Skip to main content
SpringerLink
Log in

Sunscreen use and failures — on site observations on a sun-holiday

  • Paper
  • Published:
Photochemical & Photobiological Sciences Aims and scope Submit manuscript

A Correction to this article was published on 01 December 2013

This article has been updated

Abstract

With this observation study we aimed to determine how and when sunscreen was used. 20 sun seekers were observed during a one-week sun holiday in Hurghada, Egypt. The sunscreen application thickness was related to part of body, time outdoors, exposure to ultraviolet radiation and to sunburning. Skin sites with sunscreen were exposed to UVR significantly longer and received significantly higher UVR doses than skin sites without sunscreen. They received an average of 0.62 SED [0.0–9.3 SED] (13% of their MED) before the first sunscreen application of the day. The average sunscreen used was SPF15 and the sunscreen application thickness was in average 0.79 mg cm−2 giving an approximated effect of SPF3. For different body parts either the total UVR exposure dose or the UVR exposure time and UVR exposure dose before the first sunscreen application were higher for sunburned than non-sunburned skin sites. In the final model gender, skin type and UVR to skin (adjusted for SPF and sunscreen application thickness) were significant predictors of sunburning. The sunscreen application thickness of 0.79 mg cm−2 was less than the 2 mg cm−2 used for testing SPF. The late start of sunscreen use and improper application thickness was ineffective in preventing sunburn, and therefore could not compensate for the risk of prolonged UVR exposure and high UVR doses. Our results lead us to suspect that the protective effect of sunscreen use against DNA-damage, and thereby skin cancer, is minimal the way sunscreen is used under real sun holiday conditions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Change history

References

  1. A. R. Young, G. E. Orchard, G. I. Harrison, and J. L. Klock, The detrimental effects of daily sub-erythemal exposure on human skin in vivo can be prevented by a daily-care-broad-spectrum sunscreen, J. Invest. Dermatol., 2007, 127, 975–978.

    Article  CAS  Google Scholar 

  2. A. R. Young, J. M. Sheehan, C. A. Chadwick, and C. S. Potten, Protection by ultraviolet A and B sunscreens against in situ dipyrimidine photo lesions in human epidermis is comparable to protection against sunburn, J. Invest. Dermatol., 2000, 115, 37–41.

    Article  CAS  Google Scholar 

  3. S. Seite, F. Christiaens, C. Bredoux, D. Compan, H. Zucchi, D. Lombard, A. Fourtanier, and A. R. Young, A broad-spectrum sunscreen prevents cumulative damage from repeated exposure to sub-erythemal solar ultraviolet radiation representative of temperate latitudes, J. Eur. Acad. Dermatol. Venereol., 2010, 24, 219–222.

    Article  CAS  Google Scholar 

  4. A. Green, G. Williams, and R. Neale, Daily sunscreen application and beta-carotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled study, Lancet, 1999, 354, 723–728.

    Article  CAS  Google Scholar 

  5. J. C. van der Pols, G. M. Williams, N. Pandeya, V. Logan, and A. C. Green, Prolonged prevention of squamous cell carcinoma of the skin by regular sunscreen use, Cancer Epidemiol., Biomarkers Prev., 2006, 15, 2546–2548.

    Article  Google Scholar 

  6. S. C. Thompson, D. Jolley, and R. Marks, Reduction of solar keratoses by regular sunscreen use, N. Engl. J. Med., 1993, 329, 1147–1151.

    Article  CAS  Google Scholar 

  7. C. Ulrich, J. S. Jürgensen, A. Degen, M. Hackethal, M. Ulrich, M. J. Patel, J. Eberle, D. Terhorst, W. Sterry, and E. Stockfleth, Prevention of non-melanoma skin cancer in organ transplant patients by regular use of sunscreen: a 24 months, prospective, case-control study, Br. J. Dermatol., 2009, 161, 78–84.

    Article  Google Scholar 

  8. A. C. Green, G. M. Williams, V. Logan, and G. M. Strutton, Reduced melanoma after regular sunscreen use: randomized trial follow-up, J. Clin. Oncol., 2011, 29, 257–263.

    Article  CAS  Google Scholar 

  9. J. Gardiner, P. Bailey, T. Makino, and B. Heerink, International Sunprotection Factor (SPF) test method. Colipa Guideline, 2006.

    Google Scholar 

  10. B. Petersen, P. Datta, P. A. Philipsen, and H. C. Wulf, Labeling and effectiveness testing; sunscreen drug products for over-the-counter human use. Final rule, Food and Drug Administration, HHS. Fed. Regist., 2011, 76(117), 35620–35665.

    Google Scholar 

  11. C. Stenberg, O. Larkö, Sunscreen application and its importance for the sun protection factor, Arch. Dermatol., 1985, 121, 1400–1402.

    Article  CAS  Google Scholar 

  12. P. Autier, M. Boniol, G. Severi, J. F. Dorè, Quantity of sunscreen used by European students, Br. J. Dermatol., 2001, 144, 288–291.

    Article  CAS  Google Scholar 

  13. R. Neale, G. Williams, and A. Green, Application patterns among volunteers randomized to daily sunscreen use in a skin cancer prevention trial, Arch. Dermatol., 2002, 138, 1319–1325.

    Article  Google Scholar 

  14. R. M. Azurdia, J. A. Pagliaro, B. L. Diffey, and L. E. Rhodes, Sunscreen application by photosensitive patient, Br. J. Dermatol., 1999, 140, 255–258.

