TO DETERMINE THE TREATMENT TRENDS OF MELASMA AMONG DIFFERENT AGE GROUPS IN OUR POPULATION Questionnaire

BATCH: B1a Roll number: 89-91 Names of students: 89. Azra Parveen 90. Eesha Aziz 91. Fatima Anwer 92. Habiba Noreen 93. Anum Kabir 94. Javaria Anwer 95. Ammara Aslam 96. Anum Waqar 97. Sadaf Sajid 98. Syeda Fatima Hassan

Dear Sir, We are conducting this survey to know about the different treatment trends of melasma in our population. This will allow us to better understand the treatment options of melasma, so that we can conclude which treatment has best efficacy. You are kindly requested to fill this questionnaire which will take about 15 minutes of your time only, but will be a great help to our efforts to improve the treatment of melasma. This is an anonymous survey, and all the information you provide will be kept strictly confidential. Please answer All the questions, and mark 4 the correct response. Thanks for your cooperation and participation in the survey. ______________________________________________________________________________

1. Age: _______________ (Years) 2. Sex:

Male Female

3. What is your marital status? 4. What is your education level?

5. Occupation:

Never married Married Divorced Primary or Less Intermediate High School University or above
Student Government job Private job

Widow

House wife Business Other (please specify) _____________

4. What is the total monthly Household Income from all sources (Rupees):
< 10,000 31,000-40,000 10,000-20,000 >40,000 21,000-30,000

5. How long have you been diagnosed with melasma?

Less than 1 month 1-6 month Up to a year More than a year

6. When did you plan to take some treatment for melasma?

Immediately after developing it After few weeks after developing it After few months after developing it After few years after developing it Any other (specify)_____________

7. Why did you want to treat this? Social pressure you wanted to look good 8. Did you use home remedies for its treatment? If YES then:

you thought of it as a disease to be treated if any other(give details)__________

Yes

No

a) What type of things did you use? Besan Egg Yogurt Mixture of these b) For how long did you use this? Days Weeks c) Did you follow this treatment? Regularly d) What effect did it have? No effect Worsen 9. Did you go to any beautician for its treatment? If YES then:

If any other(give detail)

__________
Months If any other (specify)____________ Irregularly Better Completely recovered

Yes

No

a) What procedure did you get?

Steam Once Twice Regularly Facial Thrice 4 times If other (specify)________ If other (specify)____________

b) How many times did you get that procedure?

c) How did you follow this treatment?

Irregularly Better Completely recovered

d) What effect did it have?

No effect Worsen

10. Did you go to any hakeem for its treatment? Yes No If YES then, give details __________________________ a) For how long did you use this? Days Months Weeks If any other (specify)____________ b) How did you follow this treatment? Regularly Irregularly c) What effect did it have? No effect Better Worsen Completely recovered 11. Did you use any special soap for it? Yes No If YES then: a) Which type of soap did you use? Beauty soap Face wash Anti bacterial soap If any other (name please)__________ b) For how long did you use this? 1-3 week 6 month- 1 year If any other Less than 6 week More than a year (specify)___________ c) Do you think it was affective? Yes No 12. Are you aware of the role of sun block or avoidance of direct sunlight in prevention of Melasma? Yes No 13. Do you use any sun block for it? If YES then: a) How did you use it? Regularly b) Do you think it was affective? Yes

Yes

No

Irregularly No

14. Did you use any fairness cream for it? Yes If YES then: Name please___________________ a) For how long did you use this? Days Weeks b) How did you follow this treatment? Regularly

No

Months If any other (specify)____________ Irregularly

c) What effect did it have? No effect Worsen 15. Did you use any bleaching agent for it? Yes If YES then, give details______________________ a) For how many times did you get it? once thrice twice 4 times b) Did you follow this treatment Regularly c) What effect did it have? No effect Worsen

Better Completely recovered

No

If any other

(specify)____________
Irregularly Better Completely recovered

16. Did you use any over the counter steroid cream like betnovate, dermovate etc for it? Yes No If YES then: a) For how long did you use this? Days Months Weeks If any other (specify)____________ b) How did you follow this treatment? Regularly Irregularly c) What effect did it have? No effect Better Worsen Completely recovered 17. Did you use any mixture for creams for it? Yes No If YES then, name please: 1. _____________ 3. _____________ 5. _____________ 2._____________ 4. _____________ a) For how long did you use this? Days Months Weeks If any other (specify)____________ b) How did you follow this treatment? Regularly Irregularly c) What effect did it have? No effect Better Worsen Completely recovered 18. Did you go to any General Medical Practitioner (MBBS) for its treatment? Yes No If YES then: a) Which type of treatment did you get? Topical Name the drugs ( if you remember Oral any)___________ b) For how long did you use this? Days Months Weeks If any other (specify)____________ c) How did you follow this treatment? Regularly Irregularly d) What effect did it have? No effect Worsen

 Better

Completely recovered

19. Did you go to any skin specialist for its treatment? Yes No If YES then a) When did you first visit skin specialist after appearance of melasma? Immediately After few months After few weeks After few years b) Which type of treatment did you get? Topical Name the drugs ( if you remember Oral any)___________ c) For how long did you use this? Days Months Weeks If any other (specify)____________ d) How did you follow this treatment? Regularly Irregularly e) What effect did it have? No effect Better Worsen Completely recovered 20. Have you ever got a laser treatment for this? Yes No If YES then, give details________________ a) How many times did you get it? once 4 times twice If any other (specify)____________ thrice b) How did you follow this treatment? Regularly Irregularly c) What effect did it have? No effect Better Worsen Completely recovered 21. Have you ever got Chemical Peeling? Yes No If YES then, give details________________ a) How many times did you get it? Once Thrice If any other Twice 4 times (specify)____________ b) Did you follow this treatment Regularly Irregularly c) What effect did it have? No effect Better Worsen Completely recovered 22. Did you follow your Melasma treatment plan by the skin specialist regularly? Yes No 23. What reason would you give for not completing your treatment course? None, Completed my treatment course Long duration of treatment Side effects of topical drugs If any other (give details)____________ Expense of treatment 24. With which type of treatment your compliance was more? (Check ALL that apply) Self medication Homeopathic Dermatologist

 Home remedies Laser treatment Beautician Hakeem Other (Please specify)____________

General practitioner Chemical peeling

25. Which treatment has the best efficacy according to you? (Please answer just one) Self medication Home remedies Hakeem Homeopathic Beautician General practitioner Dermatologist Laser treatment Chemical peeling Other (Please specify)____________

Thank You!