II. Technique
- Use Sunscreen with SPF of 15 or higher
- SPF 15-30 is typically sufficient protection
- SPF above 50 is unlikely to provide additional benefit
- No added protection or prolonged duration of activity
- Use Sunscreen that blocks UVA and UVB
- Most current Sunscreens block UVB
- SPF rating does not apply to UVA
- "Broad spectrum" denotes protection for both UVA and UVB
- Zinc Oxide
- Titanium Dioxide
- Drometrizole trisiloxane (Mexoryl)
- Shake Sunscreen well before using
- Avoid spraying Sunscreen on face
- Risk of inhalation
- Spray Sunscreen onto hands and then apply to face
- Wear Sunscreen on all outdoor daylight exposures
- Cloudy days: 80% UV radiation penetrates clouds
- Swimming: 50% UV radiation penetrates water
- High altitude (UVB increases 8-10% per 1000 feet)
- Exposure to snow or water (reflective surface)
- Apply 2-3 tablespoons (1 ounce) of Sunscreen for whole body
- Do not forget around eyes, ears and mouth
- Apply to scalp if bald or hair thinning
- Apply Sunscreen 15 minutes before exposure and then every 2 hours (regardless of SPF)
- Reapply Sunscreen every 1 hour when sweaty or wet
- Water resistant (or water proof) sun screens require the same frequent replacement when wet
- Protect babies and children well from Sun Exposure
- Keep infants under 6 months in shade or covered
- If unable to keep out of sunlight, use a physical Sunscreen
- Apply Zinc Oxide or Titanium Dioxide containing Sunscreen for maximal protection
- Replace old Sunscreens
- Changed colors
- Significantly past their expiration dates (esp. if exposed to Temperature extremes)
- Protective Clothing
- Covering skin with Ultraviolet Protection Factor (UPF) Clothing also offers sun protection
III. Physiology
- Sun Protection Factor (SPF) ratio
- Time to produce slight erythema on suncreened skin to
- Time to produce same erythema without Sunscreen
- SPF Interpretation
- "Broad spectrum" denotes protection for both UVA and UVB
- SPF gives no information on Ultraviolet A protection
- SPF reflects protection from UVB Light
- SPF 15 blocks 93% of UVB
- SPF 30 blocks 97% of UVB
- SPF 50 blocks 98% of UVB
IV. Preparations: Chemical or Organic Sunscreens
- Avobenzone (Parsol 1789)
- Absorbs both short and long wavelength Ultraviolet A
- Does not absorb Ultraviolet B (UVB)
- May be degraded by sunlight exposure
- Menthyl Anthranilate
- Absorbs shorter wave length Ultraviolet A
- Oxybenzone
- Absorbs shorter wave length Ultraviolet A
- Banned in Hawaii as of 2021 due to adverse effects to ocean wildlife (coral bleaching, reproduction)
- Octinoxate
- Absorbs UVB
- Banned in Hawaii as of 2021 due to adverse effects to ocean wildlife (coral bleaching, reproduction)
V. Preparations: Physical, Mineral or Inorganic opaque compounds (scatter light)
- Types
- Titanium Dioxide
- Zinc Oxide
- Nanoparticles
- All physical Sunscreens are classified as nanoparticle, even if they are advertised as "non-nano"
- None of the physical Sunscreens are absorbed through the skin regardless of size (nano or "non-nano")
- Nanoparticle Sunscreens are typically easier to apply
- Nanoparticle size may have environmental impact, but the effects are not currently known
VI. Efficacy
- Reduced with wind, heat, humidity, and altitude
- Reduced with poor or inadequate application
- Most persons do not apply enough Sunscreen
