheic Dermatitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.22 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.876\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStasis Dermatitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.70 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.449\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsoriasis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.63 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.459\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRosacea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12.35 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.015*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLichen Planus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.95 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.566\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSymptoms Only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.968 (4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.915\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003e*Significant at \u003cem\u003ep\u003c/em\u003e \u0026lt; .05\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eParticipants rated the impact of their skin health condition on physical, emotional, social, self-esteem, and overall well-being on a scale from 1 (no impact) to 5 (severe impact). There were significant differences across age groups in emotional (F(4,244)\u0026thinsp;=\u0026thinsp;3.15, \u003cem\u003ep\u003c/em\u003e = .015), social (F(4,248)\u0026thinsp;=\u0026thinsp;4.42, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.013), and self-esteem impacts (F(4,245)\u0026thinsp;=\u0026thinsp;4.88, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.008), but not in physical impact (F(4,246)\u0026thinsp;=\u0026thinsp;1.00, p = .407) or overall impact (F(4,247)\u0026thinsp;=\u0026thinsp;1.68, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.189).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e3.10 Correlations Among Key Variables\u003c/h2\u003e \u003cp\u003eSpearman's rho correlations showed a significant negative association between spending on skincare products and perceived product affordability (rho = -0.189, \u003cem\u003ep\u003c/em\u003e = .002) (Table\u0026nbsp;\u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e9\u003c/span\u003e), indicating that higher spending is associated with lower perceived affordability. Frequency of prescription or self-medication was positively correlated with visits to dermatology healthcare professionals (r\u0026thinsp;=\u0026thinsp;0.310, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001), suggesting that increased medical visits relate to more frequent medication use. Access to medical care was also positively correlated with paying for medical expenses (rho = .282, \u003cem\u003ep\u003c/em\u003e \u0026lt; .001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSpearman\u0026rsquo;s Correlations Among Key Variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCorrelation (rho)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpend on Skincare \u0026amp; Product Affordability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDermatology Visits \u0026amp; Prescription Frequency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.310\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccess to Medical Care \u0026amp; Medical Expenses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eInsights into the perceptions, usage patterns, and acceptability of goat milk-based skincare products among predominantly South African adults reveal high interest and perceived therapeutic value; however, interpretation is contextualised within the demographic distribution of the sample population. Although respondents resided across multiple African countries, over 80% were based in South Africa, and more than half (50.2%) in Gauteng Province. Consequently, the findings more strongly reflect perceptions within an urbanised South African context rather than continent-wide variation. Africa comprises highly heterogeneous populations with substantial genetic, climatic, and socio-cultural diversity, including differences in skin phototypes, barrier function, sebum production, and environmental exposures, which may influence both disease expression and treatment responses (Taylor, 2002; Iwuala \u0026amp; Taylor, 2022; Wright et al., 2026).\u003c/p\u003e \u003cp\u003eParticipants reported perceived benefits of goat milk products, including hydration, soothing of irritation, and improvement in barrier function. These perceptions align with established biochemical properties of goat milk. It contains lactic acid (an α-hydroxy acid), medium-chain fatty acids, vitamins A and D, and bioactive proteins such as lactoferrin and α-lactalbumin, which exhibit antimicrobial, antioxidant, and anti-inflammatory activity (Ncube et al., 2025; Park, 2017; Silanikove et al., 2010). (Kim et al., 2025; Legrand, 2016) (Legrand, 2016). These mechanisms provide biological plausibility for the user-reported outcomes.