Low Sunscreen Awareness and Misconceptions in Skin of Colour With Acne-Related Post-Inflammatory Hyperpigmentation: A...

Post-inflammatory hyperpigmentation (PIH) is a frequent sequela of acne in patients with skin of colour (SOC). While sunscreen is widely recommended for PIH prevention, little is known about real-world sunscreen practices in this group. This study aimed to evaluate sunscreen use, barriers and factors influencing adherence in SOC patients with acne-related PIH.

A cross-sectional survey was conducted on 51 SOC patients (FST III-VI) who attended a dermatology clinic in Australia between February and June 2025. An investigator-developed questionnaire assessed sunscreen use frequency, reapplication, application amount, tinted sunscreen uptake, and perceived barriers. Associations were examined using chi-square/Fisher's exact tests and logistic regression analyses. Analyses were exploratory.

Daily sunscreen use was inconsistent, with 39.2% applying occasionally (< 3 times/week) and only 33.3% applying daily. Reapplication was inadequate, with 57.5% (23/40) reapplying only when outdoors for prolonged periods. Most patients (79.5%, 31/39) applied less than one finger-length to the head and neck. Tinted sunscreen uptake was low, though shade match was a key determinant of adherence among users. Few patients recognised sunscreen's role in PIH prevention (19.6%), with professional advice emerging as an important factor associated with correct belief (no advice vs. advice, OR 0.04, p = 0.01).

Sunscreen use among SOC patients with acne-related PIH was suboptimal, with inadequate daily use, reapplication, and quantities applied. Clinician-led education was a key factor in influencing patient beliefs, highlighting the need for targeted counselling. Expanding shade-diverse, cosmetically elegant, tinted formulations may further improve adherence in SOC populations.