Craig A. Elmets, MD Reviewing Kong BY et al., JAMA Dermatol 2015 Jun 17;

For labeling to be effective, consumers must know what it means.

In 2011, the FDA approved a new sunscreen labeling system that maintained sun protection factor (SPF) as a quantitative index of ultraviolet B (UVB) protection and initiated a new system for rating UVA protection. Do consumers understand the new labels? Investigators surveyed 114 patients aged 18 and older attending an academic medical center dermatology clinic in summer 2014 regarding sunscreen labels.

Most responders did know which label items referred to UVA and to UVB protection. However, more than 40% indicated that their choice of sunscreen was driven primarily by high SPF, sensitive-skin formulation, and water or sweat resistance, and only about one third thought that use of a broad-spectrum sunscreen was important. A surprisingly small percentage understood that high SPF or broad-spectrum sunscreen protects against skin cancer (38%), that a broad-spectrum sunscreen is the most appropriate for preventing photoaging (7%), and that SPF value indicates the protective value against sunburn (23%).

Only sunscreens with an SPF of 15 or higher and broad-spectrum protection against UVA and UVB (Panel A) can claim to protect against cancer and premature skin aging.

The new, long-overdue labeling system for sunscreens announced in 2011 was welcomed by physicians. However, to be effective, it must be understood by consumers. This is particularly important for the new UVA and UVB classification. Many people don’t understand that UVA and UVB have distinct effects and are responsible for different, but overlapping, UV-light–induced skin changes. Physicians can aid patient education by better explaining these differences and the importance of broad-spectrum sunscreen. See the illustration for a comparison of labeling for products offering optimal and nonoptimal photoprotection. A publicity campaign by the FDA and other national organizations on photoprotection, the classification system used to assess their relative efficacy, and the differences in disease caused by the two forms of ultraviolet light would help people select the most suitable sunscreen.