Sun protection use and habits in the LGBTQI+ community in Lebanon: A cross sectional study.

BACKGROUND: Sun exposure is an extrinsic risk factor for skin aging, wrinkle formation, and the development of skin cancer, namely melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). Sun protection measures have emerged as an important means of preventing these harmful effects. Studies have shown that sexual minority men have a greater prevalence of skin cancer than heterosexual men. AIMS: There is limited research investigating the reasons behind this risk of skin cancer development. This is especially important because identifying preventable risk factors, like those pertaining to sun exposure behaviors, can be targeted in the fight against skin cancer and help establish screening tools and preventive interventions for the SGM community. This study focused on members of the SGM community and demonstrated their tendency not to use sun-protective measures, as well as their deficits in knowledge of skin cancer prevention. MATERIALS AND METHODS: This study is a cross-sectional study that investigates sun protection practices and trends among adults in Lebanon's SGM community using a survey. It includes adults aged 18-80 that were recruited from the dermatology clinics at AUBMC as well as LGBTQ+ organizations Helm and SIDC. RESULTS: A total of 129 participants took part in the study and completed the survey. Reasons for tanning varied among our participants: tanning to get a color (13.1%), tanning to get vitamin D (4.6%), tanning socially (6.9%), and tanning for mood elevation (0.8%). No significant association was found between sexual orientation and SPF use (p = 0.167). No significant association was found between sexual orientation and tanning frequency during summer (p-value: 0.231). Similarly, no significant association was noted between sexual orientation and tanning bed use (0.951). No significant association was noted between the type of job and SPF use (p = 0.601). Despite no significance between SPF use and the highest educational degree attained (p = 0.070), the tendency to use SPF increased with higher levels of education. Moreover, awareness of sun-induced skin cancer did not significantly affect SPF use (p = 0.067). However, a significant association was found between the information source for skin cancer and SPF use (p < 0.001) where participants receiving information from dermatologists displayed notably higher SPF use (72.2%), compared to those obtaining information from media (18.2%) or family and friends (5.3%). DISCUSSION: Surveying the perception of the Lebanese SGM community towards sun damage and their adaptive practices to prevent it can help implement and gear a nation-wide campaign to spread proper awareness about this subject. Studying their behavioral tendencies for not using sunscreen can help overcome this contributing risk factor for skin cancers. CONCLUSION: Future investigations have yet to identify confounding variables contributing to higher levels of skin cancers in this population.

The communicative paradigm shift of the digital age: The skinny on social media.

In this editorial, we explore several relevant issues pertaining to social media use including influencers and photo-editing software. The aforementioned topics are discussed vis-à-vis their profound positive and negative effects on both patients and aesthetic physicians. The reader is invited to appreciate the importance of social media use in aesthetic medicine and the pitfalls its use presents.

Presurgical Laser Hair Removal: Protocoling a Safe and Effective Procedure for Transgender Patients.

Purpose: For transgender (TG) women preparing to undergo neovaginoplasty, multidisciplinary care is essential, with physicians working together to ensure timely, complete, and cost-effective treatment. Methods: The protocol was developed through the clinical experience with >30 patients for preneovaginoplasty laser hair removal (LHR). Results: This report details the procedure used at an academic medical center for preneovaginoplasty genital LHR. Although treatment must often be individualized, methods as described for evaluation and treatment of presurgical hair have been successfully used in >30 patients. Conclusion: Given the limited available literature regarding this topic, it is our hope that this report will encourage other centers to offer safe and effective presurgical genital LHR to TG patients.

Trends in Use of Prescription Skin Lightening Creams.

The desire for an even skin tone pervades all cultures and regions of the world. Uniform skin color is considered a sign of beauty and youth. Pigmentation abnormalities can arise idiopathically with genetic predetermination, with injury and environmental exposures, and with advancing age, and can, therefore, be distressing to patients, leading them to seek a variety of treatments with professional assistance. In this short report, we describe the trends in the use of prescription lightening creams, particularly in patients with darker skin types residing in the US. Amongst 404 participants, skin hyperpigmentation had a moderate effect on patients' quality of life, and the most common diagnosis associated with the use of a prescription product was melasma (60.8%). The most common agent prescribed was hydroquinone (62.9%), followed by triple combination cream (31.4%). It is the dermatologist's duty to gauge the effect of the pigmentation disease on patients' life in order to counsel, tailor, and decide on the most appropriate treatment option.

