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1. Effect of Sunscreen Application Under Maximal Use Conditions on Plasma Concentration of Sunscreen Active Ingredients: A Randomized Clinical Trial. (PubMed)

Effect of Sunscreen Application Under Maximal Use Conditions on Plasma Concentration of Sunscreen Active Ingredients: A Randomized Clinical Trial. The US Food and Drug Administration (FDA) has provided guidance that sunscreen active ingredients with systemic absorption greater than 0.5 ng/mL or with safety concerns should undergo nonclinical toxicology assessment including systemic carcinogenicity and additional developmental and reproductive studies.To determine whether the active ingredients (...) (avobenzone, oxybenzone, octocrylene, and ecamsule) of 4 commercially available sunscreens are absorbed into systemic circulation.Randomized clinical trial conducted at a phase 1 clinical pharmacology unit in the United States and enrolling 24 healthy volunteers. Enrollment started in July 2018 and ended in August 2018.Participants were randomized to 1 of 4 sunscreens: spray 1 (n = 6 participants), spray 2 (n = 6), a lotion (n = 6), and a cream (n = 6). Two milligrams of sunscreen per 1 cm2 was applied

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2019 JAMA Controlled trial quality: uncertain

2. Regular Sunscreen Use and Risk of Mortality: Long-Term Follow-up of a Skin Cancer Prevention Trial

Regular Sunscreen Use and Risk of Mortality: Long-Term Follow-up of a Skin Cancer Prevention Trial Sunscreen is widely used to protect the skin from harmful effects of sun exposure. However, there are concerns that sunscreens may negatively affect overall health. Evidence of the general safety of long-term regular sunscreen use is therefore needed.The effect of long-term sunscreen use on mortality was assessed over a 21-year period (1993-2014) among 1,621 Australian adults who had participated (...) in a randomized skin cancer prevention trial of regular versus discretionary sunscreen use (1992-1996). In 2018, an intention-to-treat analysis was conducted using Cox proportional hazards regression to compare death rates in people who were randomized to apply sunscreen daily for 4.5years, versus randomized to use sunscreen at their usual, discretionary level. All-cause mortality and deaths resulting from cardiovascular disease, cancer, and other causes were considered.In total, 160 deaths occurred

2019 EvidenceUpdates

3. Application of SPF moisturisers is inferior to sunscreens in coverage of facial and eyelid regions. (PubMed)

Application of SPF moisturisers is inferior to sunscreens in coverage of facial and eyelid regions. Many moisturisers contain sun protection factors (SPF) equivalent to those found in sunscreens. However, there is a lack of research into how SPF moisturiser application compares to sunscreens in terms of coverage achieved and protection afforded. Previously we demonstrated that users incompletely covered their eyelid regions during routine sunscreen application. Here, we aimed to determine (...) if SPF moisturiser users also displayed these tendencies. A study population of 84 participants (22 males, 62 females, age 18-57) were exposed to UV radiation and photographed using a tripod mounted UV sensitive DSLR camera on two separate visits. At visit one, images were acquired before and after applying either SPF30 sunscreen or moisturiser, then at visit two the study was repeated with the other formulation. Images were processed for facial landmark identification followed by segmentation

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2019 PLoS ONE

4. Photophysics of sunscreen molecules in the gas phase: a stepwise approach towards understanding and developing next-generation sunscreens (PubMed)

Photophysics of sunscreen molecules in the gas phase: a stepwise approach towards understanding and developing next-generation sunscreens The relationship between exposure to ultraviolet (UV) radiation and skin cancer urges the need for extra photoprotection, which is presently provided by widespread commercially available sunscreen lotions. Apart from having a large absorption cross section in the UVA and UVB regions of the electromagnetic spectrum, the chemical absorbers (...) in these photoprotective products should also be able to dissipate the excess energy in a safe way, i.e. without releasing photoproducts or inducing any further, harmful, photochemistry. While sunscreens are tested for both their photoprotective capability and dermatological compatibility, phenomena occurring at the molecular level upon absorption of UV radiation are largely overlooked. To date, there is only a limited amount of information regarding the photochemistry and photophysics of these sunscreen molecules

