Remember the Sunscreen?

Sunscreen use recommended at a very low rate during outpatient visits, even by dermatologists

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) As skin cancer rates continue to remain high, doctors are encouraged to educate patients about the benefits of using sunscreen to lower their risk of developing the condition.

Patients would also benefit from advice about sun-protective behaviors such as wearing hats and long-sleeved clothing. However, most patients may not be receiving these tips, says a new study.

The rate at which physicians are mentioning sunscreen and other sun-protective behaviors to their patients is dismally low, even among patients with a history of skin cancer, claims the study.

"Use sunscreen when outdoors to help prevent skin cancer"

The study was conducted by Kristie L. Akamine MD, from the Center for Dermatology at Wake Forest School of Medicine, Winston-Salem, North Carolina, along with colleagues.

The objective of the study was to look at how frequently physicians recommended sunscreen to different patients.

The study researchers examined data from a national survey to identify patient visits to private physician clinics between 1989 and 2010.

Upon analysis of the data, the researchers found that sunscreen was mentioned in only 0.07 percent (12.8 million visits out of a total of 18.3 billion visits in the US) of the total number of clinic visits.

In the case of visits where patients were diagnosed with skin disease, sunscreen was mentioned at a slightly higher rate of 0.9 percent of the visits. Actinic keratosis patients were most likely to have received a recommendation for sunscreen.

Among the visits where sunscreen was mentioned, dermatologists were more likely than other specialties to have recommended it (86.4 percent of mentions).

However, on the flip side, sunscreen was only mentioned in 1.6 percent of all dermatology visits.

Dermatologists also mentioned sunscreen in only 11.2 percent of visits associated with a diagnosis or history of skin cancer or melanoma.

Study results indicated that sunscreen was mentioned most frequently to white patients and least frequently to kids.

“The findings are concerning because children and adolescents get the most sun exposure of any age group, as they tend to spend much of their time playing outdoors. Up to 80 percent of sun damage is thought to occur before age 21 years, and sunburns in childhood greatly increase the risk for future melanoma,” the study concluded.

"I would advise a patient, particularly with a personal or family history of skin cancer and those with a history of excessive natural or artificial ultraviolet radiation exposure, to ask specific questions regarding sunscreen usage and sun protection steps. In other words, a patient should be their own advocate. From the physicians standpoint, the important message of sun protection must be emphasized as frequently and clearly as possible," Dr. Coyle S. Connolly, a board-certified dermatologist, President of Connolly Dermatology, and dailyRx Contributing Expert, told dailyRx News.

"The majority of skin cancers are directly related to increased sun exposure, sunburn history, and artificial tanning usage," said Dr. Connolly.

The researchers did point out a few limitations to the study. The most significant limitation was that doctors may have mentioned sunscreen to their patients but not recorded it in their notes. Also, since patients may have had several visits over the period, it was possible they may have received counseling during one of the visits and no counseling during the rest.

The study was funded by a grant from Galderma Laboratories, a company that makes skin care products. One of the study authors disclosed consulting relationships with various pharmaceutical companies.

The study was published September 4, 2013 in JAMA Dermatology.

Review Date: 
September 3, 2013
Last Updated:
September 5, 2013