Exploring Knowledge and Self-Care Practice Toward Skin Aging and Sun Protection among College Students in Sulaimani City-Iraq
Keywords:Skin Aging, Skin Cancer, Skin Care, Sunscreen
Several studies have been performed internationally to assess the understanding and self-care exercise of people in the direction of sun exposure and sun protection measures, as self-care is an essential pillar of public health. Nevertheless, limited data on these factors are available from the Middle East. The aim of this study was to investigate the students’ awareness of skin aging and sun-protection measures among college students. For this purpose, a cross-sectional questionnaire was specially designed; a random sample of the students in the different college of the University of Sulaimani was selected. Data were collected between January and May 2017. The relationship between the skin cancer awareness and different sociodemographic characteristics was produced by applying multiple logistic regressions. The questionnaires were distributed to 450 college students. A total of 413 questionnaires had been completely responded and covered within the data analysis, with a response rate of 91.7%. 41% of the respondents were females and 61.0% of the participants were aged between 18 and 21 years old. 47% have been privy to the association between sun exposure and skin aging. The respondents had been more likely to be aware of the connection between sun exposure and skin cancer (P < 0.03). The respondents from the third class of undergraduates were more likely to be familiar (P < 0.04). Staying under the shade during the outdoor activity was reported by more than 90% of our participants and is positioned as the most frequently used sun protection method.
 A. Vierkötter and J. Krutmann. “Environmental influences on skin aging and ethnic-specific manifestations”. Dermato-Endocrinology, vol. 4, no. 3, pp. 227-231, 2012.
 B. Gilchrest and J. Krutmann. Skin Aging. Springer, Berlin, 2006.
 R. Halder and C. Ara. “Skin cancer and photoaging in ethnic skin”. Dermatologic Clinics, vol. 21, no. 4, pp. 725-732, 2003.
 E. Yurtseven, T. Ulus, S. Vehid, S. Köksal, M. Bosat and K. Akkoyun. “Assessment of knowledge, behaviour and sun protection practices among health services vocational school students”. International Journal of Environmental Research and Public Health, vol. 9, no. 12, pp. 2378-2385, 2012.
 O. Tekbas, D. Evci, and U. Ozcan. “Danger increasing with approaching summer: Sun related UV rays”. TAF Preventive Medicine Bulletin, vol. 4, no. 2, pp. 98-107, 2005.
 K. AlGhamdi, A. AlAklabi and A. AlQahtani. “Knowledge, attitudes and practices of the general public toward sun exposure and protection: A national survey in Saudi Arabia”. Saudi Pharmaceutical Journal, vol. 24, no. 6, pp. 652-657, 2016.
 B. Armstrong and A. Kricker. “The epidemiology of UV induced skin cancer”. Journal of Photochemistry and Photobiology B: Biology, vol. 63, no. 1-3, pp. 8-18, 2001.
 R. MacKie. “Effects of ultraviolet radiation on human health”. Radiation Protection Dosimetry, vol. 91, no. 1, pp. 15-18, 2000.
 M. Mabruk, L. Toh, M. Murphy, M. Leader, E. Kay and G. Murphy. “Investigation of the effect of UV irradiation on DNA damage: Comparison between skin cancer patients and normal volunteers”. Journal of Cutaneous Pathology, vol. 36, no. 7, pp. 760-765, 2009.
 L. Scerri and M. Keefe. “The adverse effects of the sun on the skin–a review”. Maltese Medical Journal, 7, pp.26-31, 1995.
 P. Unna. The Histopathology of the Diseases of the Skin. Clay, Edinburgh, 1896.
 W. Dubreuills, Des Hyperkératoses Circonscrites. Masson, Paris, 1896.
 H. Daniell. “Smoker’s Wrinkles”. Annals of Internal Medicine, vol. 75, no. 6, pp. 873, 1971.
 E. Sherertz and S. Hess. “Stated Age”. New England Journal of Medicine, vol. 329, no. 4, pp. 281-282, 1993.
 A. Vierkötter, T. Schikowski, U. Ranft, D. Sugiri, M. Matsui, U. Krämer and J. Krutmann. “Airborne Particle Exposure and Extrinsic Skin Aging”. Journal of Investigative Dermatology, vol. 130, no. 12, pp. 2719-2726, 2010.
 T. Filiz, N. Cınar, P. Topsever and F. Ucar. “Tanning youth: Knowledge, behaviors and attitudes toward sun protection of high school students in Sakarya, Turkey”. Journal of Adolescent Health, vol. 38, no. 4, pp. 469-471, 2006.
 Y. Kaymak, O. Tekbaş and S. Işıl. “Knowledge, attitudes and behaviours of university students related to sun protection”. Journal of Turkish Dermatology, vol. 41, pp. 81-85, 2007.
 P. Cohen, H. Tsai and J. Puffer. “Sun-protective behavior among high-school and collegiate athletes in los angeles, CA”. Clinical Journal of Sport Medicine, vol. 16, no. 3, pp. 253-260, 2006.
 T. Owen, D. Fitzpatrick and O. Dolan. “Knowledge, attitudes and behaviour in the sun: The barriers to behavioural change in Nothhern Ireland”. The Ulster Medical Journal, vol.73, no. 2, pp. 96-104, 2004.
 A. Geller, L. Rutsch, K. Kenausis, P. Selzer and Z. Zhang. “Can an hour or two of sun protection education keep the sunburn away? Evaluation of the environmental protection agency’s sunwise school program”. Environmental Health, vol. 2, no. 1, pp. 1-9, 2003.
 R. Bränström, S. Kristjansson, H. Dal and Y. Rodvall. “Sun exposure and sunburn among Swedish toddlers”. European Journal of Cancer, vol. 42, no. 10, pp. 1441-1447, 2006.
 N. Sendur. “Nonmelanoma skin cancer epidemiology and prevention”. Turkiye Klinikleri Journal of Internal Medical Sciences, vol. 1, pp. 80-84, 2005.
 A. Ergin, I. Ali and I.B. Mehmet. “Assessment of knowledge and behaviors of mothers with small children on the effects of the sun on health”. The Pan African Medical Journal, vol. 4, pp. 72-78, 2011.
 A. Köktürk, K. Baz and R. Buğdaycı. “Dermatoloji polikliniğine başvuran hastalarda güneşten korunma bilinci ve alışkanlıkları”, Türk Klinical Dermatology, vol. 12, pp. 198-203, 2002.
 A. Al Robaee. “Awareness to sun exposure and use of sunscreen by the general population”. Bosnian Journal of Basic Medical Sciences, vol. 10, no. 4, pp. 314-318, 2010.
 S. Aquilina, A. Gauci, M. Ellul and L. Scerri. “Sun awareness in Maltese secondary school students”. Journal of the European Academy of Dermatology and Venereology, vol. 18, no. 6, pp. 670- 675, 2004.
 K. Wesson and N. Silverberg. “Sun protection education in the United States: What we know and what needs to be taught”. Cutis, vol. 71, pp. 71-74, 2003.
 E. Thieden, P. Philipsen, J. Heydenreich and H. Wulf. “UV radiation exposure related to age, sex, occupation, and sun behavior based on time-stamped personal dosimeter readings. Archives of Dermatology, vol. 140, no. 2, 2004.
 V. Nikolaou, A. Stratigos, C. Antoniou, V. Sypsa, G. Avgerinou, I. Danopoulou, E. Nicolaidou and A. Katsambas. “Sun exposure behavior and protection practices in a Mediterranean population: A questionnaire-based study”. Photodermatology, Photoimmunology and Photomedicine, vol. 25, no. 3, pp. 132-137, 2009.