Background: Schizophrenia patients frequently engage in unhealthy lifestyle behaviors. The adverse effects of sun exposure on the human skin are well studied but only sparse data in this area have been focused on schizophrenia patients.
Aim: To assess the role of sun exposure and its effects on cutaneous photoaging in schizophrenia patients compared with age-matched healthy subjects.
Method: Skin photoaging was assessed using a modification of Glogau's classification. We developed a rating for aged appearance, applied to facial skin, dorsal hand skin, and a total integrated score. The extent of photodamage was independently evaluated by two of the investigators certified in dermatology and plastic surgery. Each rater independently estimated the subjects' age. Raters were blinded to the subjects' demographic and clinical parameters as well as to each other's ratings.
Results: Seventy-four participants were enrolled. There were 37 patients, 24 men and 13 women, mean age: 42.7+/-9.7 years. The comparison group consisted of 20 men and 17 women, mean age: 42.4+/-9.2 years. Age, gender and BMI as well as smoking status did not differ significantly between groups. The variables found to differentiate between groups were: sun exposure, use of sunscreens, overall pigmentary changes, periorbital wrinkles and the intake of concurrent medications.
Conclusion: Increased cutaneous photoaging in schizophrenia patients, evidenced by reduced sun safety behaviors, and objective clinical signs of skin photodamage were demonstrated in the present study. We suggest that preventive measures like sun safety education should be undertaken by mental health professionals.