- Multiple layers required to reach listed SPF
- Reduces Incidence of Actinic Keratoses
- Decreases photoaging
VII. Safety
- Regular Sunscreen use does NOT result in Vitamin D Deficiency
- Oxybenzone, Zinc Oxide and Titanium Dioxide are safe on skin
- Absorption
- None of the physical Sunscreens are absorbed through the skin
- Some of the chemical Sunscreens may be absorbed through the skin
- No known related safety concerns, but further research is ongoing (see link below)
- Known risk of Sunburn and Skin Cancer outweighs the potential risk of Sunscreen aborption
- Matta (2020) JAMA 323(3):256-67 +PMID: 31961417 [PubMed]
VIII. Drug Interactions
- Apply Sunscreen at least 15 to 30 minutes after applying Topical Medications
IX. Resources
- FDA Consumer update on Sunscreens and possible absorption
X. References
- (2020) Presc Lett 27(7): 41
- (2018) Presc Lett 25(7): 39
- (2013) Presc Lett 20(7): 41-2
- Potera (1997) Physician and Sports Med 25(5):117-20
- (1999) Med Lett Drugs Ther, 41(1052): 43-4 [PubMed]
- Wentzell (1996) Am Fam Physician 53(5):1713-19 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| zinc oxide (on 3/22/2023 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ZINC OXIDE 20% OINTMENT | Generic OTC | $0.06 per gram |
Ontology: Sunscreening Agents (C0038818)
| Definition (NCI_NCI-GLOSS) | A substance that helps protect the skin from the sun's harmful rays. Sunscreens reflect, absorb, and scatter both ultraviolet A and B radiation to provide protection against both types of radiation. Using lotions, creams, or gels that contain sunscreens can help protect the skin from premature aging and damage that may lead to skin cancer. |
| Definition (MSH) | Chemical or physical agents that protect the skin from sunburn and erythema by absorbing or blocking ultraviolet radiation. |
| Definition (CSP) | substance applied to the skin to protect it from the effects of sunlight; sunscreens act by absorbing ultraviolet radiation or by reflecting the incident light. |
| Concepts | Substance (T167) |
| MSH | D013473 |
| SnomedCT | 256169000, 49663007, 373498003 |
| English | Agents, Sunscreening, Sunscreens, Sunscreen agents, sun screens (medication), sun screens, sunscreen agents, sunscreen, Sunscreening Agents, Sunscreen agents (substance), Sunscreen, Sunscreening preparations, Sunscreen agent (product), Sunscreen agent (substance), Sunscreen agent, Sunscreen agent, NOS, Sunscreen, NOS, Sunblock, sunscreens |
| French | Écrans solaires, Protecteurs solaires, Produits antisolaires |
| Swedish | Solskyddsmedel |
| Czech | krémy na opalování, přípravky chránící proti slunci |
| Finnish | Aurinkosuojavoiteet |
| Russian | SOLNTSEZASHCHITNYE SREDSTVA, СОЛНЦЕЗАЩИТНЫЕ СРЕДСТВА |
| Polish | Środki przeciwsłoneczne, Ekrany przeciwsłoneczne, Substancje chroniące przed słońcem, Środki fotoprotekcyjne, Filtry przeciwsłoneczne |
| Japanese | サンスクリーン, 日焼け止め, 日やけ止め, 日焼け止めクリーム, 遮光剤, サンスクリーン剤, 遮光化粧料 |
| Portuguese | Protetores Solares, Agentes Protetores de Raios Solares, Protetores de Raios Solares |
| Spanish | Protectores Solares, pantallas solares (sustancia), pantallas solares, Protectores de Rayos Solares, Agentes Protectores de Rayos Solares, pantalla solar (producto), pantalla solar (sustancia), pantalla solar, sustancia (sustancia), pantalla solar, sustancia, pantalla solar |
| German | Sonnenschutzmittel |
