American Journal of Clinical Dermatology

, Volume 18, Issue 5, pp 643–650 | Cite as

Sunscreens: An Update

  • Jennifer Brescoll Mancuso
  • Rohit Maruthi
  • Steve Q. Wang
  • Henry W. LimEmail author
Review Article


Sunscreens have been widely used by the general public for their photoprotective properties, including prevention of photocarcinogenesis and photoaging and management of photodermatoses. It is important to emphasize to consumers the necessity of broad-spectrum protection, with coverage of both ultraviolet A (320–400 nm) and ultraviolet B (290–320 nm) radiation. This review discusses the benefits of sunscreen, different ultraviolet filters, sunscreen regulations and controversies, the importance of broad-spectrum protection, issues of photostability and formulation, and patient education and compliance.


Zinc Oxide Critical Wavelength Oxybenzone Avobenzone Sunscreen Application 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with Ethical Standards

Conflicts of interest

Henry W. Lim has received research grants from Clinuvel, Estée Lauder, Ferndale, and Allergan and consulting fees from Pierre Fabre, Ferndale, Uriage, Sanofi, and Johnson & Johnson. Steve Wang has been a consultant for Ferndale and Neutrogena. Rohit Maruthi and Jennifer Brescoll Mancuso have no conflicts of interest.


No funding was received for the preparation of this review.


