Optimal sunscreen use prevents holiday erythema

Summary Rates of skin cancer are increasing more rapidly in the UK than any other form of cancer. The deadliest form of the disease is melanoma skin cancer, which affects 128% more people now than it did 28 years ago. Sun protection factors (SPFs) are known to protect the skin from sunburn when sunscreen is applied at 2 mg per cm‐2. However, whilst on holiday, people typically apply just 0.8 mg cm‐2 of sunscreen. This study aimed to identify if typical sunscreen application during a holiday with daily sun exposure results in skin cancer risk factors such as sunburn. Participants spent one week in Tenerife, a country with a very high ultraviolet index. 22 participants applied their own sunscreen without instruction and 40 participants were given SPF 15 sunscreen and guidance on effective application (three times daily at 2 mg cm‐2). It was found that participants who followed typical sunscreen application displayed significantly greater levels of sunburn and other risk factors associated with skin cancer compared to those who followed optimal application guidelines to achieve SPF 15. Individuals who followed the effective application guidelines with SPF 15 sunscreen had no sunburn on five exposed body sites. The results of this study highlight how typical sunscreen use is not providing sufficient protection from the sun in the majority of people. As well as this, it is demonstrated that sunburn is associated with an increased risk of developing skin cancer. Therefore, achieving an adequate SPF by teaching the general public how to properly apply sunscreen may be an important step in preventing skin cancer. Linked Article: Narbutt et al. Br J Dermatol 2019; 180:604–614