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2016 Proceedings. Mathematical, Physical, and Engineering Sciences

5. Sunscreen use optimized by two consecutive applications. (PubMed)

Sunscreen use optimized by two consecutive applications. Sunscreen users are often inadequately protected and become sunburned. This study aimed to investigate how much two consecutive sunscreen applications increased the quantity of sunscreen applied and decreased the skin area left without sunscreen (missed area) compared to a single application. Thirty-one healthy volunteers wearing swimwear were included and applied sunscreen two consecutive times in a laboratory environment. Participants (...) had pictures taken in black light before and after each application. As sunscreens absorb black light, the darkness of the skin increased with increasing amounts of sunscreen applied. We conducted a standard curve establishing a link between change in picture darkness and quantity of sunscreen. The quantity of sunscreen at selected skin sites as well as the percentage of missed area was determined after each application. Participants had missed a median of 20% of their available body surface after

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2018 PLoS ONE

6. Skin cancer prevention: a review of current topical options complementary to sunscreens. (PubMed)

Skin cancer prevention: a review of current topical options complementary to sunscreens. The incidence of non-melanoma skin cancer (NMSC) is dramatically increasing worldwide, despite the increased use of improved sunscreens. In 2014, the Surgeon General estimated that 2.2-5.0 million people were treated annually for NMSC. As the number of newly diagnosed skin cancers continues to rise, there is a need for additional preventative measures beyond sunscreens. Several newer topical products

2019 Journal of the European Academy of Dermatology and Venereology

7. The effect of sunscreen on vitamin D: a review. (PubMed)

The effect of sunscreen on vitamin D: a review. Sunscreen use can prevent skin cancer, but there are concerns that it may increase the risk of vitamin D deficiency.We aimed to review the literature to investigate associations between sunscreen use and vitamin D3 or 25 hydroxy vitamin D (25(OH)D) concentration.We systematically reviewed the literature following the MOOSE guidelines. We identified manuscripts published in English between 1970 and 21 November 2017. Eligible studies were (...) . In the experimental studies sunscreen use considerably abrogated the vitamin D3 or 25(OH)D production induced by exposure to artificially generated ultraviolet radiation. The randomised controlled field trials found no effect of daily sunscreen application, but the sunscreens used had moderate protection (sun protection factor ~16). The observational studies mostly found no association or that self-reported sunscreen use was associated with higher 25(OH)D concentration.There is little evidence that sunscreen

2019 British Journal of Dermatology

8. UV detection stickers can assist people to reapply sunscreen. (PubMed)

UV detection stickers can assist people to reapply sunscreen. Sunscreen when applied at the recommended concentration (2 mg/cm2) has been shown to block the harmful molecular effects of ultraviolet radiation (UVR) in vivo. In real world conditions, however, sunscreen is often not applied/reapplied sufficiently to yield protection. This field study tested the effectiveness of UV detection stickers to prevent sunburn and improve reapplication of sunscreen. During the Ashes Cricket Test match (...) event (November 2017) in Brisbane, Australia interested spectators were recruited into the control group on DAY-1 and during subsequent days (DAY-2, DAY-3, DAY-4) new participants were recruited into the UV-Sticker group. Participants in both groups were provided with free sunscreen and participants in the UV-Sticker group were additionally provided with a UV detection sticker. Primary outcomes were self-reported sunburns and reapplication of sunscreen. Secondary endpoints included satisfaction

2019 Preventive Medicine

9. Machine learning for the prediction of sunscreen sun protection factor and protection grade of UVA. (PubMed)

Machine learning for the prediction of sunscreen sun protection factor and protection grade of UVA. We report a prediction model for sunscreen sun protection factor (SPF) and protection grade of ultraviolet (UV) A (PA) based on machine learning. We illustrate with real clinical test results of UV protection ability of sunscreen for SPF and PA. With approximately 2200 individual clinical results for both SPF and PA level detection, individually, we were able to see that active ingredient

2019 Experimental Dermatology

10. Optimal sunscreen use, during a sun holiday with a very high ultraviolet index, allows vitamin D synthesis without sunburn. (PubMed)

