Aim <p>Skin lightening is the use of topical preparations to acquire a light skin. There are several adverse effects of these preparations. The objective of the current study was to assess the knowledge about, practice of and self-reported adverse effects of skin lightening products (SLPs) among female health science students at a medical college in Pokhara, Nepal.</p> Subject and methods <p>This descriptive cross-sectional study was conducted among female students (<i>n</i> = 309) from November 2021 to April 2022. Initially it was administered face-to-face but later due to COVID restrictions it had to be done online. The questionnaire consisted of demographic details, and items measuring perception, practice and self-reported adverse events, if any, following use of these products. The data collection method was complete enumeration.</p> Results <p>Most respondents 240 (77.66%) used skin lightening products. They had good knowledge of the products, and 213 respondents (68.93%) mentioned they were aware of the ingredients present in SLPs. Users and non-users did not significantly differ in their attitudes. The common ingredients used were vitamin C, niacinamide, retinol, vitamin A, and kojic acid. About 18% (<i>n</i> = 55) of respondents reported adverse events following the application of SLPs. Ingredients present, recommendation by family/friends and reasonable price played a role in influencing decisions to use these products.</p> Conclusion <p>This study showed that most of the respondents used SL products. A variety of factors influenced their preference for a light skin.</p>