From north to south: exploring Italian sun-exposure habits through the "Save your skin" campaign

Sun exposure is the main external risk factor for skin cancer, affecting melanoma and non-melanoma differently. Although increased awareness of sun-induced skin damage and appropriate photoprotection has helped to reduce melanoma incidence, inadequate sun protection persists, influenced by geographical, social, and cultural factors. Italy's varying climates -from the colder north to the warmer south- impact sun exposure behaviours. This study examined sun protection habits from the 2023 "Save your skin" campaign to identify at-risk groups and support targeted education. Participants completed anonymous questionnaires on sun exposure, sunscreen use, and skin cancer history. Among 1,773 participants, 45% spent 2-4 weeks per year in the sun on holiday, 26% experienced occupational sun exposure, and 33% used tanning beds. Despite darker skin types, only 26% tanned easily; severe sunburn rates were consistent across regions. Central and southern participants reported more sun exposure on holiday than northern participants (p < 0.001); work-related sun exposure was more common in the south. Tanning bed use was higher in the north (p < 0.001). Although 62.46% always used sunscreen, only 32.51% applied it correctly. Misconceptions about sunscreen were widespread, and actinic damage was more frequent among those with lower photoprotection awareness. Inadequate sun protection is widespread in Italy, with regional differences in sun exposure and tanning bed use. Misconceptions about sunscreen are common, and the rate of proper application is low. The higher incidence of actinic damage among those with less photoprotection knowledge highlights the need for targeted education to improve sun safety and reduce skin cancer risk.