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Sunscreen (also commonly known as sun screen, sunblock, suntan lotion, sunburn cream, sun cream or block out)^[1] is a lotion, spray, gel or other topical product that absorbs or reflects some of the sun's ultraviolet (UV) radiation on the skin exposed to sunlight and thus helps protect against sunburn. Skin-lightening products have sunscreen to protect lightened skin because light skin is more susceptible to sun damage than darker skin. A number of sunscreens have tanning powder to help the skin to darken or tan; however, tanning powder does not provide protection from UV rays.

Depending on the mode of action, sunscreens can be classified into physical sunscreens (i.e., those that reflect the sunlight) or chemical sunscreens (i.e., those that absorb the UV light).^[2]

Medical organizations such as the American Cancer Society recommend the use of sunscreen because it aids in the prevention of developing squamous cell carcinomas.^[3] Many sunscreens do not block UVA radiation, which does not cause sunburn but can increase the rate of melanoma and photodermatitis, so people using sunscreens may be exposed to high UVA levels without realizing it.^[4] The use of broad-spectrum (UVA/UVB) sunscreens can address this concern. Diligent use of sunscreen can also slow or temporarily prevent the development of wrinkles and sagging skin.^[5]

Health effects

Benefits

Sunscreen use can help prevent melanoma^[6] and squamous cell carcinoma, two types of skin cancer.^[7] There is little evidence that it is effective in preventing basal cell carcinoma.^[8]

A 2013 study concluded that the diligent, everyday application of sunscreen can slow or temporarily prevent the development of wrinkles and sagging skin. The study involved 900 white people in Australia and required some of them to apply a broad-spectrum sunscreen every day for four and a half years. It found that people who did so had noticeably more resilient and smoother skin than those assigned to continue their usual practices.^[5]

Potential risks

In 2008 two studies by the CDC highlighted concerns about the sunscreen chemical oxybenzone (benzophenone-3). The first study detected the chemical in 97% of the 2,500 Americans tested, while the second found that mothers with high levels of oxybenzone in their bodies were more likely to give birth to underweight baby girls.^[9] While surrounded by much controversy, it does provide broad-spectrum UV coverage, including UVB and short-wave UVA rays.^[10]

In 2006 the Therapeutic Goods Administration of Australia carried out a review of sunscreen safety studies and concluded: "There is evidence from isolated cell experiments that zinc oxide and titanium dioxide can induce free radical formation in the presence of light and that this may damage these cells (photo-mutagenicity with zinc oxide). However, this would only be of concern in people using sunscreens if the zinc oxide and titanium dioxide penetrated into viable skin cells. The weight of current evidence is that they remain on the surface of the skin and in the outer dead layer (stratum corneum) of the skin."^[11]

Concerns have also been raised about potential vitamin D deficiency arising from prolonged use of sunscreen. Typical use of sunscreen does not usually result in vitamin D deficiency; however, extensive usage may.^[12] Sunscreen prevents ultraviolet light from reaching the skin and if properly applied will, under high UV Index conditions, approximately halve vitamin D synthesis; whether the effect is exacerbated under low UV intensity is not yet proven.^[13]^[14] When the UV Index is greater than 3 (which occurs daily within the tropics and daily during the spring and summer seasons in temperate regions) adequate amounts of vitamin D₃ can be made in the skin after only ten to fifteen minutes of sun exposure at least two times per week to the face, arms, hands, or back without sunscreen. With longer exposure to UVB rays, an equilibrium is achieved in the skin, and the vitamin degrades as fast as it is generated.^[15]

History

Among widely used modern sunscreens, one of the earliest was produced by Benjamin Green, an airman and later a pharmacist, in 1944.^[16] The product, Red Vet Pet (for red veterinary petrolatum), had limited effectiveness, working as a physical blocker of ultraviolet radiation. It was a disagreeable red, sticky substance similar to petroleum jelly. This product was developed during the height of World War II, when it was likely that the hazards of sun overexposure were becoming apparent to soldiers in the Pacific and to their families at home. Sales of this product boomed when Coppertone acquired the patent and marketed the substance under the Coppertone girl and Bain de Soleil branding in the early 1950s.

The first effective modern sunscreen may have been developed by chemist Franz Greiter in 1946. The product, called Gletscher Crème (Glacier Cream), subsequently became the basis for the company Piz Buin (named in honor of the place Greiter allegedly obtained the sunburn that inspired his concoction), which is still today a marketer of sunscreen products.^[17] It has been estimated that Gletscher Crème had a sun protection factor of 2.

In 1962 Franz Greiter introduced the concept of sun protection factor (SPF), which has become a worldwide standard for measuring the effectiveness of sunscreen when applied at an even rate of 2 milligrams per square centimeter (mg/cm²). Some controversy exists over the usefulness of SPF measurements, especially whether the 2 mg/cm² application rate is an accurate reflection of people’s actual use.

Newer sunscreens have been developed with the ability to better withstand contact with water, heat and sweat.

Measurements of sunscreen protection

Sun protection factor (SPF) and labeling requirements

The SPF rating is a measure of the fraction of sunburn-producing UV rays blocked. For example, "SPF 15" means that 1/15th of the burning UV will reach the skin. The effectiveness of a sunscreen can be determined "by multiplying the SPF factor by the length of time it takes for him or her to suffer a burn without sunscreen."^[18] Thus, if a person develops a sunburn in 10 minutes when not wearing a sunscreen, the same person will prevent sunburn for 150 minutes if he/she wears a sunscreen with an SPF of 15.^[19] It is important to note that sunscreens with higher SPF do not last or remain effective on the skin any longer than lower SPF and must be continually reapplied as directed, usually every two hours.^[20]

The SPF is an imperfect measure of skin damage because invisible damage and skin aging are also caused by ultraviolet type A (UVA, wavelength 320 to 400 nm), which does not cause reddening or pain. Conventional sunscreen blocks very little UVA radiation relative to the nominal SPF; broad-spectrum sunscreens are designed to protect against both UVB and UVA.^[21]^[22]^[23] According to a 2004 study, UVA also causes DNA damage to cells deep within the skin, increasing the risk of malignant melanomas.^[24] Even some products labeled "broad-spectrum UVA/UVB protection" do not provide good protection against UVA rays.^[25] Titanium dioxide probably gives good protection, but does not completely cover the UVA spectrum, as early 2000s research suggests that zinc oxide is superior to titanium dioxide at wavelengths between 340 and 380 nm.^[26]