\u003c/p\u003e \u003cp\u003eThe epidemiological profile observed mirrors broader patterns in skin disease burden. Eczema or atopic dermatitis was the most frequently reported condition (15.4%), consistent with global adult prevalence estimates ranging between 2\u0026ndash;10% and paediatric prevalence of 15\u0026ndash;20% (Nutten, 2015; Silverberg, 2017). Importantly, 12.5% reported persistent symptoms without formal diagnosis, reflecting under-recognition of dermatological disease. Population-based data from rural South Africa demonstrate point prevalences of any skin disease exceeding 60% (Naidoo et al., 2025; Wright et al., 2026), while Global Burden of Disease analyses show that sub-Saharan Africa carries one of the highest age-standardised burdens of skin and subcutaneous diseases globally in terms of DALYs (Guo \u0026amp; Zheng, 2025; Yakupu et al., 2023). These findings reinforce that chronic dermatoses represent a substantive public health concern rather than a cosmetic issue.\u003c/p\u003e \u003cp\u003eAccess barriers were substantial. Approximately two-thirds of respondents had never consulted a dermatologist, and over half reported out-of-pocket care expenditure. This aligns with documented shortages of dermatologists in sub-Saharan Africa, where specialist density may be fewer than one dermatologist per million population in several countries (Tiwari et al., 2022b). Financial constraints are known determinants of delayed care and suboptimal adherence in chronic inflammatory skin disease (Drucker et al., 2017). Psychosocial burden was evident, with the greatest impact reported in self-esteem and emotional well-being, consistent with evidence that dermatological disorders significantly impair quality of life and may confer psychiatric comorbidity risks comparable to other chronic diseases (Dalgard et al., 2015).\u003c/p\u003e \u003cp\u003eDespite this burden, openness to goat milk-based skincare was high (82.1% expressed interest), with only 10.3% reported regular use. The discrepancy between interest and sustained utilisation likely reflects limited availability of standardised medical-grade formulations, affordability constraints, and regulatory ambiguity rather than lack of acceptability. Notably, racial subgroup analyses were constrained by sample composition (94.9% Black/African; \u0026lt;10% White, Indian and Coloured racial categories), limiting robust comparison of perceptions or usage across racial groups. Given established differences in skin structure, transepidermal water loss, pigmentation biology, and inflammatory response across skin phototypes (Wilson et al., 1988; Del Bino et al., 2018), future studies with more balanced representation are warranted to explore whether therapeutic perceptions or responses differ by racial or ethnic background.\u003c/p\u003e \u003cp\u003eComparisons with other nature-derived products commonly used in Africa, such as shea butter and aloe vera, demonstrate similar patterns of cultural acceptability but limited high-quality clinical standardisation (Surjushe et al., 2008). Goat milk appears to occupy a comparable translational space: culturally familiar and biologically plausible, yet insufficiently integrated into evidence-based dermatological practice. Structured formulation development, stability testing, and controlled clinical evaluation are therefore essential.\u003c/p\u003e \u003cp\u003eEconomic and socio-cultural considerations further contextualise these findings. Smallholder goat farming is widespread across Southern and Eastern Africa, presenting opportunities for localised value chains (Kahi \u0026amp; Wasike, 2019). However, equitable integration would require regulatory oversight, quality control, and avoidance of therapeutic overstatement. Regulatory harmonisation for cosmeceuticals remains variable across African jurisdictions, which may affect consumer confidence and product standardisation.\u003c/p\u003e \u003cp\u003eSeveral limitations warrant emphasis. The sampling strategy was continent-wide in intent but respondent distribution was uneven, with strong concentration in South Africa, particularly Gauteng Province. Thus, perceptions may reflect an urban South African context rather than pan-African heterogeneity. The online design may have favoured participants with digital access and higher educational attainment. Self-reported diagnoses were not clinically verified. The cross-sectional design precludes inference regarding clinical efficacy.\u003c/p\u003e \u003cp\u003eOverall, goat milk is perceived as a culturally acceptable and potentially beneficial adjunctive skincare ingredient within this predominantly South African cohort. High expressed willingness coupled with limited regular use highlights translational barriers rather than a lack of acceptability. While mechanistic plausibility is supported by biochemical evidence, rigorous dermatological trials across diverse African populations are required before continent-wide generalisation. Strategic interventions encompassing clinical trials, formulation standardisation, regulatory oversight, and community engagement could transform goat milk from a traditional remedy into a scalable, science-backed option for managing chronic dermatoses across the continent.