Dermatologists Fail to Recommend Sunscreen to Patients

Most patients at a dermatology clinic in Riyadh, Saudi Arabia are aware of sunscreen, and many have used sunscreen, but only a third have ever received a recommendation from a general practitioner or dermatologist to use sunscreen and generally, these patients are unaware of guidelines for sunscreen use, according to study findings published in Clinical, Cosmetic and Investigational Dermatology.

Investigators aimed to evaluate the “knowledge and attitude” of dermatology patients regarding the American Academy of Dermatology (AAD) recommended sunscreen use (avoid sun exposure between 10 am and 2 pm, apply SPF-30 daily, covering the entire body with 30 mL of sunscreen a minimum of 15 minutes before sun exposure, and reapply every 2 hours).

They conducted an observational cross-sectional study that included 288 patients (67% women; 75.3% younger than 40 years of age) from a dermatology clinic at a university hospital in Riyadh, Saudi Arabia for 3 weeks beginning the middle of November 2021. Participants completed a survey based on AAD recommendations of sunscreen use and included demographic and medical history information.

Investigators found that more than 93.4% of participants had heard about sunscreen and 72% had previously used sunscreen; use was higher among women and individuals with a postgraduate education (more than 50% had an undergraduate education, less than 10% had a postgraduate education). Among those who had previously used sunscreen, use was highest among participants with photosensitive inflammatory disease with no significant difference with other reasons for visiting the hospital. History of sunscreen allergies and skin cancer were insignificant, and none of the participants had a family history of skin cancer.

Investigators noted sunscreen knowledge was higher among women, participants with Fitzpatrick I, II, and III skin types, and those with nonphotosensitive disorders. They found that 4 out of 5 participants knew the worst time for sun exposure, but only 1 out of 5 knew that sunscreen needs to be applied daily throughout the year and even fewer participants knew the correct minimum recommended SPF.

Investigators noted that a third of the participants were aware of the minimum time allowed for sunscreen application before sun exposure, 1 out of 5 participants were aware of the longest period allowed between reapplications, and fewer than 1 in 20 participants knew the proper amount of sunscreen for covering the entire body.

Investigators found participants had never received a recommendation to use sunscreen from a dermatologist (26%) and from a general practitioner (6%).

More than 36% of participants said the price of sunscreen prevented them from purchasing it, and almost 15% of participants said that even if the hospital offered them free sunscreen, they still would not use it regularly. An additional 15% said they did not know if free sunscreen would affect regular use.

Study limitations include the observational design, the single-center design, underpowered sample sizes in subgroups, preponderance of women and those younger than 40 years of age, and unconfirmed diagnoses, skin types, and medical histories. Additional limitations include participation bias and the survey failed to determine participants actual use of sunscreen relative to established guidelines.

Investigators concluded, “most participants had heard of sunscreen, however their knowledge of the guidelines for sunscreen use was poor.” They added, “Only 33% of the participants had received a recommendation for using sunscreen from their general practitioner or dermatologist.”