{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T13:12:27Z","timestamp":1788873147745,"version":"build-2803163510"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100009157","name":"National Institute on Disability, Independent Living, and Rehabilitation Research","doi-asserted-by":"publisher","award":["90DPBU0007"],"award-info":[{"award-number":["90DPBU0007"]}],"id":[{"id":"10.13039\/100009157","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Burned skin remains highly sensitive to UV radiation for years after injury, increasing the risk of damage, pigmentary changes, and carcinogenesis. Although sun protection is crucial, many burn survivors are unsure of necessary measures or how to incorporate them into daily life. This study evaluated survivors\u2019 knowledge and use of sun protection to inform future educational efforts. A cross-sectional survey was conducted at a Level 1 American Burn Association (ABA)-verified burn center from June to September 2025. Adult burn patients attending outpatient clinic visits completed a 7-item survey assessing sunscreen use on burn scars, type of sunscreen used, and barriers to adherence. A total of 50 patients were surveyed. The majority of patients were English-speaking (n\u2009=\u200935, 70%). On a scale of 0-10, with 10 being the most important, 68% (n\u2009=\u200934) of patients rated their perceived importance of sunscreen use on burn scars between 7 and 10, but only 28% (n\u2009=\u200914) applied it to healed burn wounds. Sunscreen use on scars was significantly lower among Spanish-speaking patients (6.7%) compared to English-speaking patients (37.1%) (P\u2009=\u2009.04). The most common reasons for not applying sunscreen were a lack of awareness (n\u2009=\u200913, 36%) and the belief that it was not necessary (n\u2009=\u20099, 25%). Over half of the participants (n\u2009=\u200929, 58%) reported that their healthcare team had not informed them of sunscreen use at prior appointments. Despite recognizing its importance, many burn survivors do not consistently practice sun protection, suggesting a need for reinforced education strategies to improve long-term skin protection.<\/jats:p>","DOI":"10.1093\/jbcr\/irag093","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T11:20:35Z","timestamp":1781695235000},"page":"1543-1548","source":"Crossref","is-referenced-by-count":0,"title":["A Gap in Knowledge: Patient Perspectives and Barriers to Sunscreen Use After Burn Injury"],"prefix":"10.1093","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7956-2393","authenticated-orcid":false,"given":"Sarah","family":"Wang","sequence":"first","affiliation":[{"name":"Keck School of Medicine, University of Southern California , Los Angeles, CA 90033 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1217-8468","authenticated-orcid":false,"given":"Dania","family":"Johnson","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California , Los Angeles, CA 90033 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Flores","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine , Los Angeles, CA 90033 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9630-1988","authenticated-orcid":false,"given":"Karel-Bart","family":"Celie","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine , Los Angeles, CA 90033 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina H","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Keck School of Medicine, University of Southern California , Los Angeles, CA 90033 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9410-6030","authenticated-orcid":false,"given":"Justin","family":"Gillenwater","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine , Los Angeles, CA 90033 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxwell B","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine , Los Angeles, CA 90033 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8230-1565","authenticated-orcid":false,"given":"Haig A","family":"Yenikomshian","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, Keck School of Medicine , Los Angeles, CA 90033 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"2026090808594409800_ref1","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1016\/S0094-1298(20)30958-5","article-title":"Skin care of the healed burned patient","volume":"19","author":"Poh-Fitzpatrick","year":"1992","journal-title":"Clin Plast Surg"},{"key":"2026090808594409800_ref2","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1097\/BCR.0000000000000224","article-title":"A primer on pigmentation","volume":"36","author":"Greenhalgh","year":"2015","journal-title":"J Burn Care Res Off Publ Am Burn Assoc"},{"key":"2026090808594409800_ref3","volume-title":"Sun Protection after Burn Injury | MSKTC"},{"key":"2026090808594409800_ref4","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.addr.2017.10.010","article-title":"Restoration of skin pigmentation after deep partial or full-thickness burn injury","volume":"123","author":"Dai","year":"2018","journal-title":"Adv Drug Deliv Rev"},{"key":"2026090808594409800_ref5","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1007\/s40257-021-00632-5","article-title":"Sunscreens and photoaging: a review of current literature","volume":"22","author":"Guan","year":"2021","journal-title":"Am J Clin Dermatol"},{"key":"2026090808594409800_ref6","doi-asserted-by":"publisher","first-page":"E1802","DOI":"10.1503\/cmaj.201085","article-title":"The efficacy and safety of sunscreen use for the prevention of skin cancer","volume":"192","author":"Sander","year":"2020","journal-title":"CMAJ Can Med Assoc J"},{"key":"2026090808594409800_ref7","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1111\/jdv.19677","article-title":"Photoprotection: current developments and controversies","volume":"38","author":"Pellacani","year":"2024","journal-title":"J Eur Acad