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eGoat milk-based skincare products are widely perceived as effective, culturally familiar, and desirable among African adults affected by chronic dermatoses within this predominantly Black/African cohort. Reported benefits, including enhanced hydration, anti-inflammatory effects, and improved skin comfort, are supported by emerging biochemical evidence, reinforcing goat milk\u0026rsquo;s potential as a safe and culturally acceptable dermatological intervention. However, interpretation of perceived effectiveness is contextualised within the racial composition of the sample (94.9% Black/African). The study was not sufficiently powered to conduct meaningful race-stratified comparisons, and it remains unclear whether perceptions, tolerability, or therapeutic responses may differ across racial or skin phototype groups. Given known variations in epidermal structure, barrier function, pigmentation biology, and inflammatory responses across skin types, further research, including more balanced racial and ethnic representation, is warranted to determine whether goat milk formulations demonstrate comparable acceptability and performance across diverse populations.\u003c/p\u003e \u003cp\u003eThe findings highlight both the therapeutic promise and the barriers to uptake, including limited awareness, product availability, cost, and regulatory ambiguity. Addressing these challenges will require rigorous clinical evaluation across multiple skin phototypes, formulation standardisation, clear regulatory frameworks, and community education to ensure safe, effective, and equitable access. Localised production and value addition present further opportunities to support rural micro-enterprises and generate socio-economic benefits alongside public health impact.\u003c/p\u003e \u003cp\u003eDespite study limitations, particularly the predominance of South African respondents, concentration within Gauteng Province, limited racial heterogeneity, reliance on self-reported data, and the cross-sectional design, these findings provide actionable insights into culturally informed, evidence-based approaches for chronic dermatoses management within the sampled population. Broader continental generalisation should be undertaken cautiously until multi-country, demographically balanced studies are conducted.\u003c/p\u003e \u003cp\u003eGoat milk has the potential to evolve from a traditional remedy into a scientifically validated, culturally embraced, and policy-supported intervention. Translating perception into practice through dermatologically rigorous, inclusive, and phototype-conscious research offers a pathway to transform an indigenous bioresource into a sustainable dermatological solution with both therapeutic and socio-economic significance.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e6. Acknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors gratefully acknowledge the Tshwane University of Technology (TUT) for institutional support and for providing access to analytical tools utilised in this study. Sincere appreciation is extended to Prof Mtileni (TUT) for academic guidance, methodological support in study design, and assistance with manuscript development.\u003c/p\u003e\n\u003cp\u003eThe authors further acknowledge the University of Johannesburg and The Tugizimana Lab for their institutional support. Special thanks are extended to the host (Dr Tugizimana) at The Tugizimana Lab for scholarly input, writing assistance, critical proofreading of the manuscript, and support during the publication process.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e7. Conflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there is no conflict of interest. \u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003e8. Funding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the National Research Foundation (NRF) under the Scarce Skills NRF Postdoctoral Grant (Grand ID: PSTD240327211078).\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003e9. 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Adult-onset IgE-mediated food allergy at a Winnipeg allergy clinic: a case series. \u003cem\u003eAllergy, Asthma \u0026amp; Clinical Immunology\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(1), 85. https://doi.org/10.1186/s13223-020-00483-5\u003c/li\u003e\n\u003cli\u003eWILSON, D., BERARDESCA, E., \u0026amp; MAIBACH, H. I. (1988). In vitro transepidermal water loss: differences between black and white human skin. \u003cem\u003eBritish Journal of Dermatology\u003c/em\u003e, \u003cem\u003e119\u003c/em\u003e(5), 647\u0026ndash;652. https://doi.org/10.1111/j.1365-2133.1988.tb03478.x\u003c/li\u003e\n\u003cli\u003eWright, A. K., Swan, R., Xu, J., Lwin, S. M., Azrielant, S., Chateau, A., Ede, C., Sons, J., Gxolo, Z., Skenjana, A., Mankahla, A., Drusinsky, S., Kannenberg, S. M., Mhlanga, S., Luthuli, M., Topping, L., Taicher, E., Flohr, C., Dlova, N. C., \u0026hellip; Griffiths, C. E. M. (2026). Skin disease in the Eastern Cape (SKINSCAPE): a Global Psoriasis Atlas point prevalence study in rural South Africa. \u003cem\u003eBritish Journal of Dermatology\u003c/em\u003e, \u003cem\u003e194\u003c/em\u003e(1), 125\u0026ndash;134. https://doi.org/10.1093/bjd/ljaf386\u003c/li\u003e\n\u003cli\u003eYakupu, A., Aimaier, R., Yuan, B., Chen, B., Cheng, J., Zhao, Y., Peng, Y., Dong, J., \u0026amp; Lu, S. (2023). The burden of skin and subcutaneous diseases: findings from the global burden of disease study 2019. \u003cem\u003eFrontiers in Public Health\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e. https://doi.org/10.3389/fpubh.2023.1145513\u003c/li\u003e\n\u003cli\u003eYaldo M, M. M. P. G. (2025). Increased Popularity of Goat Milk Soap: Analyzing Five Years of Google Trends: Google searches for \u0026lsquo;goat milk soap\u0026rsquo; nearly doubled from 2018 to 2023, reflecting growing public interest in natural cleansers marketed for eczema and sensitive skin despite limited scientific evidence. \u003cem\u003eJournal of Integrative Dermatology\u003c/em\u003e, \u003cem\u003e1\u003c/em\u003e, 1\u0026ndash;4.