Original articleHigh-SPF sunscreens (SPF ≥ 70) may provide ultraviolet protection above minimal recommended levels by adequately compensating for lower sunscreen user application amounts
Section snippets
Methods
This study evaluated the effects of various application densities on the actual SPF values of 6 sunscreen products, with labeled SPFs ranging from 30 to 100. The investigation was designed with a 2-step approach. An initial study (study A) was conducted on 251 volunteers to determine the SPF value of 6 sunscreens (labeled SPF from 30-100) at 4 different application densities (0.5, 1.0, 1.5, and 2.0 mg/cm2). The second study (study B), conducted on 76 volunteers after the results of study A were
Study A
A total of 237 subjects completed the study and 233 were included in SPF calculations. Data for 4 subjects were excluded because of protocol violations.
Mean SPF values and statistical information for each test product and application density are presented in Table II. For all 6 test sunscreens, the mean SPF value was progressively lower with lower application densities. However, reduced application densities yielded proportionately higher mean SPF values for products with higher labeled SPFs.
Discussion
In recent years, advancements in sunscreen formulations and access to photostabilized UV filter technology have allowed companies to manufacture products with SPF value up to 100. The marketing of very high–SPF products (SPF >50) has spurred an ongoing debate questioning their added clinical benefits. Indeed, comparative investigations on very high–SPF sunscreens are scant. Russak et al25 conducted a split-face, double-blind, randomized study comparing an SPF 50 with an SPF 85 product. A total
References (31)
Cutaneous ultraviolet exposure and its relationship to the development of skin cancer
J Am Acad Dermatol
(2008)- et al.
Melanoma Study Group of the Mayo Clinic Cancer Center. Malignant melanoma in the 21st century, part 1: epidemiology, risk factors, screening, prevention, and diagnosis
Mayo Clin Proc
(2007) - et al.
Sunscreens prevent ultraviolet photocarcinogenesis
J Am Acad Dermatol
(1980) - et al.
Sunscreens: an overview and update
J Am Acad Dermatol
(2011) - et al.
Efficacy as used, not as tested, is true measure of sunscreen performance
J Am Acad Dermatol
(2004) - et al.
Mechanisms of sunscreen failure
J Am Acad Dermatol
(2001) - et al.
The relation between the amount of sunscreen applied and the sun protection factor in Asian skin
J Am Acad Dermatol
(2010) - et al.
A comparison of sunburn protection of high-sun protection (SPF) sunscreens: SPF 85 sunscreen is significantly more protective than SPF 50
J Am Acad Dermatol
(2010) - et al.
Chronologic and actinically induced aging in human facial skin
J Invest Dermatol
(1983) Mechanisms involved in ultraviolet light-induced immunosuppression
Eur J Dermatol
(2003)
Case-control study of sun exposure and squamous cell carcinoma of the skin
Int J Cancer
Risk factors for basal cell carcinoma of the skin in men: results from the health professionals follow-up study
Am J Epidemiol
Photobiology and genetics of malignant melanoma
Br J Dermatol
Sunscreen lotions prevent ultraviolet radiation-induced suppression of antitumor immune responses
Int J Cancer
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Funded in full by Neutrogena Corp; the preparation of this manuscript was sponsored in full by Johnson and Johnson Consumer Companies.
Disclosure: Drs Ou-Yang and Appa are employees of Neutrogena Corp, the manufacturer of two of the sunscreens tested. Dr Cole is an employee of Johnson and Johnson Consumer Companies, a sister company of Neutrogena Corp. Mr Stanfield is an employee of Suncare Research Laboratories, the independent testing laboratory that received compensation for conducting this study, and he is currently a consultant to Galderma Laboratories LP. Dr Rigel is a consultant for Neutrogena Corp, Johnson and Johnson Consumer Companies, Beiersdorf, and P&G.