Optimal sunscreen use, during a sun holiday with a very high ultraviolet index, allows vitamin D synthesis without sunburn. Sunlight contains ultraviolet (UV)A and UVB radiation. UVB is essential for vitamin D synthesis but is the main cause of sunburn and skin cancer. Sunscreen use is advocated to reduce the sun's adverse effects but may compromise vitamin D status.To assess the ability of two intervention sunscreens to inhibit vitamin D synthesis during a week-long sun holiday.The impact (...) of sunscreens on vitamin D status was studied during a 1-week sun holiday in Tenerife (28° N). Comparisons were made between two formulations, each with a sun protection factor (SPF) of 15. The UVA-protection factor (PF) was low in one case and high in the other. Healthy Polish volunteers (n = 20 per group) were given the sunscreens and advised on the correct application. Comparisons were also made with discretionary sunscreen use (n = 22) and nonholiday groups (51·8° N, n = 17). Sunscreen use

2019 British Journal of Dermatology

11. Sunscreen photoprotection and vitamin D status. (PubMed)

Sunscreen photoprotection and vitamin D status. Global concern about vitamin D deficiency has fuelled debates on photoprotection and the importance of solar exposure to meet vitamin D requirements.To review the published evidence to reach a consensus on the influence of photoprotection by sunscreens on vitamin D status, considering other relevant factors.An international panel of 13 experts in endocrinology, dermatology, photobiology, epidemiology and biological anthropology reviewed (...) the literature prior to a 1-day meeting in June 2017, during which the evidence was discussed. Methods of assessment and determining factors of vitamin D status, and public health perspectives were examined and consequences of sun exposure and the effects of photoprotection were assessed.A serum level of ≥ 50 nmol L-1 25(OH)D is a target for all individuals. Broad-spectrum sunscreens that prevent erythema are unlikely to compromise vitamin D status in healthy populations. Vitamin D screening should

2019 British Journal of Dermatology

12. Association Between Perceived Skin Cancer Risk Reduction and Sunscreen Use. (PubMed)

Association Between Perceived Skin Cancer Risk Reduction and Sunscreen Use. Understanding factors that influence people to use sunscreen would allow clinicians to counsel patients in a way that is influential. Perceived efficacy of sunscreen has been associated with sunscreen use, but it is unclear whether the degree of efficacy is important.To determine whether larger perceived efficacy of sunscreen (larger skin cancer risk reduction) is associated with increased sunscreen use.A cohort of 131 (...) patients with a history of skin cancer visiting a Mohs micrographic surgery center were surveyed.Participants believed sunscreen would reduce their risk of basal cell carcinoma (BCC) by 61.1% (95% confidence interval [CI] = 56.4-65.9), squamous cell carcinoma (SCC) by 59.4% (95% CI = 54.6-64.2), and melanoma by 59.5% (95% CI = 54.8-64.3). Perceived magnitude of risk reduction of BCC, SCC, and melanoma was significant independent predictors of sunscreen use (BCC: odds ratio [OR] 3.5, 95% CI 1.1-11.2, p

2019 Dermatologic Surgery

13. Greater efficacy of SPF 100+ sunscreen compared to SPF 50+ in sunburn prevention during five consecutive days of sunlight exposure: A Randomized, Double-Blind Clinical Trial. (PubMed)

Greater efficacy of SPF 100+ sunscreen compared to SPF 50+ in sunburn prevention during five consecutive days of sunlight exposure: A Randomized, Double-Blind Clinical Trial. Beach vacations are high-risk settings for overexposure to ultraviolet (UV) radiation.To compare the sunburn protective efficacy of SPF 50+ and SPF 100+ sunscreens under actual use at the beach METHODS: A prospective, randomized, double-blind, single-center, split body/face study of 55 healthy subjects. Each subject (...) applied both sunscreens to randomized side of the face/body for up to 5 consecutive days. Blinded clinical evaluation of erythema by a single grader and objective instrumental assessments, colorimetry and diffuse reflectance spectroscopy, were performed the morning following each sun-exposure.After five days, 31 (56%) subjects had more sunburn on the SPF 50+ side and 4 (7%) on the SPF 100+ side. Overall, mean erythema intensity demonstrated statistically significantly less erythema on the SPF 100

