Chicago—The most popular sunscreens are not necessarily they most effective in reducing skin cancer risk, according to a new study.

In fact, an article published online by JAMA Dermatology notes that many of the most highly rated products do not meet American Academy of Dermatology (AAD) guidelines.

In an effort to both increase usage and make sure the products were effective, researchers from Northwestern University Feinberg School of Medicine in Chicago and coauthors sought to determine what made some sunscreens more popular than others.

To do that, they searched for “sunscreens” on Amazon.com, selecting the top 1.0% percentile of sunscreen products on the Internet retailer as of December 2015 based on average consumer review (greater than or equal to four stars) and the highest number of consumer reviews.

With 6,500 products categorized as “sunscreens,” the top 65 products were selected for analysis. The highest rated products had the following characteristics:

• median price was $3.32 an ounce;
• median SPF was 35;
• creams were most common;
• 92% had broad-spectrum coverage claims; and
• 62% were labeled as water or sweat resistant.

Yet, 40% of the most popular products failed to meet AAD criteria (SPF greater than or equal to 30, broad-spectrum claim, and water and/or sweat resistance). The most common reason, according to study authors, was lack of water/sweat resistance.

Results indicate that consumers primarily preferred sunscreens based on cosmetic elegance—skin sensation on application, color or scent—followed by product performance and compatibility with skin type.

“Because water exposure reduces the efficacy of sunscreens when a person is sweating or immersed in water, water-resistant products are often reserved for use in water-related activities or sports with profuse sweating,” the study points out. “Previous studies showed that two-thirds of sunscreen products are advertised as cosmetics (38%; 25 of 65) or moisturizers (26%; 17 of 65), whereas a minority were advertised as a stand-alone sunscreen (19%; 12 of 65). These findings may cause consumer confusion regarding what makes up an adequate sunscreen product.”

Popular sunscreens that met AAD criteria included Hawaiian Tropic Sunscreen Silk Hydration SPF 30, Neutrogena Age Shield Face Lotion Sunscreen SPF 110, EltaMD UV Physician SPF 41, Neutrogena Ultra Sheer Dry-Touch Sunscreen SPF 55, and Neutrogena Sunscreen Ultra Sheer Stick SPF 70, according to a chart included with the report.

The researchers note, however, that seven of the top 65 products had SPF of less than 30 and advised pharmacists and other healthcare providers to “educate consumers on these key considerations.”

They also emphasized that cost should be no barrier, explaining, “Nine of 10 of the least costly sunscreen products in the cohort did adhere to AAD guidelines.”

“Dermatologists should counsel patients that sunscreen products come with numerous marketing claims and varying cosmetic applicability, all of which must be balanced with adequate photoprotection,” concludes the study, which said it was limited in generalizability because of the lack of demographic information on the consumer reviewers.

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