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Understanding factors that influence people to use sunscreen would allow clinicians to counsel patients in a way that is influential. Perceived efficacy of sunscreen has been associated with sunscreen use, but it is unclear whether the degree of efficacy is important.To determine whether larger perceived efficacy of sunscreen (larger skin cancer risk reduction) is associated with increased sunscreen use.A cohort of 131 patients with a history of skin cancer visiting a Mohs micrographic surgery center were surveyed.Participants believed sunscreen would reduce their risk of basal cell carcinoma (BCC) by 61.1% (95% confidence interval [CI] = 56.4–65.9), squamous cell carcinoma (SCC) by 59.4% (95% CI = 54.6–64.2), and melanoma by 59.5% (95% CI = 54.8–64.3). Perceived magnitude of risk reduction of BCC, SCC, and melanoma was significant independent predictors of sunscreen use (BCC: odds ratio [OR] 3.5, 95% CI 1.1–11.2, p = .04. Squamous cell carcinoma: OR 2.8, 95% CI 1.0–7.6, p = .05. Melanoma: OR 5.0, 95% CI 1.8–14.2, p = .002).Larger perceived skin cancer (BCC, SCC, and melanoma) risk reduction was associated with increased sunscreen use.