Online Survey of US Dermatologists’ Sunscreen Opinions: Perceptions, Recommendation Factors, and Self-Usage

September 2016 | Volume 15 | Issue 9 | Original Article | 1121 | Copyright © 2016

Aaron S. Farberg MD,a Adam C. Rigel MMS MS,b and Darrell S. Rigel MD MSc

aIcahn School of Medicine at Mount Sinai, New York, NY
bAffiliated Dermatology, New York, NY
cNYU School of Medicine, New York, NY

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Abstract

The American Academy of Dermatology and dermatologists’ themselves, have recommended public education and patient counseling regarding sunscreen. The purpose of this study was to determine US dermatologists’ actual sunscreen perceptions as well as their recommendations and personal usage. 540 practicing US dermatologists responded to an online survey that assessed each physician’s perception of safety and efficacy of sunscreen, recommendation factors, and personal usage. Dermatologists have an overall positive view of sunscreen. 99% of dermatologists agree that regular sunscreen use helps lower skin cancer risk, reduces subsequent photoaging, and recommend their family/friends use sunscreen. Most dermatologists believe that oxybenzone and retinyl palmitate are safe in sunscreen (86% and 85%, respectively). Dermatologists used multiple sunscreen recommendation criteria including Sun Protection Factor (SPF) level, broad spectrum protection, cosmetic elegance/feel, and photostability (96%, 98%, 85%, and 68%, respectively). The use of sunscreen remains a critical part of sun protection. Therefore, it is important to assess and understand the perspective and patient recommendations provided by dermatologists.

J Drugs Dermatol. 2016;15(9):1121-1123.

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INTRODUCTION

As the incidence of skin cancer continues to rise, ultraviolet radiation from the sun remains both the primary cause and only recognized modifiable risk factor for developing skin cancer. Current methods of sun protection typically include seeking shade, using protective clothing, and sun avoidance. Regular sunscreen use is another critical component of sun protection and has been shown to reduce skin cancer risk.1 Acknowledging the importance of sunscreen in the prevention of skin cancer, multiple professional organizations including the American Academy of Dermatology (AAD) and dermatologists’ themselves, have recommended public education and patient counseling regarding sunscreen.2,3 Dermatologists often discuss these issues with their patients but their actual views have not been evaluated.2

However, there have often been conflicting sunscreen messages (sometimes without scientific support) that have led to confusion by the public.4 Controversy has also emerged surrounding the safety and possibility of adverse effects from various sunscreen ingredients.5 The purpose of this study was to determine US dermatologists’ actual sunscreen perceptions, potential safety concerns as well as their recommendations and personal usage.

METHODS

The survey instrument for this IRB exempt study was validated and emailed in April 2016 to 6,350 practicing US dermatologists using the same methodology as in recently published studies.2 A contracted survey company was employed to assist in collecting and organizing responses in order to minimize error. To verify the representative nature of the responding subset, respondent demographics were compared to US AAD membership data. Furthermore, the suggested sample size for proportions with 95% confidence for the population surveyed was calculated as a target response rate of at least 361 respondents.6

Respondents were asked about their years in practice and geographic location. Each physician’s perception of safety and efficacy of sunscreen, recommendation factors, and usage was collected and evaluated. Most questions were straightforward statements to which respondents were asked to agree or disagree. Comparative data were analyzed using standard chi square methods and 95% confidence levels and odds ratios were computed where appropriate.

RESULTS

540 (9%) of those surveyed responded and completed enough of the questions to be included in the outcome analyses. Dermatologists have an overall positive perception of sunscreen as summarized in Table 1. 99% of dermatologists agree that regular sunscreen use helps lower skin cancer risk and reduces subsequent photoaging. Nearly all dermatologists (96%) consider Food and Drug Administration (FDA) approved sunscreens currently available in the US to be safe and also believe their patients generally under apply sunscreen. 92% of dermatologists are comfortable recommending sunscreens with a SPF50 or higher. Most

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