Sunscreen highlights

By Megan Bennett, Staff Writer, March 1, 2026

As skin cancer diagnoses steadily rise in the U.S., the need for regularly applied, adequately protective sunscreen (along with other sun-safe practices) is more important than ever.

Data on Americans’ regular sunscreen use have only shown marginal improvement over the years. A 2020 JAAD study examining National Health Information Survey (NHIS) results from 2005 to 2015 showed that reported sunscreen use improved approximately 5 percentage points (from 30.6% in 2005 to 35.5% in 2015) (doi: 10.1016/j.jaad.2020.02.027). The same data show that while a portion of regular sunscreen users were using higher SPF by the end of 2015, approximately 20% used lower than the AAD-recommended SPF 30 (doi: 10.1016/j.jaad.2022.07.064).

“The American Academy of Dermatology, the Skin Cancer Foundation, and the Melanoma Research Foundation have done a really great job over the last 30 years to educate everyone about the danger of UV from the sun as well as the need to protect against UV light using sunscreen,” said Steven Wang, MD, FAAD, chair of the Photobiology Committee of the Skin Cancer Foundation and chair of dermatology at Hoag Memorial Hospital Presbyterian in Newport Beach, California. “The problem is that knowledge doesn’t always influence behavior.”

Anecdotally, however, Henry Lim, MD, FAAD, senior vice president of academic programs at Henry Ford Health in Detroit, has seen positive momentum on patients’ sunscreen awareness and use in recent years, in a variety of ages and skin tones.

“I see improved use in younger people as well as older patients,” said Dr. Lim. “Many of my older patients acknowledge that they had a lot of sun exposure in their younger years and are now very careful in terms of wearing photoprotective clothing, sunglasses, and sunscreen.”

The data, along with pervasive sunscreen controversies and regulatory challenges to approve ultraviolet (UV) radiation filters in the U.S., show there is still needed progress to best prevent skin cancer and lessen skin damage from sun exposure.

There are bright spots, however. Evolving knowledge of sunscreen efficacy means dermatologists have more information to pass along to their patients and the public. Additionally, the passing of the SAFE Sunscreen Standards Act in late 2025 as well as the pending approval of the U.S.’s first new filter (bemotrizinol) in nearly 30 years is expected to improve sun-protection options.

Reckoning with ‘real-world’ use

“The importance of sunscreen as a primary method of photoprotection has grown as the role of UVR in sunburn, photocarcinogenesis, pigmentary disorders, and idiopathic photodermatoses has become more well understood,” states a recent JAAD article examining the current state of sunscreen efficacy, regulation, and safety.

The two-part article, released in 2024 (doi: 10.1016/j.jaad.2024.02.065) and 2025 (doi: 10.1016/j.jaad.2024.02.066) offered several takeaways, the first of which is that the recommended amount of sunscreen (two milligrams per square centimeter) is rarely applied. Users typically apply only about 25% of that amount. “When users apply the less-than-recommended amount, the real SPF is really one third or one half of the SPF that is stated on the packaging label,” said Dr. Wang. “For example, if you bought a product that has SPF 50, you’re really getting SPF 15 or 25.” The AAD’s official recommendation is SPF 30 or higher, reapplied every two hours if outdoors, or after swimming or sweating.

A 2018 randomized trial published in JAAD also found that SPF 100+ sunscreen protected participants from sunburn more than SPF 50 in real-life conditions (doi: 10.1016/j.jaad.2017.12.062).

“It’s really tough to get somebody to use more sunscreen when there are already barriers to using it ... I tell patients that you can’t go too high with SPF, but you can go too low.”

Advising patients to simply apply the recommended amount of sunscreen would likely not improve adherence, noted Brandon Adler, MD, FAAD, clinical assistant professor of dermatology at the University of Southern California’s Keck School of Medicine. “It’s really tough to get somebody to use more sunscreen when there are already barriers to using it,” he said, later adding, “I tell patients that you can’t go too high with SPF, but you can go too low.”

Alternatively, Peter Lio, MD, FAAD, a clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine — who often works with sunscreen-sensitive, atopic dermatitis patients — says he often advocates for the “Australian approach: slip slap slop. Slip on a protective shirt, slap on a hat, and use sunscreen when you’re outside.”

Tinted sunscreens expand protection

For protection from visible light (VL) and preventing pigmentary disorders like melasma and erythema, tinted sunscreens — and their inclusion of iron oxides — are in a class of their own. This is encouraging for people with skin of color, for whom VL has a disproportionate effect, but the discourse around sunscreen efficacy has primarily been on UV rather than both UV and VL.