| Italian | Protettivi solari |
Ontology: Zinc Oxide (C0043491)
| Definition (NCI_NCI-GLOSS) | A compound that may enhance immune function, especially when administered by inhalation. |
| Definition (MSH) | A mild astringent and topical protectant with some antiseptic action. It is also used in bandages, pastes, ointments, dental cements, and as a sunblock. |
| Concepts | Pharmacologic Substance (T121) , Inorganic Chemical (T197) |
| MSH | D015034 |
| SnomedCT | 332177006, 398971002, 42841002 |
| English | Lassar Paste, Lassar's Paste, Lassars Paste, Oxide, Zinc, Paste, Lassar's, Zinc Oxide, Zinc oxide (ZnO), C.I. Pigment White 4, Lassar's paste, zinc oxide, mineral supplements zinc oxide, zinc oxide (medication), sun screens zinc oxide, sunscreen with zinc oxide (medication), sunscreen with zinc oxide, ZINC OXIDE, Zinc Oxide [Chemical/Ingredient], lassar's paste, oxide zinc, as zinc oxide, ZINC Oxide, Zinc oxide, Zinc oxide (product), Zinc oxide (substance), ZnO, ZINC (AS OXIDE) |
| French | Oxyde de zinc |
| Swedish | Zinkoxid |
| Czech | oxid zinečnatý |
| Finnish | Sinkkioksidi |
| Russian | TSINKA OKIS', TSINKA OKSID, ЦИНКА ОКИСЬ, ЦИНКА ОКСИД |
| Spanish | Óxido de Zinc, Óxido de Cinc, óxido de cinc (producto), óxido de cinc (sustancia), óxido de cinc, óxido de zinc |
| Italian | Pasta di Lassar, Ossido di zinco |
| Polish | Biel cynkowa, Tlenek cynkowy |
| Japanese | 酸化亜鉛, 亜鉛華 |
| Norwegian | Sinkoksyd |
| German | Zinkoxid |
| Portuguese | Óxido de Zinco |
Ontology: Octinoxate (C0046100)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C118580 |
| SnomedCT | 12695000, 256173002 |
| English | 2-Ethylhexyl-p-methoxycinnamat, octyl-methoxycinnamate, Octinoxate, octylmethoxycinnamate, octylmethoxycinnamate [Chemical/Ingredient], OCTINOXATE, octinoxate, octyl methoxycinnamate, Octyl methoxycinnamate (substance), Octyl methoxycinnamate, 2-Ethylhexyl-p-methoxycinnamate, 2-Ethylhexyl-p-methoxycinnamate (substance), OMC cinnamate, OCTYL METHOXYCINNAMATE, 2-ethylhexyl-4-methoxycinnamate, 2-ethylhexyl-p-methoxycinnamate |
| Spanish | octilmetoxicinamato, octilmetoxicinamato (sustancia), 2-etilhexil-p-metoxicinamato (sustancia), 2-etilhexil-p-metoxicinamato |
Ontology: oxybenzone (C0069803)
| Definition (NCI) | A benzophenone derivative used as a sunscreen agent. Oxybenzone absorbs UVB and UVA II rays, resulting in a photochemical excitation and absorption of energy. Upon return to ground state, the absorbed energy results in emission of longer wavelength radiation and decreased skin penetration of radiation which reduces the risk of DNA damage. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C005290 |
| SnomedCT | 256175009, 256181001, 255934009, 255882004, 72179002 |
| English | 2-hydroxy-4-methoxybenzophenone, oxybenzone, benzophenone-3, 2-Hydroxy-4-methoxy-benzophenone, 2-Hydroxy-4-methoxybenzophenon, 2-OH-4-methoxy-benzophenone, Anuvex, Benzophenone-3, 2-Hydroxy-4-methoxybenzophenone,[2-Hydroxy-4-methoxyphenyl]phenylmethanone, HMBP cpd, oxybenzone [Chemical/Ingredient], OXYBENZONE, benzophenone 3, Oxybenzone, 2-Hydroxy-4-methoxybenzophenone, Oxybenzone (substance), Oxybenzone [dup] (substance), BENZOPHENONE-3 |
| Spanish | oxibenzona (sustancia), oxibenzona |
Ontology: titanium dioxide (C0076733)
| Concepts | Pharmacologic Substance (T121) , Inorganic Chemical (T197) |
| MSH | C009495 |
