1 Gallagher R.P.

Lee T.K.

Bajdik C.D.

Borugian M. Ultraviolet radiation. 2 Robinson J.K.

Jablonski N.G. Sun protection and skin self-examination and the US preventive services task force recommendation on behavioral counseling for skin cancer prevention. 3 Covolo L.

Ceretti E.

Moneda M.

et al. Does evidence support the use of mobile phone apps as a driver for promoting healthy lifestyles from a public health perspective? A systematic review of randomized control trials. To the Editor: Primary prevention of skin cancer is best achieved by protecting the skin from exposure to ultraviolet (UV) radiation; exposure to UV radiation increases the risk for both melanoma and nonmelanoma skin cancers.The US Preventive Task Force recommends that children and adults be counseled on using sun protection practices to minimize UV exposure and suggests that mobile smartphone applications might be useful to facilitate these behaviors.The effectiveness of smartphone applications to promote a variety of health behaviors targeting exercise performance, weight loss, diet, smoking cessation, alcohol consumption, and sun protection has been examined in the published literature.Skin cancer prevention is particularly amenable to intervention from smartphone applications by helping individuals monitor UV exposure and provide tailored recommendations and reminders for protecting their skin. Dozens of applications of varying quality are currently available, making it difficult for interested users to find applications with useful, intuitive, and effective features.

4 Zhao J.

Freeman B.

Li M. Can mobile phone apps influence people's health behavior change? An evidence review. The purpose of this study was to provide a comprehensive list of currently available sun protection smartphone applications and their features. In August 2018, we searched the Apple (Cupertino, CA) and Android (Google, Menlo Park, CA) App stores for applications that promote sun protection practices. Search terms included “skin cancer,” “sun,” “UV protection,” and “melanoma.” Results were screened according to predefined inclusion and exclusion criteria. Smartphone apps were included if they provided specific, personalized advice regarding sun protection using local UV indices and the user's personal skin characteristics. We excluded apps that only provided weather, UV information, or general recommendations and those that were not in English, were country specific, or not for patient use. We also excluded apps that were incompatible with the latest smartphone operating systems and that required purchase of a wearable UV dosimeter. Last, we compared apps on the basis of features that have been shown to improve the effectiveness of apps targeting behavior change, such as having a user-friendly design, providing real-time feedback, and offering tailored advice supplemented by additional information.

5 Buller D.B.

Berwick M.

Lantz K.

et al. Evaluation of immediate and 12-week effects of a smartphone sun-safety mobile application: a randomized clinical trial. Table I Smartphone applications meeting criteria, providing personalized sun protection recommendations to minimize UV exposure No. Name Developer Platform Cost, USD Last updated Features 1 Dermosil Care Guide Dermoshop Oy iOS only Free January 2016 Personalized sun protection recommendations based on UV index, skin color, and landscape surface reflection; UV forecast (hourly and weekly) 2 Healthy Sun Pavel Chekhau iOS only Free August 2018 Personalized exposure time based on UV index, skin color, SPF of sunscreen, and landscape surface reflection; skin scanner to evaluate and track skin lesions 3 QSun Comfable Inc iOS and Android Free; pro version $3.99/month or $23.99/year; wearable technology for real-time UV data collection $149 August 2018 Skin type assessment; personalized sun protection recommendations based on UV, skin type, and landscape; notifications for high UV and reminders to reapply sunscreen; sunscreen scanner identifies effective sunscreen properties; sunscreen calculator estimates amount of sunscreen to apply based on height and weight; skin scanner estimates skin health and age; UV forecast (daily and weekly); sun-safe activity tracker (pro version only); vitamin D intake tracker (pro version only) 4 SunSense Raymio iOS and Android Free; wearable technology for real-time UV data collection $59.99 July 2018 Personalized sun protection recommendations based on UV index, skin color, landscape surface reflection, and cloud cover; “Plan your day” function; UV forecast (daily notification); reminders and alerts to reapply sunscreen or seek additional protection; general sun protection advice and information; multiple user profiles 5 SunZapp Klein Buendel Inc iOS and Android Free; pro version $1.99 (iOS only) April 2018 Skin type assessment; personalized sun protection recommendations based on UV index, skin type, and SPF of sunscreen; UV forecast (daily); “Plan your day” function (up to 5 days in advance; pro version only); multiple user profiles (pro version only) 6 UVI Mate Alexander Ershov iOS and Android Free; pro version $6.49 /year August 2018 Personalized sun protection recommendations based on UV index, skin color, and cloud cover; vitamin D intake tracker; UV forecast (next 2 hours, next 6 hours in pro version); reminder to reapply sunscreen; UV index adjusted according to landscape (pro version only); multiple user profiles (pro version only) 7 UVLens Spark 64 iOS and Android Free May 2018 Skin type assessment; personalized sun protection recommendations based on UV index and skin type; reminder to reapply sunscreen based on SPF and time to burn estimation; UV forecast (2 days) 8 UV Notifier Bella Saadllah (Z-team) iOS and Android Free August 2017 Skin type assessment; personalized sun protection recommendations based on UV index and skin type; UV danger and time to burn alerts 9 UV SunTan Timer Richard Acherki iOS only $2.99 October 2014 Personalized sun protection recommendations based on UV index, skin color, and SPF of sunscreen; reminder to get out of the sun SPF, Sun protection factor; UV, ultraviolet. Our search revealed 1060 results across both app stores (including duplicates), from which we identified 9 eligible apps ( Table I ). Most apps were user friendly, intuitive, and provided personalized sun protection recommendations tailored to user skin type and color. Recommendations included avoiding being outdoors during periods of high UV light, a minimum sunscreen sun protection factor and time until reapplication, and types of physical protection (ie, clothing, hats, and sunglasses). However, we found limited published evidence regarding the effectiveness of these apps for facilitating sun protection behaviors. In fact, only SunZapp developers (Klein Buendel Inc, Golden, CO) provided citations to 3 published studies showing limited improvement in sun protection.We found most apps included in this review to be easy to use while providing instant feedback and tailored recommendations to users, but only SunSense (Raymio, Copenhagen, Denmark) satisfied all criteria by offering additional information about sun protection. Although we have identified several apps with the potential to promote sun safety, further investigation is required to establish whether their use results in sustained behavior change and reductions in UV exposure. Future research should also consider comparing apps that utilize wearable technology for real-time UV tracking and those that rely on regional UV indices.