Owing to consumer confusion over the real degree and duration of protection offered, labeling restrictions are in force in several countries. In the EU, sunscreen labels can only go up to SPF 50+ (initially listed as 30 but soon revised to 50).^[27] Australia's Therapeutic Goods Administration increased the upper limit to 50+ in 2012.^[28]^[29] In the 2007 and 2011 draft rules, the Food and Drug Administration (FDA) proposed a maximum SPF label of 50, to limit unrealistic claims.^[30]^[31]^[32] Others have proposed restricting the active ingredients to an SPF of no more than 50, due to lack of evidence that higher dosages provide more meaningful protection.^[33]

The SPF can be measured by applying sunscreen to the skin of a volunteer and measuring how long it takes before sunburn occurs when exposed to an artificial sunlight source. In the US, such an in vivo test is required by the FDA. It can also be measured in vitro with the help of a specially designed spectrometer. In this case, the actual transmittance of the sunscreen is measured, along with the degradation of the product due to being exposed to sunlight. In this case, the transmittance of the sunscreen must be measured over all wavelengths in the UVB range (290–320 nm), along with a table of how effective various wavelengths are in causing sunburn (the erythemal action spectrum) and the actual intensity spectrum of sunlight (see the figure). Such in vitro measurements agree very well with in vivo measurements.^[34] Numerous methods have been devised for evaluation of UVA and UVB protection. The most reliable spectrophotochemical methods eliminate the subjective nature of grading erythema.^[35]

The ultraviolet protection factor (UPF) is a similar scale developed for rating fabrics for sun protective clothing.

Mathematically, the SPF (or the UPF) is calculated from measured data as

\mathrm {SPF} ={\frac {\int A(\lambda )E(\lambda )d\lambda }{\int A(\lambda )E(\lambda )/\mathrm {MPF} (\lambda )\,d\lambda }},

where $E(\lambda )$ is the solar irradiance spectrum, $A(\lambda )$ the erythemal action spectrum, and $\mathrm {MPF} (\lambda )$ the monochromatic protection factor, all functions of the wavelength $\lambda$ . The MPF is roughly the inverse of the transmittance at a given wavelength.

The above means that the SPF is not simply the inverse of the transmittance in the UVB region. If that were true, then applying two layers of SPF 5 sunscreen would be equivalent to SPF 25 (5 times 5). The actual combined SPF is always lower than the square of the single-layer SPF.

UVA protection

Persistent pigment darkening (PPD)

The persistent pigment darkening (PPD) method is a method of measuring UVA protection, similar to the SPF method of measuring UVB light protection. Originally developed in Japan, it is the preferred method used by manufacturers such as L'Oréal.

Instead of measuring erythema or reddening of the skin, the PPD method uses UVA radiation to cause a persistent darkening or tanning of the skin. Theoretically, a sunscreen with a PPD rating of 10 should allow a person 10 times as much UVA exposure as would be without protection. The PPD method is an in vivo test like SPF. In addition, Colipa has introduced a method that, it is claimed, can measure this in vitro and provide parity with the PPD method.^[36]

SPF equivalence

As part of revised guidelines for sunscreens in the EU, there is a requirement to provide the consumer with a minimum level of UVA protection in relation to the SPF. This should be a UVA PF of at least 1/3 of the SPF to carry the UVA seal. The implementation of this seal is in its phase-in period,^[when?] so a sunscreen without it may already offer this protection.^[37]

A set of final U.S. FDA rules effective from summer 2012 defines the phrase "broad spectrum" as having a UVA SPF at least as high as the UVB SPF.^[31]

Star rating system

In the UK and Ireland, the Boots star rating system is a proprietary in vitro method used to describe the ratio of UVA to UVB protection offered by sunscreen creams and sprays. Based on original work by Prof. Brian Diffey at Newcastle University, the Boots Company in Nottingham, UK, developed a standard method that has been adopted by most companies marketing these products in the UK. The logo and methodology of the test are licenced for a token fee to any manufacturer or brand of sunscreens that are sold in the Boots retail chain, provided the products to which the logo is applied perform to the standard claimed. Own Label products exclusively sold in other retailers are now excluded from the terms of the licence. It should not be confused with SPF, which is measured with reference to burning and UVB. One-star products provide the least ratio of UVA protection; five-star products are best. The method has recently been revised in the light of the Colipa UVA PF test, and with the new EU recommendations regarding UVA PF. The method still uses a spectrophotometer to measure absorption of UVA vs UVB; the difference stems from a requirement to pre-irradiate samples (where this was not previously required) to give a better indication of UVA protection, and of photostability when the product is used. With the current methodology, the lowest rating is three stars, the highest being five stars. In August 2007, the FDA put out for consultation the proposal that a version of this protocol be used to inform users of American product of the protection that it gives against UVA,^[38] but after concern this would be too confusing this was not adopted.^[33]

PA system

Asian brands, particularly Japanese ones, tend to use The Protection Grade of UVA (PA) system to measure the UVA protection a sunscreen provides. The PA system is based on the PPD reaction and is now widely adopted on the labels of sunscreens. According to the Japan Cosmetic Industry Association, PA+ corresponds to a UVA protection factor between two and four, PA++ between four and eight, and PA+++ more than eight.

Sunblock

Sunblock typically refers to opaque sunscreen that is effective at blocking both UVA and UVB rays and uses a heavy carrier oil to resist being washed off. Titanium dioxide and zinc oxide are two of the important ingredients in sunblock.^[39] Unlike the organic sun-blocking agents used in many sunscreens, these metal oxides do not degrade with exposure to sunlight.

The use of the word "sunblock" in the marketing of sunscreens is controversial. Since 2013, the FDA has banned such use because it can lead consumers to overestimate the effectiveness of products so labeled.^[31] Nonetheless, many consumers use the words sunblock and sunscreen synonymously.