| SnomedCT | 432929006, 62036000 |
| English | titanium dioxide, titanium oxide, Titanium dioxide (product), Pigment White 6, Titanium White, Titanium(IV) Oxide, titanium dioxide [Chemical/Ingredient], TITANIUM DIOXIDE, Titanium Dioxide, dioxide titanium, titanium dioxde, TITANIUM dioxide, Titanium dioxide, Titanium dioxide (substance) |
| Spanish | dióxido de titanio (producto), dióxido de titanio (sustancia), dióxido de titanio |
Ontology: avobenzone (C0097513)
| Definition (NCI) | A sunscreen blocker. Avobenzone is a topical, broad range UV protector and blocks UVA I, UVA II, and UVB wavelengths, thereby limiting the impact of UV rays on skin. (NCI05) |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C049935 |
| SnomedCT | 256171000, 422621002 |
| English | 4-tert-butyl-4'-methoxydibenzoylmethane, avobenzone, 4-tert-But-4'-meth-dibenzlmete, Avobenzone (Obsolete), 1-(4-(1,1-Dimethylethyl)phenyl)-3-(4-methoxyphenyl)-1,3-propanedione, 1-(p-tert-Butylphenyl)-3-(p-methoxyphenyl)-1,3-propanedione, Avobenzone, Avobenzone (product), 4-tert-butyl-4'-methoxydibenzoylmethane [Chemical/Ingredient], AVOBENZONE, Butyl methoxydibenzoylmethane, 4-tertiary-Butyl-4'-methoxy-dibenzoylmethane, 4-tertiary-Butyl-4'-methoxy-dibenzoylmethane (substance) |
| Spanish | avobenzona (producto), avobenzona, 4-terbutil-4-metoxi-dibenzoilmetano (sustancia), 4-terbutil-4-metoxi-dibenzoilmetano |
Ontology: meradimate (C0304629)
| Concepts | Organic Chemical (T109) |
| MSH | C413549 |
| SnomedCT | 46491005 |
| English | meradimate, MERADIMATE, Meradimate, Cyclohexanol, 5-Methyl-2-(1-Methylethyl)-, 2-Aminobenzoate, Menthyl Anthranilate, Anthranilic Acid, P-Menth-3-yl Ester, menthyl anthranilate, Menthyl anthranilate, Menthyl anthranilate (substance) |
| Spanish | mentilantranilato (sustancia), mentilantranilato |
Ontology: Sun protection factor (C0796617)
| Definition (MSH) | A measure of relative protection provided by SUNSCREENING AGENTS against burns due to ultraviolet (UV) radiation from a light source. |
| Definition (NCI_NCI-GLOSS) | A scale for rating the level of sunburn protection in sunscreen products. The higher the sun protection factor, the more sunburn protection it gives. Sunscreens with a value of 2 through 11 give minimal protection against sunburns. Sunscreens with a value of 12 through 29 give moderate protection. Sun protection factors of 30 or higher give high protection against sunburn. |
| Concepts | Quantitative Concept (T081) |
| MSH | D059405 |
| English | Sun protection factor, spf, sun protection factor (SPF), Factors, Sun Protection, Sun Protection Factor, Sun Protection Factors, Factor, Sun Protection, Protection Factor, Sun, Protection Factors, Sun, sun protection factor, SPF |
| French | Facteur de protection solaire, Indice de protection solaire |
| Portuguese | Fator de Proteção Solar |
| Russian | SOLNTSEZASHCHITNYE FAKTORY, СОЛНЦЕЗАЩИТНЫЕ ФАКТОРЫ |
| Spanish | Factor de Protección Solar |
| Czech | ochranný sluneční faktor, SPF |
| Polish | Czynnik ochrony przeciwsłonecznej, Czynnik SPF |
| Italian | Fattore di protezione solare, Indice di protezione solare |
| German | Lichtschutzfaktor |
| Norwegian | Solbeskyttelsesfaktor, Solfaktor |
Ontology: drometrizole (C0910661)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C401764 |
| English | drometrizole, Drometrizole, DROMETRIZOLE |