Willingness-to-pay and Time Trade-off: The Burden of Disease in Patients with Benign Hyperpigmentation.

Objective: We assessed willingness-to-pay (WTP) and time trade-off (TTO) as methods to quantify the disease burden of benign hyperpigmentation. Design: This was a cross-sectional pilot study that included 85 adults. A paper survey was used to collect demographic and health utility information; an accompanying dermatological exam assessed disease severity. Setting: This was a single-site study performed at an urban dermatology clinic. Participants: Adults 18 years of age or older who spoke English, Spanish, or Portuguese were included. Measurements: Utility measures included WTP, TTO, and time spent concealing the condition; correlation with quality of life was also assessed. Results: Mean WTP for 25-percent improvement (WTP25) of the skin condition was $38.95; for a 50-percent improvement (WTP50), $83.18. Participants were willing to give up 1.4 hours per day to receive a therapy that would completely cure their condition. The average proportion of monthly income that participants were willing to spend on a therapy that could cure their condition was 13.3 percent. Daily concealment time was, on average, 20.8 minutes, which correlated with a worsened quality of life. Conclusion: Disease burden was high, overall, for benign hyperpigmentation conditions. Health utilities offer a patient-centered method of assessing impact on quality of life.

Patterns of Over-the-counter Lightening Agent Use among Patients with Hyperpigmentation Disorders: A United States-based Cohort Study.

Background: Over-the-counter (OTC) lightening agents are commonly used to treat hyperpigmentation disorders. Objective: We sought to determine the characteristics, trends, and preferences of patients with hyperpigmentation disorders seeking OTC agents in the United States. Design: The study was a cross-sectional study of consecutive patients with a disorder of hyperpigmentation seen in a United States-based outpatient dermatology clinic. Multivariable logistic regression models were used to identify factors associated with the use of OTC lightening agents. Setting: The study setting was an outpatient US-based dermatology clinic in Boston, Massachusetts. Results: Of the 406 patients studied, the majority were women (88.9%) with Fitzpatrick Skin Types IV to VI (64.5%). The most frequent diagnoses were melasma (42.9%) and post-inflammatory hyperpigmentation (PIH, 33.9%). Of our responders, 51.0 percent reported use of OTC agents and 44.9 percent reported use of prescription lightening products. Hydroquinone was the most commonly used cream (59.1%), followed by triple combination cream (fluocinolone acetonide, hydroquinone, and tretinoin, 16.3%). Of the cohort, 28.9 percent felt that the greater expense of the product correlated with greater efficacy. After multivariable adjustment, factors associated with a greater odds of using an OTC lightening agent included having a diagnosis of melasma (odds ratio [OR] 5.36; 95% CI: 2.98, 9.63; P<0.01) or PIH (OR 2.38; 95% CI: 1.25, 4.53; P≤0.01). Conclusion: The use of OTC lightening agents is widespread among those patients with hyperpigmentation disorders who reside in the United States. Those with melasma and PIH were more likely to use an OTC lightening cream. The majority of patients believed that OTC creams were safe to use without physician supervision. In those who had also tried prescription products, triple combination was deemed most effective compared to other lightening agents.

Assessing the safety of superficial chemical peels in darker skin: A retrospective study.

BACKGROUND: Chemical peels have shown efficacy in the treatment of acne, photoaging, and pigmentary dyschromias; however, studies evaluating side effects, particularly in patients with skin of color, are limited. OBJECTIVE: We sought to determine the frequency of side effects and complications associated with superficial chemical peels in patients with skin types III-VI. METHODS: A 5-year single center retrospective analysis was performed. RESULTS: Of 473 chemical peel treatments included in this study, 18 (3.8%) were associated with short-term (≤2 weeks) or long-term (>2 weeks) complications. The most frequent complications were crusting (2.3%), postinflammatory hyperpigmentation (1.9%), and erythema (1.9%). All side effects resolved within 8 months of treatment and were located on the face. When stratified by season, side effects were noted to be less common during the winter. In the adjusted model, Fitzpatrick skin type VI was associated with a higher odds of side effects (odds ratio 5.14, 95% confidence interval 1.21-21.8; P = .0118). LIMITATIONS: Single center retrospective design. CONCLUSION: In this study, superficial chemical peels performed on patients with skin types III-VI had a relatively low complication rate, and skin type VI had higher odds of experiencing an adverse event. Side effects were noted to be less frequent during the winter months.