For total protection against damage from the sun, the skin needs to be protected from UVA, UVB and IRA (infrared light). Roughly 35% of solar energy is IRA.^[40]

Active ingredients

Sunscreens contain one or more of the following ingredients:

Organic chemical compounds that absorb ultraviolet light.
Inorganic particulates that reflect, scatter, and absorb UV light (such as titanium dioxide, zinc oxide, or a combination of both).^[39]
Organic particulates that mostly absorb light like organic chemical compounds, but contain multiple chromophores that may reflect and scatter a fraction of light like inorganic particulates, and behave differently in formulations than organic chemical compounds. An example is Tinosorb M. Since the UV-attenuating efficacy depends strongly on particle size, the material is micronised to particle sizes below 200 nm. The mode of action of this photostable filter system is governed to about 90% by absorption and 10% by scattering of UV light.

The principal ingredients in sunscreens are usually aromatic molecules conjugated with carbonyl groups. This general structure allows the molecule to absorb high-energy ultraviolet rays and release the energy as lower-energy rays, thereby preventing the skin-damaging ultraviolet rays from reaching the skin. So, upon exposure to UV light, most of the ingredients (with the notable exception of avobenzone) do not undergo significant chemical change, allowing these ingredients to retain the UV-absorbing potency without significant photodegradation.^[41] A chemical stabilizer is included in some sunscreens containing avobenzone to slow its breakdown; examples include formulations containing Helioplex^[42] and AvoTriplex.^[43] The stability of avobenzone can also be improved by bemotrizinol,^[44] octocrylene^[45] and various other photostabilisers.

Sunscreening agents are used in some hair care products such as shampoos, conditioners and styling agents to protect against protein degradation and color loss. Currently, benzophenone-4 and ethylhexyl methoxycinnamate are the two sunscreens most commonly used in hair products. Cinnamidopyltrimonium chloride and a few others are used to a much less degree. The common sunscreens used on skin are rarely used for hair products due to their texture and weight effects.

The FDA made significant changes on sunscreen product labeling in 2011, ruling that:

To be classified as "broad spectrum", sunscreen products must provide protection against both UVA and UVB.
Claims of products being "waterproof", "sweatproof" or "sunblocks" are prohibited.
"Water resistance" claims on the front label must indicate how long the sunscreen remains effective and specify whether this applies to swimming or sweating, based on standard testing.
Sunscreens must include "Drug Facts" information on the container. However, there is no regulation that deems it necessary to mention whether the contents contain nanoparticles of mineral ingredients. (The EU has stricter regulation against the use of nanoparticles, and in 2009 introduced labeling requirements for nanoparticle ingredients in certain sunscreens and cosmetics.)^[46]^[47]

The following are the FDA allowable active ingredients in sunscreens:

UV-filter	Other names	Maximum concentration	Permitted in these countries	Results of safety testing
p-Aminobenzoic acid	PABA	15% (EC: banned from sale to consumers from 8 October 2009)	USA, AUS	Protects against skin tumors in mice.^[48]^[49]^[50] Shown to increase DNA defects, however, and is now less commonly used.
Padimate O	OD-PABA, octyldimethyl-PABA, σ-PABA	8% (EC, USA, AUS) 10% (JP) (Not currently supported in EC and may be delisted)	EC, USA, AUS, JP
Phenylbenzimidazole sulfonic acid	Ensulizole, Eusolex 232, PBSA, Parsol HS	4% (US, AUS) 8% (EC) 3% (JP)	EC, USA, AUS, JP	Genotoxic in bacteria^[51]
Cinoxate	2-Ethoxyethyl p-methoxycinnamate	3% (US) 6% (AUS)	USA, AUS
Dioxybenzone	Benzophenone-8	3%	USA, AUS
Oxybenzone	Benzophenone-3, Eusolex 4360, Escalol 567	6% (US) 10% (AUS, EC) 5% (JP)	EC, USA, AUS, JP
Homosalate	Homomethyl salicylate, HMS	10% (EC, JP) 15% (US, AUS)	EC, USA, AUS, JP
Menthyl anthranilate	Meradimate	5%	USA, AUS
Octocrylene	Eusolex OCR, 2-Cyano-3,3-diphenyl acrylic acid, 2-ethylhexylester	10%	EC, USA, AUS, JP	Increases ROS^[52]
Octyl methoxycinnamate	Octinoxate, EMC, OMC, Ethylhexyl methoxycinnamate, Escalol 557, 2-Ethylhexyl-paramethoxycinnamate, Parsol MCX	7.5% (US) 10% (EC, AUS) 20% (JP)	EC, USA, AUS, JP
Octyl salicylate	Octisalate, 2-Ethylhexyl salicylate, Escalol 587,	5% (EC, USA, AUS) 10% (JP)	EC, USA, AUS, JP
Sulisobenzone	2-Hydroxy-4-Methoxybenzophenone-5-sulfonic acid, 3-Benzoyl-4-hydroxy-6-methoxybenzenesulfonic acid, Benzophenone-4, Escalol 577	5% (EC) 10% (US, AUS, JP)	EC, USA, AUS, JP
Trolamine salicylate	Triethanolamine salicylate	12%	USA, AUS
Avobenzone	1-(4-methoxyphenyl)-3-(4-tert-butyl phenyl)propane-1,3-dione, Butyl methoxy dibenzoylmethane, BMDBM, Parsol 1789, Eusolex 9020	3% (US) 5% (EC, AUS)10% (JP)	EC, USA, AUS, JP	Not available^[53]
Ecamsule	Mexoryl SX, Terephthalylidene Dicamphor Sulfonic Acid	10%	EC, AUS (US: approved in certain formulations up to 3% via New Drug Application (NDA) Route)	Protects against skin tumors in mice^[54]^[55]^[56]
Titanium dioxide	CI77891	25% (No limit Japan)	EC, USA, AUS, JP
Zinc oxide		25% (US) 20% (AUS) (EC: 25%, provided particle size >100 nm) (Japan: no limit)	EC, USA, AUS, JP	Protects against skin tumors in mice^[54]

Other ingredients approved within the EU^[57] and other parts of the world,^[58] that have not been included in the current FDA Monograph:

UV-filter	Other names	Maximum concentration	Permitted in
4-Methylbenzylidene camphor	Enzacamene, Parsol 5000, Eusolex 6300, MBC	4%^*	EC, AUS
Tinosorb M	Bisoctrizole, Methylene Bis-Benzotriazolyl Tetramethylbutylphenol, MBBT	10%^*	EC, AUS, JP
Tinosorb S	Bis-ethylhexyloxyphenol methoxyphenol triazine, Bemotrizinol, BEMT, anisotriazine	10% (EC, AUS) 3% (JP)^*	EC, AUS, JP
Neo Heliopan AP	Bisdisulizole Disodium, Disodium phenyl dibenzimidazole tetrasulfonate, bisimidazylate, DPDT	10%	EC, AUS
Mexoryl XL	Drometrizole Trisiloxane	15%	EC, AUS
Benzophenone-9	Uvinul DS 49, CAS 3121-60-6, Sodium Dihydroxy Dimethoxy Disulfobenzophenone ^[59]	10%	JP
Uvinul T 150	Octyl triazone, ethylhexyl triazone, EHT	5% (EC, AUS) 3% (JP)^*	EC, AUS
Uvinul A Plus	Diethylamino Hydroxybenzoyl Hexyl Benzoate	10% (EC,JP)	EC, JP
Uvasorb HEB	Iscotrizinol, Diethylhexyl butamido triazone, DBT	10% (EC) 5% (JP)^*	EC, JP
Parsol SLX	Dimethico-diethylbenzalmalonate, Polysilicone-15	10%	EC, AUS, JP
Amiloxate	Isopentyl-4-methoxycinnamate, Isoamyl p-Methoxycinnamate, IMC, Neo Heliopan E1000	10%^*	EC, AUS

Many of the ingredients awaiting approval by the FDA were relatively new and developed to absorb UVA.^[60]

^* Time and Extent Application (TEA), Proposed Rule on FDA approval expected 2009

Application

A sunscreen study from 2001 suggests that the best protection is achieved by dividing the SPF number in half and reapplying that many minutes after sun exposure begins. For example, if the SPF is 30, sunscreen should be reapplied once after 15 minutes of exposure. Further reapplication is only necessary after activities such as swimming, sweating, or rubbing/wiping.^[61]

More recent research at the University of California, Riverside, indicates that sunscreen must be reapplied within 2 hours in order to remain effective. Not reapplying could even cause more cell damage than not using sunscreen at all, due to the release of extra free radicals from those sunscreen chemicals that were absorbed into the skin.^[52]

Dosage

The dose used in FDA sunscreen testing is 2.2 mg/cm² of exposed skin.^[41] If one assumes an "average" adult build of height 5 ft 4 in (163 cm) and weight 150 lb (68 kg) with a 32-inch (82-cm) waist, that adult wearing a bathing suit covering the groin area should apply 29 g (approximately 1 oz) evenly to the uncovered body area. Considering only the face, this translates to about 1/4 to 1/3 of a teaspoon for the average adult face. Larger or smaller individuals should scale these quantities accordingly.

Some studies have shown that people commonly apply only 1/2 to 1/4 of the amount recommended to achieve the rated sun protection factor (SPF), and in consequence the effective SPF should be downgraded to a square root or 4th root of the advertised value.^[62] A later study found a significant exponential relation between SPF and the amount of sunscreen applied, and the results are closer to linearity than expected by theory.^[63]

Label regulations

Updated package labeling standards in the United States were under development since 1978. A set of final FDA rules, published in June 2011, bans "waterproof" claims, instead requiring claims of 40 or 80 minutes "water-resistant" protection. It also requires a standardized "Drug Facts" label and requires specific FDA approval for "sunblock" and "instant protection" labels. Claims of protection over two hours are not allowed without specific approval.^[31]

Due to requests by several trade associations and the personal care industry, the FDA extended the implementation period for 6 months from the original compliance dates. The revised implementation date was December 17, 2013 for products with annual sales less than US $25,000, and December 17, 2012 for all other products.^[64] The extension allowed manufacturers adequate time for thorough testing and the full implementation of the new labeling requirements which cover:

Broad Spectrum designation
Use claims
"Waterproof," "sweatproof" or "sunblock" claims
Water resistance claims
Drug facts
Maximum SPF value on sunscreen labels to "50+"

These labeling changes were designed to help consumers identify and select suitable sunscreen products offering protection from sunburn, early skin aging, and skin cancer.^[65]