2019 Journal of American Academy of Dermatology

14. Regular Sunscreen Use and Risk of Mortality: Long-Term Follow-up of a Skin Cancer Prevention Trial. (PubMed)

Regular Sunscreen Use and Risk of Mortality: Long-Term Follow-up of a Skin Cancer Prevention Trial. Sunscreen is widely used to protect the skin from harmful effects of sun exposure. However, there are concerns that sunscreens may negatively affect overall health. Evidence of the general safety of long-term regular sunscreen use is therefore needed.The effect of long-term sunscreen use on mortality was assessed over a 21-year period (1993-2014) among 1,621 Australian adults who had participated (...) in a randomized skin cancer prevention trial of regular versus discretionary sunscreen use (1992-1996). In 2018, an intention-to-treat analysis was conducted using Cox proportional hazards regression to compare death rates in people who were randomized to apply sunscreen daily for 4.5years, versus randomized to use sunscreen at their usual, discretionary level. All-cause mortality and deaths resulting from cardiovascular disease, cancer, and other causes were considered.In total, 160 deaths occurred

2019 American journal of preventive medicine Controlled trial quality: predicted high

15. The Role of Dispensing Device and Label Warnings on Dosing for Sunscreen Application: A Randomized Trial. (PubMed)

The Role of Dispensing Device and Label Warnings on Dosing for Sunscreen Application: A Randomized Trial. Drug manufacturers are expected to provide labeling information needed to yield safe and effective product use. However, it is not clear that consumers dose sunscreen, an over-the-counter drug, appropriately; in fact, existing evidence suggests underdosing as a common phenomenon. The objective of this study was to evaluate the effect of dispensing device and labeling on self-administered (...) doses of sunscreen in young adults. To investigate those effects, a 2 × 2 factorial laboratory experiment crossing dispensing device (two levels) with labeling treatment (two levels) was conducted. Participants applied sunscreen from each of the four treatments; dosing concentration, measured in mg/cm2, served as the response variable. Participants (n = 94) were recruited on the campuses of Michigan State University (East Lansing, MI) and California Polytechnic State University (San Luis Obispo, CA

2019 Health Education & Behavior

16. A randomized study to evaluate the efficacy and effectiveness of two sunscreen formulations on Indian skin types IV and V with pigmentation irregularities. (PubMed)

A randomized study to evaluate the efficacy and effectiveness of two sunscreen formulations on Indian skin types IV and V with pigmentation irregularities. Regular exposure to ultraviolet rays is high in India, where most Indians present Fitzpatrick skin phototypes IV and V.To evaluate the efficacy and compare the effectiveness of two sunscreen products on Indian skin types IV and V with pigmentation irregularities.A randomized, uncontrolled and investigator-blinded, single-center study (...) enrolled adult men and women (18-45 years) with Fitzpatrick skin phototypes IV (28° < individual typological angle <10°) and V (10° < individual typological angle < -30°) with pigmentary abnormalities seen on the face in adults (actinic lentigines and postinflammatory hyperpigmentation), who did not use sunscreens. Participants were randomized (1:1) to either of the two marketed sunscreen products, Product A (sun protection factor 50 PA+++) or Product B (sun protection factor 19 PA+++), applied twice

2019 Indian journal of dermatology, venereology and leprology Controlled trial quality: uncertain

17. DNA Methyltransferases in Malar Melasma and Their Modification by Sunscreen in Combination with 4% Niacinamide, 0.05% Retinoic Acid, or Placebo. (PubMed)