  1. 1.
    Osterwalder U, Herzog B. Chemistry and properties of organic and inorganic UV filters. In: Lim HW, Draelos ZD, editors. Clinical guide to sunscreens and photoprotection. New York: Informa Healthcare USA; 2009. p. 11–38.Google Scholar
  2. 2.
    Marrot L, Meunier JR. Skin DNA photodamage and its biological consequences. J Am Acad Dermatol. 2008;58(5):S139–48.CrossRefPubMedGoogle Scholar
  3. 3.
    American Cancer Society. Cancer facts and figures. Atlanta: ACS; 2016. p. 1–72.Google Scholar
  4. 4.
    Green AC, Williams GM, Logan V, et al. Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol. 2011;29(3):257–63.CrossRefPubMedGoogle Scholar
  5. 5.
    van der Pols JC, Williams GM, Pandeya N, et al. Prolonged prevention of squamous cell carcinoma of the skin by regular sunscreen use. Cancer Epidemiol Biomark Prev. 2006;15(12):2546–8.CrossRefGoogle Scholar
  6. 6.
    Hughes MC, Williams GM, Baker P, Green AC. Sunscreen and prevention of skin aging: a randomized trial. Ann Intern Med. 2013;158(11):781–90.CrossRefPubMedGoogle Scholar
  7. 7.
    Seité S, Fourtanier AM. The benefit of daily photoprotection. J Am Acad Dermatol. 2008;58(5):160–6.CrossRefGoogle Scholar
  8. 8.
    Moyal DD, Fourtanier AM. Broad-spectrum sunscreens provide better protection from solar ultraviolet-simulated radiation and natural sunlight-induced immunosuppression in human beings. J Am Acad Dermatol. 2008;58(5 Suppl 2):S149–54.CrossRefPubMedGoogle Scholar
  9. 9.
    Kuhn A, Gensch K, Haust M, et al. Photoprotective effects of a broad-spectrum sunscreen in ultraviolet-induced cutaneous lupus erythematosus: a randomized, vehicle-controlled, double-blind study. J Am Acad Dermatol. 2011;64(1):37–48.CrossRefPubMedGoogle Scholar
  10. 10.
    Lodén M, Beitner H, Gonzalez H, et al. Sunscreen use: controversies, challenges and regulatory aspects. Br J Dermatol. 2011;165(2):255–62.CrossRefPubMedGoogle Scholar
  11. 11.
    Jansen R, Osterwalder U, Wang SQ, et al. Photoprotection part II. Sunscreen: development, efficacy, and controversies. J Am Acad Dermatol. 2013;69(6):867.e1–14.CrossRefGoogle Scholar
  12. 12.
    DeLeo VA. Sunscreens. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. Philadelphia: Elsevier Saunders; 2012.Google Scholar
  13. 13.
    Forestier S. Rationale for sunscreen development. J Am Acad Dermatol. 2008;58(5 Suppl 2):S133–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Tuchinda C, Lim HW, Osterwalder U, Rougier A. Novel emerging sunscreen technologies. Dermatol Clin. 2006;24(1):105–17.CrossRefPubMedGoogle Scholar
  15. 15.
    Cole C, Shyr T, Ou-Yang H. Metal oxide sunscreens protect skin by absorption, not by reflection or scattering. Photodermatol Photoimmunol Photomed. 2016;32(1):5–10.CrossRefPubMedGoogle Scholar
  16. 16.
    Nash J, Tanner P. Are European sunscreen products superior? A market evaluation. J Am Acad Dermatol. 2007;56(2 Suppl 2):AB166.Google Scholar
  17. 17.
    Ahmed FK. Worldwide regulation of UV filters: current status and future trends. In: Lim HW, Draelos ZD, editors. Clinical guide to sunscreens and photoprotection. New York: Informa Healthcare USA; 2009. p. 65–81.Google Scholar
  18. 18.
    Whitfield, Ed. H.R.4250 - 113th Congress (2013-2014): Sunscreen Innovation Act. 2014. Accessed 14 May 2017.
  19. 19.
    Diffey B. New sunscreens and the precautionary principle. JAMA Dermatol. 2016;152(5):511–2.CrossRefPubMedGoogle Scholar
  20. 20.
    Wang SQ, Xu H, Stanfield JW, et al. Comparison of ultraviolet A light protection standards in the United States and European Union through in vitro measurements of commercially available sunscreens. J Am Acad Dermatol. 2017. doi: 10.1016/j.jaad.2017.01.017.Google Scholar
  21. 21.
    Osterwalder U, Lim HW. Novel developments in photoprotection: part I. In: Lim HW, Hönigsmann H, Hawk JLM, editors. Photodermatology. New York: Informa Healthcare USA; 2007. p. 279–98.Google Scholar
  22. 22.
    Wang SQ, Burnett ME, Lim HW. Safety of oxybenzone: putting numbers into perspective. Arch Dermatol. 2011;147:865–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Downs CA, Kramarsky-Winter E, Segal R, et al. Toxicopathological effects of the sunscreen UV filter, oxybenzone (benzophenone-3), on coral planulae and cultured primary cells and its environmental contamination in Hawaii and the US Virgin Islands. Arch Environ Contam Toxicol. 2016;70(2):265–88.CrossRefPubMedGoogle Scholar
  24. 24.
    US Department of Commerce, National Oceanic and Atmospheric Administration. National Ocean Service. What is coral bleaching? Accessed 15 March 2010.