Notes

^ "Preventing melanoma". Cancer Research UK. Retrieved 2009-09-22.
^ Sunscreens | The Ageing Skin
^ What You Need To Know About Skin Cancer
^ Terence SC Poon, Ross StC Barnetson and Gary M Halliday (2003). "Prevention of Immunosuppression by Sunscreens in Humans Is Unrelated to Protection from Erythema and Dependent on Protection from Ultraviolet A in the Face of Constant Ultraviolet B Protection". J Invest Dermatol. 121: 184–90. doi:10.1046/j.1523-1747.2003.12317.x.
^ ^a ^b "Sunscreen and Prevention of Skin Aging". 158 (11). Annals of Internal Medicine. June 4, 2013: 781–790. {{cite journal}}: Cite journal requires |journal= (help); Unknown parameter |authors= ignored (help)
^ Kanavy HE, Gerstenblith MR (December 2011). "Ultraviolet radiation and melanoma". Semin Cutan Med Surg. 30 (4): 222–8. doi:10.1016/j.sder.2011.08.003. PMID 22123420.
^ Burnett ME, Wang SQ (April 2011). "Current sunscreen controversies: a critical review". Photodermatol Photoimmunol Photomed. 27 (2): 58–67. doi:10.1111/j.1600-0781.2011.00557.x. PMID 21392107.
^ Kütting B, Drexler H (December 2010). "UV-induced skin cancer at workplace and evidence-based prevention". Int Arch Occup Environ Health. 83 (8): 843–54. doi:10.1007/s00420-010-0532-4. PMID 20414668.
^ "CDC: Americans Carry Body Burden of Toxic Sunscreen Chemical". Environmental Working Group. March 25, 2008. Retrieved July 23, 2014.
^ Burnett, M. E. and Wang, S. Q. (2011), Current sunscreen controversies: a critical review. Photodermatology, Photoimmunology & Photomedicine, 27: 58–67
^ "Safety of sunscreens containing nanoparticles of zinc oxide or titanium dioxide". February 2006. Retrieved 16 April 2014.
^ Norval, M; Wulf, HC (October 2009). "Does chronic sunscreen use reduce vitamin D production to insufficient levels?". The British journal of dermatology. 161 (4): 732–6. doi:10.1111/j.1365-2133.2009.09332.x. PMID 19663879.
^ Professor Young (2013-06-04). "Worried suncream blocks vitamin D? Here's good news..." Boots. Daily Mail. Retrieved 2013-07-05.
^ "Dietary Reference Intakes for Calcium and Vitamin D". National Academies Press. 2011. Retrieved July 23, 2014.
^ "Dietary Supplement Fact Sheet: Vitamin D". National Institutes of Health. Archived from the original on 2007-09-10. Retrieved 2007-09-10.
^ Wang, Steven Q; Hu, Judy Y. "Challenges in Making an Effective Sunscreen". The Skin Cancer Foundation. Retrieved 2014-06-12.
^ "Gletscher Crème". 2010-04-22. Piz Buin. Archived from the original on 2010-05-12. Retrieved 2013-06-29.
^ Sunblock. UCSF. School of Medicine. Dept of Dermatology.
^ Sunblock. UCSF. School of Medicine. Dept of Dermatology.
^ "Sunscreen FAQs". American Academy of Dermatology. Retrieved July 22, 2014.
^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 12118426, please use {{cite journal}} with |pmid= 12118426 instead.
^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi: 10.1046/j.1523-1747.2003.12498.x, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi= 10.1046/j.1523-1747.2003.12498.x instead.
^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi: 10.1016/j.jaad.2007.04.035, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi= 10.1016/j.jaad.2007.04.035 instead.
^ Berneburg M, Plettenberg H, Medve-König K, Pfahlberg A, Gers-Barlag H, Gefeller O, Krutmann J (2004). "Induction of the photoaging-associated mitochondrial common deletion in vivo in normal human skin". J Invest Dermatol. 122 (5): 1277–83. doi:10.1111/j.0022-202X.2004.22502.x. PMID 15140232.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^ MSNBC.com : Sunscreen — protection or 'snake oil?'
^ Pinnell SR, Fairhurst D, Gillies R, Mitchnick MA, Kollias N (April 2000). "Microfine zinc oxide is a superior sunscreen ingredient to microfine titanium dioxide". Dermatol Surg. 26 (4): 309–14. doi:10.1046/j.1524-4725.2000.99237.x. PMID 10759815.{{cite journal}}: CS1 maint: multiple names: authors list (link) ^{[dead link]}
^ "Commission Recommendation of 22 September 2006 on the efficacy of sunscreen products and the claims made relating thereto". Official Journal of the European Union. 2006-09-22. Retrieved 2009-09-25. {{cite journal}}: Cite journal requires |journal= (help)
^ "UV Resource Guide - Sunscreens". Arpansa. 2008-12-20. Retrieved 2009-09-25.
^ "SPF50+ Sunscreen". 2013-02-01. Retrieved 2014-02-06.
^ Questions and Answers on the 2007 Sunscreen Proposed Rule
^ ^a ^b ^c ^d "Questions and Answers: FDA announces new requirements for over-the-counter (OTC) sunscreen products marketed in the U.S." 2011-06-23. Retrieved 2012-04-10.
^ Department of Health and Human Services; Food and Drug Administration (17 June 2011). "Revised Effectiveness Determination; Sunscreen Drug Products for Over-the-Counter Human Use" (PDF). Federal Register. 76 (117): 35672–35678. Retrieved 21 November 2013.
^ ^a ^b "Sunscreen Takes Some Heat: New Dangers, New Rules". 2011-06-16. Retrieved 2012-04-10.
^ Optometrics products
^ Dominique Moyal "How to measure UVA protection afforded by suncreen products" www.medscape.com/viewarticle/576849
^ Colipa UVA method^{[dead link]}
^ www.colipa.com^{[dead link]}
^ Questions and Answers on the 2007 Sunscreen Proposed Rule
^ ^a ^b "Nanotechnology Information Center: Properties, Applications, Research, and Safety Guidelines". American Elements.
^ P. Schroeder, PhD and J. Krutmann, MD What is Needed for a Sunscreen to Provide Complete Protection
^ ^a ^b "Re: Tentative Final Monograph for OTC Sunscreen" (PDF). Food and Drug Administration (United States). 1998-09-11. Retrieved 2009-09-25.
^ Neutrogena | How Helioplex Works
^ Banana Boat AvoTriplex
^ Chatelain E, Gabard B. (September 2001). "Photostabilization of Butyl methoxydibenzoylmethane (Avobenzone) and Ethylhexyl methoxycinnamate by Bis-ethylhexyloxyphenol methoxyphenyl triazine (Tinosorb S), a new UV broadband filter". Photochem Photobiol. 74 (3): 401–6. doi:10.1562/0031-8655(2001)074<0401:POBMAA>2.0.CO;2. PMID 11594052.
^ DSM Nutritional Products North America - Cosmetics: Basis for Performance - Parsol 340 - Octocrylene
^ "Is Sunscreen Safe?". Eluxe Magazine. June 8, 2014. Retrieved June 10, 2014. {{cite magazine}}: Cite magazine requires |magazine= (help)
^ New sunscreen labeling rules announced by U.S. FDA SGS SafeGuards Bulletin, Retrieved 06/20/2013
^ "The inhibiting effect of PABA on photocarcinogenesis". Archives of Dermatological Research. 282 (1): 38–41. 1990. doi:10.1007/BF00505643. PMID 2317082. {{cite journal}}: Unknown parameter |authors= ignored (help)
^ "The effect of short-term application of PABA on photocarcinogenesis". Acta Derm Venerol. 70 (1): 72–75. 1990. PMID 1967881. {{cite journal}}: Unknown parameter |authors= ignored (help)
^ "The sensitization of near-ultraviolet radiation killing of mammalian cells by the sunscreen agent para-aminobenzoic acid". Journal of Investigative Dermatology. 79 (6): 354–357. 1982. doi:10.1111/1523-1747.ep12529409. PMID 6982950. {{cite journal}}: Unknown parameter |authors= ignored (help)
^ Mosley, C N; Wang, L; Gilley, S; Wang, S; Yu, H (2007). "Light-Induced Cytotoxicity and Genotoxicity of a Sunscreen Agent, 2-Phenylbenzimidazol in Salmonella typhimurium TA 102 and HaCaT Keratinocytes". International Journal of Environmental Research and Public Health. 4 (2): 126–131. doi:10.3390/ijerph2007040006. PMID 17617675. {{cite journal}}: Cite has empty unknown parameter: |month= (help)CS1 maint: unflagged free DOI (link)
^ ^a ^b Kerry M. Hanson, Enrico Gratton and Christopher J. Bardeen (2006). "Sunscreen enhancement of UV-induced reactive oxygen species in the skin". Free Radical Biology and Medicine. 41 (8): 1205–12. doi:10.1016/j.freeradbiomed.2006.06.011. PMID 17015167.
^ Nash, JF (2006). "Human Safety and Efficacy of Ultraviolet Filters and Sunscreen Products". Dermatologic Clinics. 24 (1): 35–51. doi:10.1016/j.det.2005.09.006. PMID 16311166.
^ ^a ^b Lautenschlager, Stephan; Wulf, Hans Christian; Pittelkow, Mark R (2007). "photoprotection". Lancet. 370 (9586): 528–37. doi:10.1016/S0140-6736(07)60638-2. PMID 17693182.
^ Benech-Kieffer F, Meuling WJ, Leclerc C, Roza L, Leclaire J, Nohynek G (Nov–Dec 2003). "Percutaneous absorption of Mexoryl SX in human volunteers: comparison with in vitro data". Skin Pharmacol Appl Skin Physiol. 16 (6): 343–55. doi:10.1159/000072929. PMID 14528058.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^ Fourtanier A (October 1996). "Mexoryl SX protects against solar-simulated UVR-induced photocarcinogenesis in mice". Photochem Photobiol. 64 (4): 688–93. doi:10.1111/j.1751-1097.1996.tb03125.x. PMID 8863475.
^ "Regulation No. 1223/2009 on cosmetic products". Official Journal of the European Union. December 22, 2009. Retrieved July 23, 2014.
^ Australian Regulatory Guidelines for OTC Medicines - Chapter 10
^ "Uvinul Grades" (PDF). Retrieved 2009-09-25.
^ Kapes, Beth (July 2005). "Docs rally for better sun protection — Advances still unavailable in United States". Dermatology Times. 26 (7): 100. Retrieved July 23, 2014.
^ Diffey B (2001). "When should sunscreen be reapplied?". J Am Acad Dermatol. 45 (6): 882–5. doi:10.1067/mjd.2001.117385. PMID 11712033.
^ Faurschou A, Wulf HC (April 2007). "The relation between sun protection factor and amount of sunscreen applied in vivo". Br. J. Dermatol. 156 (4): 716–9. doi:10.1111/j.1365-2133.2006.07684.x. PMID 17493070.
^ Schalka S, dos Reis VM, Cucé LC (August 2009). "The influence of the amount of sunscreen applied and its sun protection factor (SPF): evaluation of two sunscreens including the same ingredients at different concentrations". Photodermatol Photoimmunol Photomed. 25 (4): 175–80. doi:10.1111/j.1600-0781.2009.00408.x. PMID 19614894.{{cite journal}}: CS1 maint: multiple names: authors list (link)
^ Labeling and Effectiveness Testing; Sunscreen Drug Products for Over-the-Counter Human Use; Delay of Compliance Dates Retrieved 09/27/2012
^ US FDA Delays Implementation Deadlines for Sunscreen Labeling Requirements SGS SafeGuard Bulletin, Retrieved 09/27/2012

