Sunscreens: expectation and realization

Background: The technical performance of sunscreens has improved dramatically over the past 20 years, so have we now succeeded in delivering protection that meets consumers' expectations? Methods: From a public health perspective, the desire to prevent sunburn and protect against skin cancer are the two major drivers for using sunscreen. This review examines how well consumers can expect to realize these expectations. Results: Sunscreens are used regularly by a minority of people, even during recreational summer exposure. The failure of sunscreen to prevent sunburn is almost always due to the way that sunscreens are applied rather than technical failure of the product. The mismatch between the labelled protection (sun protection factor) and that delivered in practice is a contributory factor to this ‘failure’. Sunscreens have been shown to be effective in reducing the incidence of squamous cell cancer and with promising benefits for basal cell cancer. However, the evidence that they are effective in melanoma remains lacking. Conclusion: The formulation and extinction of sunscreens have undoubtedly improved over recent years. Yet the notion that sunscreens provide unequivocal protection against the deleterious effects of sun exposure by everyone who uses them remains elusive.