DNA Methyltransferases in Malar Melasma and Their Modification by Sunscreen in Combination with 4% Niacinamide, 0.05% Retinoic Acid, or Placebo. Malar melasma has a chronic and recurrent character that may be related to epigenetic changes.To recognize the expression and DNA methylation of DNA methyltransferases (DNMTs) in malar melasma and perilesional skin, as well as the changes in DNMTs after their treatment with sunscreen in combination with 4% niacinamide, 0.05% retinoic acid (...) , or placebo.Thirty female patients were clinically evaluated for the expression of DNMT1 and DNMT3b using real-time PCR and immunofluorescence. These initial results were compared to results after eight weeks of treatment with sunscreen in combination with niacinamide, retinoic acid, or placebo.The relative expression of DNMT1 was significantly elevated in melasma compared with unaffected skin in all subjects, indicating DNA hypermethylation. After treatment, it was decreased in all groups: niacinamide (7 versus

2019 BioMed research international Controlled trial quality: uncertain

18. Sunscreen or simulated sweat minimizes the impact of acute ultraviolet radiation on cutaneous microvascular function in healthy humans. (PubMed)

Sunscreen or simulated sweat minimizes the impact of acute ultraviolet radiation on cutaneous microvascular function in healthy humans. What is the central question of this study? Are ultraviolet radiation (UVR)-induced increases in skin blood flow independent of skin erythema? Does broad-spectrum UVR exposure attenuate NO-mediated cutaneous vasodilatation, and does sunscreen or sweat modulate this response? What are the main findings and their importance? Erythema and vascular responses to UVR (...) are temporally distinct, and sunscreen prevents both responses. Exposure to UVR attenuates NO-mediated vasodilatation in the cutaneous microvasculature; sunscreen or simulated sweat on the skin attenuates this response. Sun over-exposure may elicit deleterious effects on human skin that are separate from sunburn, and sunscreen or sweat on the skin may provide protection.Exposure to ultraviolet radiation (UVR) may result in cutaneous vascular dysfunction independent of erythema (skin reddening). Two studies

2019 Experimental physiology Controlled trial quality: uncertain

19. Outdoor testing of the photoprotection provided by a new water-based broad-spectrum SPF50+ sunscreen product: two double-blind, split-face, randomized controlled studies in healthy adults. (PubMed)

Outdoor testing of the photoprotection provided by a new water-based broad-spectrum SPF50+ sunscreen product: two double-blind, split-face, randomized controlled studies in healthy adults. Users often under-apply sunscreens, and one of the main reasons cited for this is the cosmetic formulation of the product. To address this, we developed a water-based sunscreen. The product underwent standard laboratory testing (ISO 24444: 2010) and was determined as sun protection factor (SPF) 50+. However (...) , such laboratory testing does not take into account environmental factors of in-use conditions that could potentially affect sunscreen efficacy, particularly of new cosmetic formulations. We aimed to test this product in conditions more representative of real-life solar exposure, to confirm its reported laboratory efficacy.Two double-blind, randomized, controlled, split-face intra-individual studies were conducted during summer months in Barcelona. One study compared the product against an SPF15 control

2019 Clinical, cosmetic and investigational dermatology Controlled trial quality: uncertain

20. New Methodology to Evaluate Sunscreens Under Outdoor Conditions: A Double-Blind, Randomized Intra-Individual Clinical Study of a Water-Based Broad-Spectrum SPF50+ Versus SPF15 (P3) and SPF50. (PubMed)

New Methodology to Evaluate Sunscreens Under Outdoor Conditions: A Double-Blind, Randomized Intra-Individual Clinical Study of a Water-Based Broad-Spectrum SPF50+ Versus SPF15 (P3) and SPF50. This study explored a new method to test sunscreens in outdoor conditions (very high to extreme ultraviolet [UV] radiation) approximating real-life solar exposure while maintaining scientific standards and acceptable conditions, and assessed the efficacy of a water-based sun-protection factor (SPF) 50 (...) + versus a reference SPF15 and two comparator SPF50+ products.Thirty-five subjects underwent testing in summertime Mauritius. In each subject, five test areas were marked on the back. One area was left unprotected, and four sunscreens were applied to the others: investigational product (IP), SPF15 (ISO 24444:2010 reference standard P3), and two marketed SPF50+ controls. Subjects spent 1-2 h (depending on skin type) in the sun. After 24 h, erythema was assessed by clinical scoring (0-5) and colorimetry

2019 Dermatology and therapy Controlled trial quality: uncertain

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