“The impact of VL on human skin is only beginning to be understood. With a greater understanding of the effects of solar radiation on different skin types and the development of sunscreen products that provide protection across the spectrum, from VL to UV, ‘photoprotection for all’ can become an achievable reality in the near future,” write the authors of a 2022 JAAD study examining the gaps in equitable photoprotection for various skin tones (doi:10.1016/j.jaad.2021.12.023).

“Anyone who is particularly concerned about the effects of photoaging on the skin, regardless of their skin type, should consider the benefits of tinted sunscreen since we know that visible light is an important part of the photoaging process,” said Dr. Adler.

Despite being the best option available to combat visible light, Dr. Lim added that tinted products come with their own barriers. Just like makeup, it stains clothes and color matching for both extremes of the Fitzpatrick scale is challenging, he said. A report he co-authored in 2024 also highlighted that tinted sunscreens are typically more costly, offer lower SPF, and are less water resistant.

“Some of the newer developments in sunscreen involve using biological agents that interfere and downregulate the biologic activities that are induced by visible light and sunlight,” said Dr. Lim.

“Nowadays, the molecular mechanism is quite well understood. You can block, for example, the development of the pigmentation secondary to exposure to sunlight, including the visible light, without using a filter but by using a biological agent in combination with sunscreen,” he added. “There are more, newer directions in research of using traditional sunscreen and incorporating agents that could have this biological photoprotection property, but it will take time to figure out which agents would work well.”

Better UVA options needed

The two-part JAAD article also pointed out the connection between UVA and melanoma development. “There is controversy regarding the effectiveness of UVB protection alone in melanoma prevention, which relates to data supporting an association between UVA and melanoma development,” it states.

Despite FDA requirements that any sunscreen above SPF 15 must be broad-spectrum, protecting both from UVA and UVB, the U.S. is notably behind on its available UVA filters.

“Both will be helpful,” Dr. Adler said when asked if more UVA filters along with broad-spectrum requirements would better combat melanoma in the U.S., “but with the caveat that melanoma is a complex cancer in both its development and its diagnosis. We know that UVA is far from the only aspect we need to consider to improve our melanoma rates. It’s part of the puzzle.”

Sunscreens abroad, Dr. Lim explained, also have newer, larger-molecule UVA filters. “The larger the molecule, the less likely it penetrates the skin. The filters approved in the U.S. have smaller molecules (less than 500 Daltons) and the penetration is higher.”

Combating misinformation

One of the leading controversies surrounding chemical sunscreens is that they cause endocrine disruption. Though studies have linked sunscreen ingredients like oxybenzone to endocrine disruption when tested on animals, there is no clear correlation for the same in humans.

“There’s no question that chemical sunscreens are absorbed into the body,” said Dr. Adler, but he emphasizes to patients that there are no known adverse effects from it. The studies in animals, he added, were done with unrealistic exposure scenarios compared to routine sunscreen use.

“That, understandably, creates anxiety for some people. I make sure to let patients know that I personally wear chemical sunscreen, and I don’t believe that the available evidence suggests that there’s any harm with routine use of chemical sunscreen ingredients.”

However, for those who are still worried, he and other dermatologists recommend a physical sunscreen. This is the same recommendation for those concerned about a potential correlation between sunscreen and frontal fibrosing alopecia. This claim is more controversial, said Dr. Lim, because the data are not completely clear. Beyond using physical sunscreens, he added, physicians can advise patients to protect their hairline with hats or other covers and continue to use sunscreen on the rest of their face.

“Most of these concerns about sunscreen safety and hair loss are not very well proven with strong data,” said Dr. Wang. “However, we’re living in the world of social media, and it’s very difficult to dispel misinformation.”

“Most of these concerns about sunscreen safety and hair loss are not very well proven with strong data. However, we’re living in the world of social media, and it’s very difficult to dispel misinformation.”

Environmental impact

A 2015 study published in the Archives of Environmental Contamination and Toxicology concluded that oxybenzone can cause coral bleaching. Between 2019 and 2021, the state of Hawaii, the U.S. Virgin Islands, and the city of Key West, Florida, banned the sale of sunscreens with oxybenzone and octinoxate. The impact of these bans has yet to be determined.

Dr. Adler and other physicians emphasized that the study showing oxybenzone’s toxicity with coral was done in a lab, using levels of the chemical that likely don’t correlate with the levels being absorbed into the water from sunscreen-lathered humans.