Dermatol Venereol JEADV"},{"key":"2026090808594409800_ref8","volume-title":"Sun Protection"},{"key":"2026090808594409800_ref9","doi-asserted-by":"publisher","first-page":"19","DOI":"10.2165\/0128071-200910001-00004","article-title":"Role of UV light in photodamage, skin aging, and skin cancer: importance of photoprotection","volume":"10","author":"Gonzaga","year":"2009","journal-title":"Am J Clin Dermatol"},{"key":"2026090808594409800_ref10","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1001\/jamadermatol.2013.4741","article-title":"Trends in sunscreen recommendation among US physicians","volume":"150","author":"Akamine","year":"2014","journal-title":"JAMA Dermatol"},{"key":"2026090808594409800_ref11","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1080\/09546634.2019.1587147","article-title":"Assessing factors affecting sunscreen use and barriers to compliance: a cross-sectional survey-based study","volume":"31","author":"Weig","year":"2020","journal-title":"J Dermatol Treat"},{"key":"2026090808594409800_ref12","doi-asserted-by":"publisher","first-page":"2199","DOI":"10.1158\/1055-9965.EPI-10-0196","article-title":"Mei, et\u00a0al. predictors of sun protection behaviours and severe sunburn INAN international on-line study","volume":"19","author":"Br\u00e4nstr\u00f6m","year":"2010","journal-title":"Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol"},{"key":"2026090808594409800_ref13","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1007\/s00403-020-02123-9","article-title":"Effects of health beliefs, social support, and self-efficacy on sun protection behaviors among medical students: testing of an extended health belief model","volume":"313","author":"Pearlman","year":"2021","journal-title":"Arch Dermatol Res"},{"key":"2026090808594409800_ref14","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.1016\/j.jaad.2010.10.002","article-title":"Sun protection behaviors of melanoma survivors","volume":"66","author":"Mayer","year":"2012","journal-title":"J Am Acad Dermatol"},{"key":"2026090808594409800_ref15","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1001\/archderm.141.8.978","article-title":"Sunscreen use before and after transplantation and assessment of risk factors associated with skin cancer development in renal transplant recipients","volume":"141","author":"Moloney","year":"2005","journal-title":"Arch Dermatol"},{"key":"2026090808594409800_ref16","doi-asserted-by":"publisher","first-page":"285","DOI":"10.4103\/ijd.IJD_609_17","article-title":"Knowledge and attitude of general population toward effects of sun exposure and use of sunscreens","volume":"63","author":"Agarwal","year":"2018","journal-title":"Indian J Dermatol"},{"key":"2026090808594409800_ref17","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1111\/j.1365-2133.2012.11213.x","article-title":"Factors affecting sunscreen use and sun avoidance in a U.S. National Sample of organ transplant recipients","volume":"168","author":"Mihalis","year":"2013","journal-title":"Br J Dermatol"},{"key":"2026090808594409800_ref18","volume-title":"Patients & Families | UW Health"},{"key":"2026090808594409800_ref19","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1186\/1471-2458-12-985","article-title":"Sun protection and exposure behaviors among Hispanic adults in the United States: differences according to acculturation and among Hispanic subgroups","volume":"12","author":"Coups","year":"2012","journal-title":"BMC Public Health"},{"key":"2026090808594409800_ref20","doi-asserted-by":"publisher","first-page":"161960","DOI":"10.1155\/2014\/161960","article-title":"Sun protection beliefs among Hispanics in the US","volume":"2014","author":"Santiago-Rivas","year":"2014","journal-title":"J Skin Cancer"},{"key":"2026090808594409800_ref21","first-page":"35","article-title":"Patient knowledge of sunscreen guidelines and frequency of physician counseling","volume":"11","author":"Vasicek","year":"2018","journal-title":"J Clin Aesthetic Dermatol"},{"key":"2026090808594409800_ref22","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1001\/archdermatol.2010.421","article-title":"Spanish-speaking patient health educational preferences","volume":"147","author":"Hernandez","year":"2011","journal-title":"Arch Dermatol"},{"key":"2026090808594409800_ref23","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1097\/01.BCR.0000095516.98523.04","article-title":"Effects of enhanced patient education on compliance with silicone gel sheeting and burn scar outcome: a randomized prospective study","volume":"24","author":"So","year":"2003","journal-title":"J Burn Care Rehabil"},{"key":"2026090808594409800_ref24","doi-asserted-by":"publisher","first-page":"S153","DOI":"10.1093\/jbcr\/irad045.218","article-title":"743 educate before you operate: improving the informed consent process","volume":"44","author":"Piatkowski","year":"2023","journal-title":"J Burn Care Res Off Publ Am Burn Assoc"}],"container-title":["Journal of Burn Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jbcr\/advance-article-pdf\/doi\/10.1093\/jbcr\/irag093\/68541898\/irag093.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbcr\/article-pdf\/47\/5\/1543\/68541898\/irag093.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbcr\/article-pdf\/47\/5\/1543\/68541898\/irag093.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:59:52Z","timestamp":1788872392000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbcr\/article\/47\/5\/1543\/8709851"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":24,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,6,17]]},"published-print":{"date-parts":[[2026,9,8]]}},"URL":"https:\/\/doi.org\/10.1093\/jbcr\/irag093","relation":{},"ISSN":["1559-047X","1559-0488"],"issn-type":[{"value":"1559-047X","type":"print"},{"value":"1559-0488","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,6,17]]}}}