External links

FDA rulemaking history for sunscreens
- FDA monograph on sunscreen
- FDA monograph on dosing, mechanism of action, and photodegradation of sunscreen (PDF file)
Make sure your sunscreen has The Skin Cancer Foundation's Seal of Recommendation
Environmental Working Group: July 2009 Sunscreen Safety Guide and Report
Information on what sunscreens are and how they work from The Skin Cancer Foundation
Sun Safety for Babies and Children University of Florida/IFAS Extension Department of Family, Youth and Community Sciences
Article on UV absorbers not yet approved by the FDA
Radiation protectants and their CAS registry number
European Cosmetics ingredient database (CosIng)
How does sunscreen work? Simple explanation from physics.org

[1] "Preventing melanoma". Cancer Research UK. Retrieved 2009-09-22.

[pharmax-2] Sunscreens | The Ageing Skin

[3] What You Need To Know About Skin Cancer

[4] Terence SC Poon, Ross StC Barnetson and Gary M Halliday (2003). "Prevention of Immunosuppression by Sunscreens in Humans Is Unrelated to Protection from Erythema and Dependent on Protection from Ultraviolet A in the Face of Constant Ultraviolet B Protection". J Invest Dermatol. 121: 184–90. doi:10.1046/j.1523-1747.2003.12317.x.

[wrinkles-5] "Sunscreen and Prevention of Skin Aging". 158 (11). Annals of Internal Medicine. June 4, 2013: 781–790. {{cite journal}}: Cite journal requires |journal= (help); Unknown parameter |authors= ignored (help)

[SunM-6] Kanavy HE, Gerstenblith MR (December 2011). "Ultraviolet radiation and melanoma". Semin Cutan Med Surg. 30 (4): 222–8. doi:10.1016/j.sder.2011.08.003. PMID 22123420.

[SunS-7] Burnett ME, Wang SQ (April 2011). "Current sunscreen controversies: a critical review". Photodermatol Photoimmunol Photomed. 27 (2): 58–67. doi:10.1111/j.1600-0781.2011.00557.x. PMID 21392107.

