Knowledge, Attitude, and Behavior of Photoprotection in Thai Vitiligo Patients

Vitiligo is a chronic pigmentary disorder characterized by the progressive loss of melanocytes, resulting in skin depigmentation. Although UV-based therapies, such as narrowband UVB, are commonly used for treatment, excessive sun exposure may aggravate the disease. Understanding patients' perceptions and behaviors related to sun exposure is crucial, particularly in tropical countries like Thailand, where UV levels are high.

To assess the knowledge, attitudes, and photoprotection behaviors of Thai vitiligo patients compared to healthy controls.

A cross-sectional study was conducted from January to August 2025 using a self-administered questionnaire. The questionnaire assessed participants' demographics, vitiligo-related characteristics, knowledge and attitudes toward sun exposure, perceived skin cancer risk, and sun protection practices. Data from 105 vitiligo patients and 85 controls were analyzed using chi-square and descriptive statistics.

Vitiligo patients showed greater awareness of the effects of sunlight on their condition than the control group. A higher proportion thought mild sunlight may improve vitiligo (57.1% vs 31.8%, p < 0.001). Only 25.7% of patients believed they had an increased risk of skin cancer. Vitiligo patients were more likely to use sunscreen regularly (53.3% vs 37.6%, p = 0.031) and during outdoor activities (61.0 vs 40.0%, p = 0.004) compared to control. However, reapplication rates were suboptimal with 75.2% of vitiligo patients never reapplied sunscreen, and fewer patients reapplied occasionally compared to controls (18.1% vs 37.6%, p = 0.002).

Thai vitiligo patients demonstrated moderate understanding of photoprotection and skin cancer risk, but significant behavioral gaps exist, notably in terms of sunscreen reapplication and comprehensive sun protection methods. These findings underscore the need for focused educational efforts to close the knowledge-practice gap, highlighting both the benefits and risks of UV exposure in vitiligo treatment.