Challenges with Sunscreen Education

Readers of DermLetter know just how important sunscreen is. From both a medical and cosmetic perspective, regular sunscreen use is the most cost efficient and effective form of skincare that one can purchase. I'm willing to bet though, that many of you still don't use sunscreen on a regular basis, despite knowing better.

The American Academy of Dermatology reported that only 14% of men and 29% of women use sunscreens on their face and body on a regular basis. Frankly, these numbers are horrifying. We know that sun exposure over time has serious effects both medically and cosmetically. In lighter skin toned individuals, the risk of skin cancer, and the effects of wrinkling and solar elastosis are elevated. In darker skin toned individuals, sun exposure elevates the risk of hyperpigmentation. Sun damage also accounts for nearly 10 years worth of skin aging in terms of appearance.

Almost every dermatologist, health expert, and health organization has been actively working to educate the public about the effects of UV exposure for the last two decades, and yet, these numbers continue to show that the message isn't getting through for one reason or another. If there's anything clear in the often muddled waters of skincare science, it's that sun protection is important. In fact, it's the one area where the science is mostly unanimous, but public behavior hasn't caught up. It might simply be that it takes time for public awareness to catch up to the science, as was the case with cigarettes. It's also true however, that there are challenges that go beyond the medical facts when it comes to sunscreen, and why people don't use them.

First, the way humans assess risk is not perfectly rational. We work against several biases when we try to convince people to use sunscreens:

  • People are extremely poor at properly understanding risks that are incremental in nature. Obesity, heart attack, type II diabetes, and skin damage are all examples of taking accumulated risks that, taken individually seem statistically meaningless, but over time may as well be sealed fate. Premature aging is invisible on a daily basis. It's only after the fact that you notice a blotch here, a wrinkle there.
  • People assess risk poorly when the risk is variable, uncertain, or invisible. Sunscreens do not stop all incidents of skin cancer, and not using sunscreens does not guarantee that you will get skin cancer. The damage due to sun exposure accumulates over decades and is often confused with natural aging when it does become visible. The skin cancer risks--the DNA damage--is invisible.
  • The way that people assess risk is rarely if ever, "value-neutral." We tend to like "natural" things, and have an aversion to "unnatural" things. Sunlight is natural while sunscreens are not. Tanning is in many cultures, but especially in Caucasian culture, considered healthy and invokes images of an active lifestyle. The sun is the source of life and light, and is overwhelmingly a positive imagery that infiltrates our language (a sunny disposition).
  • Prevention is (almost) always more effective than treatment, but what you prevented is less visible than what you treated and cured.

As you can see, there are several biases working against sunscreens, but this doesn't mean that it's impossible to change public opinion and behavior. Brushing teeth has largely become normalized, and this also suffers from much the same problem as sunscreens--it's preventative, there's plenty of individual variation, and it's "unnatural." Education is important, clearly, but there's also another angle that both the skincare manufacturers and users should consider: Convenience and comfort.

Convenience and Comfort

First, if you look at the study from the American Academy of Dermatology above, men use sunscreen less than half as much as women on a regular basis (14% to 29%). The reason for using or not using sunscreen was not explicitly surveyed with the study, but many dermatologists speculate that this is likely in part due to the many cosmetic products that women use, which contain sunscreen in them. That is, some of it has to do with cultural norms, but the important factor that should be considered here is convenience.

  • More 2-in-1 type skincare products that contain SPF.
  • Improving texture of sunscreens. Particularly for men who have more facial and body hair, thick textures are a big disincentive to apply sunscreen.
  • Fear of triggering acne is a big disincentive. Non-comedogenic sunscreen products are a must to convince people to use sunscreens.
  • As users, don't take convenience for granted. Use the product that you can fit into your daily routine. Knowing about sun protection is important, but to act on it, it's important to make sure that applying sunscreen is both practical and convenient.