[8] Kütting B, Drexler H (December 2010). "UV-induced skin cancer at workplace and evidence-based prevention". Int Arch Occup Environ Health. 83 (8): 843–54. doi:10.1007/s00420-010-0532-4. PMID 20414668.

[9] "CDC: Americans Carry Body Burden of Toxic Sunscreen Chemical". Environmental Working Group. March 25, 2008. Retrieved July 23, 2014.

[10] Burnett, M. E. and Wang, S. Q. (2011), Current sunscreen controversies: a critical review. Photodermatology, Photoimmunology & Photomedicine, 27: 58–67

[zotd-11] "Safety of sunscreens containing nanoparticles of zinc oxide or titanium dioxide". February 2006. Retrieved 16 April 2014.

[12] Norval, M; Wulf, HC (October 2009). "Does chronic sunscreen use reduce vitamin D production to insufficient levels?". The British journal of dermatology. 161 (4): 732–6. doi:10.1111/j.1365-2133.2009.09332.x. PMID 19663879.

[13] Professor Young (2013-06-04). "Worried suncream blocks vitamin D? Here's good news..." Boots. Daily Mail. Retrieved 2013-07-05.

[14] "Dietary Reference Intakes for Calcium and Vitamin D". National Academies Press. 2011. Retrieved July 23, 2014.

[15] "Dietary Supplement Fact Sheet: Vitamin D". National Institutes of Health. Archived from the original on 2007-09-10. Retrieved 2007-09-10.

[16] Wang, Steven Q; Hu, Judy Y. "Challenges in Making an Effective Sunscreen". The Skin Cancer Foundation. Retrieved 2014-06-12.

[17] "Gletscher Crème". 2010-04-22. Piz Buin. Archived from the original on 2010-05-12. Retrieved 2013-06-29.

[18] Sunblock. UCSF. School of Medicine. Dept of Dermatology.

[19] Sunblock. UCSF. School of Medicine. Dept of Dermatology.

[20] "Sunscreen FAQs". American Academy of Dermatology. Retrieved July 22, 2014.

[21] Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 12118426, please use {{cite journal}} with |pmid= 12118426 instead.

[22] Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi: 10.1046/j.1523-1747.2003.12498.x, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi= 10.1046/j.1523-1747.2003.12498.x instead.

[23] Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi: 10.1016/j.jaad.2007.04.035, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi= 10.1016/j.jaad.2007.04.035 instead.

[24] Berneburg M, Plettenberg H, Medve-König K, Pfahlberg A, Gers-Barlag H, Gefeller O, Krutmann J (2004). "Induction of the photoaging-associated mitochondrial common deletion in vivo in normal human skin". J Invest Dermatol. 122 (5): 1277–83. doi:10.1111/j.0022-202X.2004.22502.x. PMID 15140232.{{cite journal}}: CS1 maint: multiple names: authors list (link)

[25] MSNBC.com : Sunscreen — protection or 'snake oil?'

[26] Pinnell SR, Fairhurst D, Gillies R, Mitchnick MA, Kollias N (April 2000). "Microfine zinc oxide is a superior sunscreen ingredient to microfine titanium dioxide". Dermatol Surg. 26 (4): 309–14. doi:10.1046/j.1524-4725.2000.99237.x. PMID 10759815.{{cite journal}}: CS1 maint: multiple names: authors list (link) ^{[dead link]}

[27] "Commission Recommendation of 22 September 2006 on the efficacy of sunscreen products and the claims made relating thereto". Official Journal of the European Union. 2006-09-22. Retrieved 2009-09-25. {{cite journal}}: Cite journal requires |journal= (help)

[28] "UV Resource Guide - Sunscreens". Arpansa. 2008-12-20. Retrieved 2009-09-25.

[29] "SPF50+ Sunscreen". 2013-02-01. Retrieved 2014-02-06.

[30] Questions and Answers on the 2007 Sunscreen Proposed Rule

[fda2011-31] "Questions and Answers: FDA announces new requirements for over-the-counter (OTC) sunscreen products marketed in the U.S." 2011-06-23. Retrieved 2012-04-10.

[32] Department of Health and Human Services; Food and Drug Administration (17 June 2011). "Revised Effectiveness Determination; Sunscreen Drug Products for Over-the-Counter Human Use" (PDF). Federal Register. 76 (117): 35672–35678. Retrieved 21 November 2013.

[onpoint-33] "Sunscreen Takes Some Heat: New Dangers, New Rules". 2011-06-16. Retrieved 2012-04-10.

[34] Optometrics products

[35] Dominique Moyal "How to measure UVA protection afforded by suncreen products" www.medscape.com/viewarticle/576849

[36] Colipa UVA method^{[dead link]}

[37] www.colipa.com^{[dead link]}

[38] Questions and Answers on the 2007 Sunscreen Proposed Rule

[americanelements-39] "Nanotechnology Information Center: Properties, Applications, Research, and Safety Guidelines". American Elements.

[40] P. Schroeder, PhD and J. Krutmann, MD What is Needed for a Sunscreen to Provide Complete Protection

[CTFA1998-41] "Re: Tentative Final Monograph for OTC Sunscreen" (PDF). Food and Drug Administration (United States). 1998-09-11. Retrieved 2009-09-25.

[42] Neutrogena | How Helioplex Works

[43] Banana Boat AvoTriplex

[44] Chatelain E, Gabard B. (September 2001). "Photostabilization of Butyl methoxydibenzoylmethane (Avobenzone) and Ethylhexyl methoxycinnamate by Bis-ethylhexyloxyphenol methoxyphenyl triazine (Tinosorb S), a new UV broadband filter". Photochem Photobiol. 74 (3): 401–6. doi:10.1562/0031-8655(2001)074<0401:POBMAA>2.0.CO;2. PMID 11594052.