“Sunscreen filters may be adding insult to injury,” said Dr. Adler. “The corals are already weakened by the effects of climate change and rising sea temperatures and may be more susceptible than they would have been otherwise to the effects of sunscreen ingredients.”

The findings from the coral study may be moot. The Environmental Working Group, a D.C.-based nonprofit that examines sunscreen safety annually, released a 2025 report stating that of the approximately 2,200 products it reviewed, only 9% of the chemical sunscreens contained oxybenzone, a far cry from the 70% in 2016.

Several sunscreens, mostly those without the commonly banned chemicals, market themselves as “reef-safe,” but this distinction is not regulated by any organization. A 2020 study published in JAAD that examined more than 50 products advertised as reef-safe, which on average are more expensive, found that 4% still included oxybenzone or octinoxate, and 44% included other ingredients that the National Oceanic and Atmospheric Administration has deemed “reef-toxic.” Dr. Wang called this label a marketing gimmick.

“‘Reef-safe’ is much like other labels that are used on products these days, like ‘clean’ or ‘hypoallergenic,’ for which there are no definitions,” said Dr. Adler. “What’s reef safe to one manufacturer may be different from what’s reef safe to another.”

Researchers have called for more studies about the environmental impact of sunscreen ingredients entering bodies of water, and the AAD has expressed support for the Environmental Protection Agency to study the effect of UV filters on marine life. In the meantime, for patients who are still worried, dermatologists can recommend physical sunscreens, which have shown no negative impact.

New filter, law could ‘modernize’ U.S. offerings

Compared to other countries, the U.S. is behind on sunscreen development. The FDA has not approved a new ingredient since 1999. (This excludes the UVA filter ecamsule, which was approved in 2006 under a New Drug Application. Certain products containing the filter are approved rather than the filter itself.) “In the U.S., we’re starved for innovation,” said Dr. Lio.

Some of the hurdles in the U.S., Dr. Lim explained, derive from sunscreen being regulated as a drug rather than a cosmetic. Most sunscreen manufacturing is conducted in Europe, but the FDA doesn’t accept much of the safety data from overseas because the U.S. requires animal testing, a practice that Europe has been phasing out. For the manufacturers to add another test for U.S. approval, he said, would be time-consuming and expensive for an uncertain outcome.

The advancement in other parts of the world compared to the U.S. is not only evident to physicians but consumers as well. “I have so many patients who tell me whenever they go to Europe, they stock up on sunscreen and bring it back in suitcases,” said Dr. Lio. “That tells us we’re doing something wrong.”

However, there is some hope. The Supporting Accessible, Flexible, and Effective (SAFE) Sunscreen Standards Act — bipartisan legislation which was led by Rep. John Joyce, MD, FAAD, and signed into law in November 2025 — calls on the FDA to update its approval processes within the next year to consider non-animal data so more safety data can be considered from filters already approved overseas.

Dr. Adler, along with other dermatologists, is cautiously optimistic about this federal push. “We’re going to see how it plays out, but I’m extremely hopeful that this may be finally what we needed to modernize U.S. sunscreen approval processes,” he said.

Any regulatory changes that result from the new law would overshadow the current FDA sunscreen regulations. Proposed in 2021, these updates included categorizing active ingredients as Generally Recognized as Safe and Effective (GRASE). It also outlined labeling requirements, broad-spectrum requirements for any product above SPF 15, and a maximum SPF of 60+.

Notably, zinc oxide and titanium dioxide were deemed GRASE, but a dozen regular sunscreen ingredients — including avobenzone, oxybenzone, and octinoxate — require more research to get the FDA’s approval under the current structure.

The current regulations require maximal usage trials involving humans to determine GRASE status, “which is very arduous for manufacturers,” noted Dr. Adler, and does not align with practices in Europe and Asia. He’s encouraged by the new law’s language about considering real-world evidence as alternatives to maximal usage and animal testing.

In December 2025, the FDA announced the proposed approval of bemotrizinol (BEMT). The organic, broad-spectrum filter would be the first new active ingredient since 1999 and would join the small group of GRASE ingredients. BEMT has been approved in Europe since 2000.

BEMT could be the first and only ingredient that gets approved under existing FDA requirements, Dr. Adler noted. Following the SAFE Sunscreen Standards Act, “we may see an onslaught of additional agents approved because there is good safety data from Europe and good real-world evidence of efficacy,” he added.

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