• Indermeet Kohli, Cynthia L Nicholson, Joshua D Williams, Alexis B Lyons, InSeok Seo, Prithwiraj Maitra, Xiaoyan Tian, Evren Atillasoy, Henry W Lim, and Iltefat H Hamzavi.
• Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
• J. Am. Acad. Dermatol. 2020 Apr 1; 82 (4): 869-877.

BackgroundBeach vacations are high-risk settings for overexposure to ultraviolet radiation.ObjectiveTo compare the sunburn protective efficacy of SPF 50+ and SPF 100+ sunscreens under actual use at the beach.MethodsA prospective, randomized, double-blind, single-center, split-body/face study of 55 healthy individuals. Each participant applied both sunscreens to randomized sides of the face/body for up to 5 consecutive days. Blinded clinical evaluation of erythema by a single grader and objective instrumental assessments, colorimetry, and diffuse reflectance spectroscopy were performed the morning after each sun exposure.ResultsAfter 5 days, 31 (56%) participants had more sunburn on the SPF 50+ side compared to 4 (7%) on the SPF 100+ side. Overall, mean erythema intensity showed statistically significantly less erythema on the SPF 100+ side compared with the SPF 50+ side. The first observation of sunburn exclusively on the SPF 50+ side occurred after 1 day of sun exposure, whereas that for SPF 100+ occurred after 3 days of sun exposure.LimitationsOnly initial sunscreen application was monitored, only 1 participant with skin phototype I was recruited, and participants were recruited from a local beach area.ConclusionSPF 100+ was significantly more effective in protecting against ultraviolet radiation-induced erythema and sunburn than SPF 50+ in actual use in a beach vacation setting.Copyright © 2020. Published by Elsevier Inc.

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