[45] DSM Nutritional Products North America - Cosmetics: Basis for Performance - Parsol 340 - Octocrylene

[46] "Is Sunscreen Safe?". Eluxe Magazine. June 8, 2014. Retrieved June 10, 2014. {{cite magazine}}: Cite magazine requires |magazine= (help)

[47] New sunscreen labeling rules announced by U.S. FDA SGS SafeGuards Bulletin, Retrieved 06/20/2013

[48] "The inhibiting effect of PABA on photocarcinogenesis". Archives of Dermatological Research. 282 (1): 38–41. 1990. doi:10.1007/BF00505643. PMID 2317082. {{cite journal}}: Unknown parameter |authors= ignored (help)

[49] "The effect of short-term application of PABA on photocarcinogenesis". Acta Derm Venerol. 70 (1): 72–75. 1990. PMID 1967881. {{cite journal}}: Unknown parameter |authors= ignored (help)

[Sensitization-50] "The sensitization of near-ultraviolet radiation killing of mammalian cells by the sunscreen agent para-aminobenzoic acid". Journal of Investigative Dermatology. 79 (6): 354–357. 1982. doi:10.1111/1523-1747.ep12529409. PMID 6982950. {{cite journal}}: Unknown parameter |authors= ignored (help)

[Mosley2007-51] Mosley, C N; Wang, L; Gilley, S; Wang, S; Yu, H (2007). "Light-Induced Cytotoxicity and Genotoxicity of a Sunscreen Agent, 2-Phenylbenzimidazol in Salmonella typhimurium TA 102 and HaCaT Keratinocytes". International Journal of Environmental Research and Public Health. 4 (2): 126–131. doi:10.3390/ijerph2007040006. PMID 17617675. {{cite journal}}: Cite has empty unknown parameter: |month= (help)CS1 maint: unflagged free DOI (link)

[Hanson-52] Kerry M. Hanson, Enrico Gratton and Christopher J. Bardeen (2006). "Sunscreen enhancement of UV-induced reactive oxygen species in the skin". Free Radical Biology and Medicine. 41 (8): 1205–12. doi:10.1016/j.freeradbiomed.2006.06.011. PMID 17015167.

[53] Nash, JF (2006). "Human Safety and Efficacy of Ultraviolet Filters and Sunscreen Products". Dermatologic Clinics. 24 (1): 35–51. doi:10.1016/j.det.2005.09.006. PMID 16311166.

[autogenerated1-54] Lautenschlager, Stephan; Wulf, Hans Christian; Pittelkow, Mark R (2007). "photoprotection". Lancet. 370 (9586): 528–37. doi:10.1016/S0140-6736(07)60638-2. PMID 17693182.

[55] Benech-Kieffer F, Meuling WJ, Leclerc C, Roza L, Leclaire J, Nohynek G (Nov–Dec 2003). "Percutaneous absorption of Mexoryl SX in human volunteers: comparison with in vitro data". Skin Pharmacol Appl Skin Physiol. 16 (6): 343–55. doi:10.1159/000072929. PMID 14528058.{{cite journal}}: CS1 maint: multiple names: authors list (link)

[56] Fourtanier A (October 1996). "Mexoryl SX protects against solar-simulated UVR-induced photocarcinogenesis in mice". Photochem Photobiol. 64 (4): 688–93. doi:10.1111/j.1751-1097.1996.tb03125.x. PMID 8863475.

[57] "Regulation No. 1223/2009 on cosmetic products". Official Journal of the European Union. December 22, 2009. Retrieved July 23, 2014.

[58] Australian Regulatory Guidelines for OTC Medicines - Chapter 10

[59] "Uvinul Grades" (PDF). Retrieved 2009-09-25.

[60] Kapes, Beth (July 2005). "Docs rally for better sun protection — Advances still unavailable in United States". Dermatology Times. 26 (7): 100. Retrieved July 23, 2014.

[61] Diffey B (2001). "When should sunscreen be reapplied?". J Am Acad Dermatol. 45 (6): 882–5. doi:10.1067/mjd.2001.117385. PMID 11712033.

[62] Faurschou A, Wulf HC (April 2007). "The relation between sun protection factor and amount of sunscreen applied in vivo". Br. J. Dermatol. 156 (4): 716–9. doi:10.1111/j.1365-2133.2006.07684.x. PMID 17493070.

[DOI10.1111/j.1600-0781.2009.00408.x-63] Schalka S, dos Reis VM, Cucé LC (August 2009). "The influence of the amount of sunscreen applied and its sun protection factor (SPF): evaluation of two sunscreens including the same ingredients at different concentrations". Photodermatol Photoimmunol Photomed. 25 (4): 175–80. doi:10.1111/j.1600-0781.2009.00408.x. PMID 19614894.{{cite journal}}: CS1 maint: multiple names: authors list (link)

[64] Labeling and Effectiveness Testing; Sunscreen Drug Products for Over-the-Counter Human Use; Delay of Compliance Dates Retrieved 09/27/2012

[65] US FDA Delays Implementation Deadlines for Sunscreen Labeling Requirements SGS SafeGuard Bulletin, Retrieved 09/27/2012

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v t e Sunscreening agents approved by the US FDA or other agencies
UVA: 400–315 nm UVB: 315–290 nm Chemical agents unless otherwise noted
UVA filters	Avobenzone (Parsol 1789) Bisdisulizole disodium (Neo Heliopan AP) Diethylamino hydroxybenzoyl hexyl benzoate (Uvinul A Plus) Ecamsule (Mexoryl SX) Menthyl anthranilate
UVB filters	Amiloxate 4-Aminobenzoic acid (PABA) Cinoxate Ethylhexyl triazone (Uvinul T 150) Homosalate 4-Methylbenzylidene camphor (Enzacamene) Octyl methoxycinnamate (Octinoxate) Octyl salicylate (Octisalate) Padimate O (Escalol 507) Phenylbenzimidazole sulfonic acid (Ensulizole) Polysilicone-15 (Parsol SLX) Trolamine salicylate
UVA+UVB filters	Bemotrizinol (Tinosorb S) Benzophenones 1–12 Dioxybenzone Drometrizole trisiloxane (Mexoryl XL) Iscotrizinol (Uvasorb HEB) Octocrylene Oxybenzone (Eusolex 4360) Sulisobenzone Hybrid (chemical/physical): Bisoctrizole (Tinosorb M / Eversorb M) Physical: Titanium dioxide Zinc oxide
See also: Photoprotection, Sun protective clothing, Sun tanning, and Sunburn