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Sun exposure is the greatest triggering factor in melasma, yet few studies investigate how patients with melasma practice sun-protective behaviors such as avoiding sun exposure, seeking shade, and using sunscreen correctly. The purpose of this project was to gain perspective about barriers to sun-protective behaviors of patients with melasma. A mixed-methods design was utilized to investigate sun-protective behaviors through a demographic questionnaire, Sun Exposure and Protection Index (SEPI) survey, and semi-structured interviews. Twenty-one participants completed the SEPI survey and 13 participants were interviewed. The majority of participants were 25-34 years (38%), Caucasian/White (57%), and had melasma for 3 or more years (84%). When asked how often they thought about their melasma, participants answered “always” (43%) and “often” (38%) most frequently. Regarding sunscreen reapplication, only five participants (23%) reapplied sunscreen every 2 hours as recommended. As time spent thinking about melasma increased, sunscreen SPF increased (rs = 0.44, p = .044). As sunscreen reapplication increased, SEPI II Scores decreased (rs = -0.47, p = .030). Interviews revealed a lack of knowledge and perceived risk regarding incidental sun exposures and proper sunscreen use. This study was limited by its small sample size of all female and mainly white, young adult participants which may be difficult to generalize to other populations. Patients with melasma would benefit from education that discusses how to iv properly choose, apply, and reapply sunscreen and how to recognize and limit incidental sun exposure.
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