Sun-protective behaviors in patients with cutaneous hyperpigmentation: A cross-sectional study

J Am Acad Dermatol. 2017 May;76(5):841-846.e2. doi: 10.1016/j.jaad.2016.12.018. Epub 2017 Feb 16.

Abstract

Background: Disorders of hyperpigmentation are seen commonly in clinical practice. Despite numerous studies investigating sun-protective habits among healthy persons, little is known about these behaviors within patient populations with hyperpigmentation disorders.

Objective: We sought to examine photo-protective behaviors and their associations in individuals with disorders of hyperpigmentation.

Methods: This cross-sectional study was conducted with 404 adults who complained of cutaneous hyperpigmentation.

Results: About 67.5% reported using a product containing sunscreen, and 91% endorsed using one with a sun protection factor of 21 or higher. Among the participants, 48.5% were not sure if their sunscreen provided broad-spectrum protection, and only 7.6% reapplied every 2 hours. The odds of a patient with melasma using sunscreen were 6.7 times the odds of a patient with postinflammatory hyperpigmentation using sunscreen (P < .001). Additional predictors for sunscreen use were female sex (OR = 3.8, P = .0004) and disease duration of ≥1 year (OR = 2.1, P = .003). In a multivariate analysis, the odds ratio of sunscreen use among African Americans compared to whites was 0.31 (P = .008).

Limitations: Limitations included recall bias, question misinterpretation, and reporter bias.

Conclusion: Patients diagnosed with postinflammatory hyperpigmentation, men, and those with disease duration <1 year reported lower sunscreen usage. These groups might benefit from increased counseling on sun-protective behaviors.

Keywords: broad spectrum; cutaneous hyperpigmentation; darker skin; melasma; postinflammatory hyperpigmentation; sun protection factor; sun-protective behaviors; sunscreen.

MeSH terms

  • Adolescent
  • Adult
  • Black or African American / statistics & numerical data
  • Cross-Sectional Studies
  • Female
  • Health Behavior* / ethnology
  • Humans
  • Hyperpigmentation / etiology
  • Hyperpigmentation / psychology*
  • Inflammation / complications
  • Male
  • Melanosis / psychology
  • Middle Aged
  • Sex Factors
  • Sun Protection Factor
  • Sunlight*
  • Sunscreening Agents / administration & dosage
  • Sunscreening Agents / therapeutic use*
  • Time Factors
  • White People / statistics & numerical data
  • Young Adult

Substances

  • Sunscreening Agents