    Article  CAS  Google Scholar 

  15. N. Bech-Thomsen, and H. C. Wulf, Sunbathers application of sunscreen is probably inadequate to obtain the sun protection factor assigned to the preparation, Photodermatol., Photoimmunol. Photomed., 1992/1993, 9, 242–244.

    Google Scholar 

  16. E. Thieden, P. A. Philipsen, J. Sandby-Møller, and H. C. Wulf, Sunscreen use related to UV exposure, age, sex, and occupation based on personal dosimeter readings and sun-exposure behaviour diaries, Arch. Dermatol., 2005, 141, 482–488.

    Google Scholar 

  17. H. C. Wulf, I. M. Stender, J. Lock-Andersen, Sunscreens used at the beach do not protect against erythema: a new definition of SPF is proposed, Photodermatol., Photoimmunol. Photomed., 1997, 13, 129–132.

    Article  CAS  Google Scholar 

  18. H. C. Wulf, P. A. Philipsen, and M. H. Ravnbak, Minimal erythema dose and minimal melanogenesis dose relate better to objectively measured skin type than to Fitzpaticks skin type, Photodermatol., Photoimmunol. Photomed., 2010, 26, 280–284.

    Article  Google Scholar 

  19. G. I. Harrison, and A. Young, Ultraviolet radiation-induced erythema in human skin, Methods, 2002, 28, 14–19.

    Article  CAS  Google Scholar 

  20. B. Kongshoj, A. Thorleifsson, and H. C. Wulf, Pheomelanin and eumelanin in human skin determined by high-performance liquid chromatography and its relation to in vivo reflectance measurements, Photodermatol., Photoimmunol. Photomed., 2006, 22, 141–147.

    Article  CAS  Google Scholar 

  21. B. L. Diffey, C. T. Jansen, F. Urbach, and H. C. Wulf, The standard erythema dose: a new photobiological concept, Photodermatol., Photoimmunol. Photomed., 1997, 13, 64–66.

    Article  CAS  Google Scholar 

  22. T. B. Fitzpatrick, The validity and practicality of sun-reactive skin-type I through IV (Editorial), Arch. Dermatol., 1988, 124, 869–871.

    Article  CAS  Google Scholar 

  23. R. D. Mosteller, Simplified calculation of body surface area, N. Engl. J. Med., 1987, 317, 1098.

    Article  CAS  Google Scholar 

  24. A. Augustsson, U. Stierner, I. Rosdahl, and M. Suurkula, Regional distribution of melanocytic naevi in relation to sun exposure, and site-specific counts predicting total number of naevi, Acta Derm. Venereol., 1992, 72, 123–127.

    CAS  Google Scholar 

  25. H. C. Wulf, I. M. Stender, J. Lock-Andersen, Sunscreen used at the beach do not protect against erythema: a new definition of SPF is proposed, Photodermatol., Photoimmunol. Photomed., 1997, 13, 129–132.

    Article  CAS  Google Scholar 

  26. J. Heydenreich, and H. C. Wulf, Miniature personal electronic UVR dosimeter with erythemal response and time-stamped readings in a wristwatch, Photochem. Photobiol., 2005, 81, 1138–1144.

    Article  CAS  Google Scholar 

  27. A. F. Mckinlay, and B. L. Diffey, A reference spectrum for ultraviolet induced erythema in human skin, CIE. J., 1987, 6, 17–22.

    Google Scholar 

  28. H. C. Wulf, Method and apparatus for determining an individual‘s ability to stand exposure to ultraviolet radiation, US Pat., 4882598, 1–38, 1989.

    Google Scholar 

  29. R. Bimczok, H. Gers-Barlag, C. Mundt, E. Klette, S. Bielfeldt, T. Rudolph, F. Pflücker, U. Heinrich, H. Tronnier, W. Johncock, B. Klebon, H. Westenfelder, H. Flöser-Müller, K. Jenni, D. Kockott, J. Lademann, B. Herzog, and M. Rohr, Influence of applied quantity of sunscreen products on the sun protection factor–a multicenter study organized by the DGK task force sun protection, Skin Pharmacol. Physiol., 2007, 20, 57–64.

    Article  CAS  Google Scholar 

  30. A. Faurschou, and H. C. Wulf, The relation between sun protection factor and amount of sunscreen applied in vivo, Br. J. Dermatol., 2007, 156, 716–719.

    Article  CAS  Google Scholar 

  31. S. M. Kim, B. H. Oh, Y. W. Lee, Y. B. Choe, and K. Joong, The relation between the amount of sunscreen applied and the sun protection factor in Asian skin, J. Am. Acad. Dermatol., 2010, 62, 218–222.

    Article  Google Scholar 

  32. S. Schalka, V. M. Silva dos Reis, L. C. Cucé, 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., 2009, 25, 175–180.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatological Research, Bispebjerg Hospital, Bispebjerg Bakke 23, Copenhagen, 2400, Denmark

    Bibi Petersen, Pameli Datta, Peter Alshede Philipsen & Hans Christian Wulf

Authors
  1. Bibi Petersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pameli Datta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter Alshede Philipsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hans Christian Wulf
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bibi Petersen.

Additional information

This article is published as part of a themed issue on current topics in photodermatology.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Petersen, B., Datta, P., Philipsen, P.A. et al. Sunscreen use and failures — on site observations on a sun-holiday. Photochem Photobiol Sci 12, 190–196 (2013). https://doi.org/10.1039/c2pp25127b

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1039/c2pp25127b

Search

Navigation