title: Sun-protective behaviors in patients with cutaneous hyperpigmentation: A cross-sectional study.
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).
  
  
  CONCLUSIONS
  Limitations included recall bias, question misinterpretation, and reporter bias.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Mayra B C
authors.initials: MBC
authors.lastname: Maymone
authors.affiliation: Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts.
authors.forename: Hind H
authors.initials: HH
authors.lastname: Neamah
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Wirya
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Patzelt
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Pedro Q
authors.initials: PQ
authors.lastname: Zancanaro
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts. Electronic address: nvashi@bu.edu.
authors.forename: Neelam A
authors.initials: NA
authors.lastname: Vashi
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology / Q000523:psychology*; D007249:Inflammation / Q000150:complications; D008297:Male; D008548:Melanosis / Q000523:psychology; D008875:Middle Aged; D012737:Sex Factors; D059405:Sun Protection Factor; D013472:Sunlight; D013473:Sunscreening Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D013473:Sunscreening Agents
keywords: broad spectrum; cutaneous hyperpigmentation; darker skin; melasma; postinflammatory hyperpigmentation; sun protection factor; sun-protective behaviors; sunscreen