Abstract
Objective
Melasma is a common facial hyperpigmentation disorder with substantial psychosocial burden, yet patient-centered knowledge, attitudes, and practices (KAP) remain insufficiently characterized. To investigate the levels of knowledge, attitudes, and practices (KAP) regarding melasma among female patients.
Methods
This cross-sectional study was conducted in Dali, Yunnan Province between June 20, 2024 and November 13, 2025. Data were collected using a self-designed, Chinese-language online questionnaire distributed via the Questionnaire Star (Wenjuanxing) mini-program on WeChat.
Results
A total of 518 valid questionnaires were included. Most participants were aged 31–50 years (67.0%), lived in urban areas (62.9%), and had a bachelor’s degree or above (48.8%). Mean (SD) scores were 8.92 (3.80) for knowledge (possible range: 0–18), 22.97 (5.06) for attitude (8–40), and 20.30 (3.88) for practice (7–35). Structural equation modeling showed that knowledge was directly associated with attitude (
β
= 0.153,
p
= 0.002) and practice (
β
= 0.492,
p
β
= 0.357,
p
β
= 0.054,
p
= 0.002). Multivariate logistic regression identified rural/suburban residence (OR = 0.546, 95%CI 0.363–0.820) and never using sun protection (OR = 0.384, 95%CI 0.176–0.837) as independent predictors of lower knowledge, whereas prior treatment-seeking predicted higher knowledge (OR = 2.079, 95%CI 1.230–3.515). Each one-point increase in knowledge score (OR = 1.150, 95% CI 1.081–1.223,
p
p
r
= 0.145–0.390, all
p
≤ 0.001).
Conclusion
Participants demonstrated knowledge scores below the scale midpoint, attitude scores in the lower half of the possible range, and practices indicating infrequent routine monitoring and active information seeking. Feasible improvements may include structured, photoprotection-centered education with brief standardized counseling and digital follow-up, prioritizing groups with low sun-protection use and rural/suburban residence to improve long-term self-management behaviors.