Disease characteristics, determinants, and perception of use of sunscreen and sun‐protective behaviors among patients of color with melasma: A cross‐sectional study

Melasma is an acquired state of hyperpigmentation that most commonly affects the face. The use of sunscreen is essential in melasma treatment. We sought to investigate patients' perspectives and behaviors toward sunscreen usage.A cross-sectional hospital-based study targeted 418 melasma patients from May 2019 to May 2021. Data regarding socio-demographic characteristics and the knowledge, attitude, and behavior toward sunscreen and sun exposure were collected and analyzed. Furthermore, a complete clinical assessment was done.The mean age of the patients was 35.4 ± 8.6 years. Melasma distribution was mostly centro-facial (49.8%). The mean duration of the disease was 22.3 ± 11.6 months, with a mean Melasma Area and Severity Index (MASI) score of 18.6 ± 8.9. Only 170 patients believed that sun exposure played a role in their disease. Skin darkening was the most recognized effect of sun exposure by 92.9% of participants. 58.6% reported using sunscreen with a higher female predominance (p < .001), while males reported more broad-spectrum sunscreen usage (p < .001). The reason that was reported the most behind not using sunscreen was the high cost (94%).Our study showed a sound level of knowledge regarding the effects of sun exposure, and sunscreen advantages and disadvantages, with relatively inadequate translation into their attitudes and practices regarding sun-protective behaviors. The use of sunscreen among the patients was average in numbers with a higher female predominance.