  25. 25.
    Herzog SM, Lim HW, Williams MS, et al. Sun protection factor communication of sunscreen effectiveness: a web-based study of perception of effectiveness by dermatologists. JAMA Dermatol. 2017;153(3):348–50.CrossRefPubMedGoogle Scholar
  26. 26.
    Rougier A, Seite S, Lim HW. Novel developments in photoprotection: part II. In: Lim HW, Hönigsmann H, Hawk JLM, editors. Photodermatology. New York: Informa Healthcare USA; 2007. p. 297–310.Google Scholar
  27. 27.
    Wang SQ, Lim HW. Current status of the sunscreen regulation in the United States: 2011 Food and Drug Administration’s final rule on labeling and effectiveness testing. J Am Acad Dermatol. 2011;65(4):863–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Sambandan DR, Ratner D. Sunscreens: an overview and update. J Am Acad Dermatol. 2011;64(4):748–58.CrossRefPubMedGoogle Scholar
  29. 29.
    Cole C, Appa Y, Ou-Yang H. A broad spectrum high-SPF photostable sunscreen with a high UVA-PF can protect against cellular damage at high UV exposure doses. Photodermatol Photoimmunol Photomed. 2014;30(4):212–9.CrossRefPubMedGoogle Scholar
  30. 30.
    Zastrow L, Lademann J. Light—instead of UV protection: new requirements for skin cancer prevention. Anticancer Res. 2016;36(3):1389–93.PubMedGoogle Scholar
  31. 31.
    Mahmoud BH, Ruvolo E, Hexsel CL, Liu Y, Owen MR, Kollias N, Lim HW, Hamzavi IH. Impact of long-wavelength UVA and visible light on melanocompetent skin. J Investig Dermatol. 2010;130(8):2092–7.CrossRefPubMedGoogle Scholar
  32. 32.
    Liebel F, Kaur S, Ruvolo E, et al. Irradiation of skin with visible light induces reactive oxygen species and matrix-degrading enzymes. J Invest Dermatol. 2012;132(7):1901–7.CrossRefPubMedGoogle Scholar
  33. 33.
    Grether-Beck S, Marini A, Jaenicke T, Krutmann J. Effective photoprotection of human skin against infrared A radiation by topically applied antioxidants: results from a vehicle controlled, double-blind, randomized study. Photochem Photobiol. 2015;91(1):248–50.CrossRefPubMedGoogle Scholar
  34. 34.
    Jung GW, Ting PT, Salopek TG. Stability of sunscreens and sunblocks following exposure to extreme temperatures. J Am Acad Dermatol. 2012;66(6):1007–9.CrossRefPubMedGoogle Scholar
  35. 35.
    American Academy of Dermatology. How to select a sunscreen. Accessed 8 Jan 2017.
  36. 36.
    Isedeh P, Osterwalder U, Lim HW. Teaspoon rule revisited: proper amount of sunscreen application. Photodermatol Photoimmunol Photomed. 2013;29(1):55–6.CrossRefPubMedGoogle Scholar
  37. 37.
    Faurschou A, Wulf HC. The relation between sun protection factor and amount of sunscreen applied in vivo. Br J Dermatol. 2007;156(4):716–9.CrossRefPubMedGoogle Scholar
  38. 38.
    Ou-Yang H, Stanfield J, Cole C, et al. High-SPF sunscreens (SPF ≥70) may provide ultraviolet protection above minimal recommended levels by adequately compensating for lower sunscreen user application amounts. J Amer Acad Dermatol. 2012;67(6):1220–7.CrossRefGoogle Scholar
  39. 39.
    Akamine KL, Gustafson CJ, Davis SA, et al. Trends in sunscreen recommendation among US physicians. JAMA Dermatol. 2014;150(1):51–5.CrossRefPubMedGoogle Scholar
  40. 40.
    Xu S, Kwa M, Agarwal A, et al. Sunscreen product performance and other determinants of consumer preferences. JAMA Dermatol. 2016;152(8):920–7.CrossRefPubMedGoogle Scholar
  41. 41.
    Armstrong AW, Watson AJ, Makredes M, et al. Text-message reminders to improve sunscreen use: a randomized, controlled trial using electronic monitoring. Arch Dermatol. 2009;145(11):1230–6.CrossRefPubMedGoogle Scholar
  42. 42.
    Rosen C, Naylor M. Public education in photoprotection. In: Lim HW, Hönigsmann H, Hawk JLM, editors. Photodermatology. New York: Informa Healthcare USA; 2007. p. 311–8.Google Scholar
  43. 43.
    Wang SQ, Halpern AC. Public education in photoprotection. In: Lim HW, Draelos ZD, editors. Clinical guide to sunscreens and photoprotection. New York: Informa Healthcare USA; 2009. p. 281–92.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Jennifer Brescoll Mancuso
    • 1
  • Rohit Maruthi
    • 2
  • Steve Q. Wang
    • 3
  • Henry W. Lim
    • 1
    • 4
    Email author
  1. 1.Department of DermatologyHenry Ford HospitalDetroitUSA
  2. 2.Boston University School of MedicineBostonUSA
  3. 3.Department of DermatologyMemorial Sloane KetteringNew YorkUSA
  4. 4.Department of DermatologyHenry Ford Medical Center-New Center OneDetroitUSA

Personalised recommendations