Pigmentary Disorders around the World: Self-Reported Prevalence and Impact on QOL and Social Stigmatization

ABSTRACT

Pigmentary disorders are prevalent around the world, but there are few large epidemiologic studies. We assessed the worldwide prevalence and impact of pigmentary disorders through an online survey of 48,000 adults in 34 countries. We also evaluated social stigmatization, respondents' QOL, and sun behavior/knowledge. A total of 50% of respondents had at ≥1 pigmentary disorder: solar lentigo (13,192 [27.5%]), axillary hyperpigmentation (8289 [17.2%)], postinflammatory hyperpigmentation (7126 [14.8%]), periorbital hyperpigmentation (7076 [14.7%]), vitiligo (3394 [7.1%]), and melasma (5237 [10.9%]). Among them, 9844 (42.9%) had physician diagnosis (including 8107 [35.3%] by a dermatologist), 4754 (20%) were self-diagnosed before the survey, and an additional 4735 (20.6%%) reported self-diagnosis of disease from survey definitions and digital images; 917 (4%) responded "other" (526 [2.3%]) or "prefer not to answer" (391 [1.7 %]). The disorders were frequently long lasting (mean duration ≥5 years in 15,442 [69.5%] of 22,220 respondents). There was a high self-reported impact on QOL and a high perception of social stigmatization. Knowledge of sun protection and photoprotective behaviors was suboptimal but was superior in individuals who had a hyperpigmentary disorder diagnosed by a healthcare professional. This large-scale, worldwide survey provides important data about pigmentary disorders and their strong impact on affected individuals.