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Rachel Neale, PhD; Gail Williams, PhD; Adèle Green, MB BS, PhD

Arch Dermatol. 2002;138:1319-1325.

Background  Despite many investigations of sunscreen use, there have been few among adults in the community at large. Better understanding of sunscreen application patterns will lead to more strategic skin cancer prevention strategies among sun-exposed populations.

Objective  To explore patterns of sunscreen use, particularly the quantity of sunscreen used and the application frequency, among participants in a community-based sunscreen intervention.

Design  Follow-up of patterns of sunscreen use over 4.5 years.

Setting  Nambour, a subtropical town in Queensland, Australia.

Participants  People drawn randomly from the electoral register who were later randomized as part of a skin cancer prevention trial.

Interventions  Daily application of a standard sun protection factor 15+ broad-spectrum retail sunscreen to the head and neck, arms, and hands.

Outcome Measures  Frequency of application of sunscreen, weight of sunscreen applied, and quantity applied per unit area of skin.

Results  Fifty-six percent of participants reported applying sunscreen on at least 5 days per week, with 27% using sunscreen infrequently on 2 or fewer days per week. The median daily amount of sunscreen applied averaged over the duration of the trial was 1.5 g/d (range, 0-7.4 g/d). The median quantity of sunscreen applied was 0.79 mg/cm², which was less than half the amount needed to achieve the labeled sun protection factor.

Conclusions  It is possible to implement the daily application of sunscreen in sun-exposed populations, although protection would be increased if the quantity of sunscreen applied were greater.

From the Population and Clinical Sciences Division, Queensland Institute of Medical Research (Drs Neale and Green), and Australian Centre for International and Tropical Health and Nutrition (School of Public Health), University of Queensland (Dr Williams), Brisbane, Australia.

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