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Chronic dermatoses, cosmeceuticals, atopic dermatitis, goat milk, health services, psoriasis","lastPublishedDoi":"10.21203/rs.3.rs-9230570/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9230570/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eChronic dermatoses, including eczema and psoriasis, contribute substantially to morbidity in African populations, where access to dermatological care and affordable treatment remains limited. Goat milk has gained attention as a potential natural adjunct owing to its anti-inflammatory, antimicrobial, and barrier-supportive properties. To investigate perceptions, usage patterns, and acceptability of goat milk-based skincare products among African adults with chronic dermatoses, and to examine healthcare access and treatment experiences. A cross-sectional online survey was conducted among adults (\u0026ge;\u0026thinsp;18 years) residing in Africa. The structured questionnaire captured demographic characteristics, skin condition history, healthcare access, product usage, quality of life impact, and awareness of goat milk-based formulations. Descriptive and inferential analyses were performed. Among 273 respondents (68.1% female; 94.9% Black/African; predominantly South African), 15.4% reported eczema and 2.2% psoriasis, while 12.5% experienced symptoms without a formal diagnosis. Two-thirds (66.8%) had never consulted a dermatologist, and 52.4% paid for care out-of-pocket. Although only 38.9% had used goat milk cosmetics, 64.7% expressed a willingness to adopt scientifically validated, affordable formulations. Regular use was low (10.3%), but 64.7% of users rated goat milk products as effective or very effective. Interest exceeded current uptake, indicating translational and accessibility gaps.\u003c/p\u003e \u003cp\u003eGoat milk-based skincare is perceived as a culturally acceptable and potentially beneficial adjunct for chronic dermatoses in this predominantly Black African cohort. High willingness but low regular use underscores unmet dermatological needs and highlights the importance of rigorous clinical validation, inclusive research across skin phototypes, and equitable product development strategies.\u003c/p\u003e","manuscriptTitle":"Perceptions and Potential of Goat Milk for Cosmetic and Medicinal Management of Chronic Dermatoses in Africa: A Cross-Sectional Survey-Based Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-21 22:58:57","doi":"10.21203/rs.3.rs-9230570/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-21T10:10:18+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-20T01:17:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"107932065159537411739821454259344569605","date":"2026-04-20T00:05:05+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-19T15:58:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-18T15:15:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"280597868121632917007684873983612158801","date":"2026-04-16T01:51:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"47820942298521344707577743277515990028","date":"2026-04-15T09:32:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"223817199666231932259564506490815338788","date":"2026-04-14T19:36:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"315733854845667547096259847244398109793","date":"2026-04-14T16:51:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"17310142765460600001480871092522762559","date":"2026-04-14T14:41:13+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-14T13:37:58+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-14T13:34:02+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-08T07:14:23+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-06T11:38:13+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2026-04-06T11:00:30+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3c638ce5-66d2-4d82-affc-837cb403a229","owner":[],"postedDate":"April 21st, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[{"id":66610760,"name":"Health sciences/Diseases"},{"id":66610761,"name":"Health sciences/Health care"},{"id":66610762,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2026-04-21T22:58:57+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-21 22:58:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9230570","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9230570","identity":"rs-9230570","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}