1 Yazdani Abyaneh M.A.

Griffith R.D.

Falto-Aizpurua L.

Nouri K. Evaluation of sunscreens distributed by 2 major US retailers for meeting recommendations by the American Academy of Dermatology. , 2 American Academy of Dermatology. How to select a sunscreen. Available at: https://www.aad.org/public/spot-skin-cancer/learn-about-skin-cancer/prevent/how-to-select-a-sunscreen. Accessed January 24, 2017. 3 Food and Drug Administration; Health and Human Services

Labeling and effectiveness testing; sunscreen drug products for over-the-counter human use. Final rule. , 4 Wang S.Q.

Stanfield J.W.

Osterwalder U. In vitro assessments of UVA protection by popular sunscreens available in the United States. To the Editor: In 2014, Yazdani et al published an article detailing the proportion of sunscreens distributed by the largest United States retailer (Walmart, Bentonville, AR) and pharmacy (Walgreens, Deerfield, IL) that met American Academy of Dermatology (AAD) recommendations: 1) sun protection factor (SPF) ≥30, 2) broad-spectrum coverage, and 3) water resistant for 40-80 minutes.These recommendations were released following standardization of sunscreen labeling and effectiveness testing by the Food and Drug Administration in 2011.The authors also determined whether products that included tanning or bronzing on their primary display panel were less likely to meet these recommendations. In their study, Yazdani and colleagues found that only 34.5% of sunscreens sold at the largest US retailer and 41.0% of sunscreens sold at the largest US pharmacy retailer met all AAD recommendations. In addition, tanning and bronzing products were significantly less likely to meet AAD recommendations.

1 Yazdani Abyaneh M.A.

Griffith R.D.

Falto-Aizpurua L.

Nouri K. Evaluation of sunscreens distributed by 2 major US retailers for meeting recommendations by the American Academy of Dermatology. 1 Yazdani Abyaneh M.A.

Griffith R.D.

Falto-Aizpurua L.

Nouri K. Evaluation of sunscreens distributed by 2 major US retailers for meeting recommendations by the American Academy of Dermatology. 1 Yazdani Abyaneh M.A.

Griffith R.D.

Falto-Aizpurua L.

Nouri K. Evaluation of sunscreens distributed by 2 major US retailers for meeting recommendations by the American Academy of Dermatology. We conducted a follow-up to this study in January 2017 to determine if a greater percentage of sunscreens and tanning and bronzing products now meet AAD guidelines. The websites of both Walmart and Walgreens were visited on January 25, 2017, and the study methods as detailed by Yazdani et al were replicated as follows: Walmart > “pharmacy, health & beauty” > “skin care” > “sun care”; Walgreens > “beauty” > “sun care” > “shop all sun care.”Items without SPF values were excluded.We analyzed the principal display panel for all remaining items to record if the product had an SPF ≥30, was water-resistant for 40-80 minutes, fit the broad-spectrum labeling requirements by the FDA, and advertised bronzing or tanning.

Table I Proportion of sunscreen products meeting AAD recommendations, January 2017 Products Walmart, n (%) Walgreens, n (%) P value

Walmart

(2017 vs 2014) P value

Walgreens

(2017 vs 2014) Total search hits 2157 691 Products evaluated 251 221 Products with SPF ≥30 205 (81.7) 191 (86.4) .14 .16 Products with broad-spectrum coverage 234 (93.2) 212 (95.9) <.01 ∗ ∗ Signifies statistically significant increase in sunscreens available in 2017 compared with 2014. Statistical significance determined as P < .05 with χ2 test. <.01 ∗ ∗ Signifies statistically significant increase in sunscreens available in 2017 compared with 2014. Statistical significance determined as P < .05 with χ2 test. Products with water resistance (40-80 minutes) 190 (75.7) 182 (82.3) <.01 ∗ ∗ Signifies statistically significant increase in sunscreens available in 2017 compared with 2014. Statistical significance determined as P < .05 with χ2 test. <.01 ∗ ∗ Signifies statistically significant increase in sunscreens available in 2017 compared with 2014. Statistical significance determined as P < .05 with χ2 test. Products meeting all 3 AAD recommendations 164 (65.3) 161 (72.9) <.01 ∗ ∗ Signifies statistically significant increase in sunscreens available in 2017 compared with 2014. Statistical significance determined as P < .05 with χ2 test. <.01 ∗ ∗ Signifies statistically significant increase in sunscreens available in 2017 compared with 2014. Statistical significance determined as P < .05 with χ2 test. AAD, American Academy of Dermatology; SPF, sun protection factor. Table II Comparison of sunscreens at Walmart and Walgreens with and without tanning and bronzing advertised on the principal display panel meeting AAD recommendations Category Sunscreens with tanning or bronzing on primary display, n (%) Sunscreens without tanning or bronzing on primary display, n (%) P value Walmart Total number of products 21 230 Products with SPF ≥30 5 (23.8) 200 (87.0) <.01 Products with broad-spectrum coverage 15 (71.4) 219 (95.2) <.01 Products with water resistance (40-80 minutes) 20 (95.2) 170 (73.9) .029 Products meeting all 3 AAD recommendations 4 (19.0) 160 (69.6) <.01 P value (sunscreens meeting all 3 AAD recommendations in 2017 compared with 2014) .058 <.01 ∗ ∗ Signifies statistically significant increase in sunscreens available in 2017 compared with 2014. Statistical significance determined as P < .05 with χ2 test. Walgreens Total products 10 211 Products with SPF ≥30 2 (20.0) 189 (89.6) <.01 Products with broad-spectrum coverage 9 (90.0) 203 (96.2) .33 Products with water resistance, 40-80 min 9 (90.0) 183 (86.7) .76 Products meeting all 3 recommendations 2 (20.0) 159 (75.3) <.01 P value (sunscreens meeting all 3 AAD recommendations in 2017 compared with 2014) .95 <.01 ∗ ∗ Signifies statistically significant increase in sunscreens available in 2017 compared with 2014. Statistical significance determined as P < .05 with χ2 test. AAD, American Academy of Dermatology; SPF, sun protection factor. We examined 251 and 221 evalutable products at the websites of Walmart and Walgreens, respectively. Most sunscreens available had SPF ≥30 (81.7% and 86.4%), demonstrated broad-spectrum coverage per FDA regulations (93.2% and 95.9%), and were water resistant for 40-80 minutes (75.7% and 82.3%). In addition, most products met all 3 AAD recommendations (65.3% and 72.9%) ( Table I ). Our findings demonstrate that significantly more products with broad-spectrum coverage and water resistance are available to consumers in 2017 than in 2014 (P < .01). The proportion of products with SPF ≥30 remained stable, possibly because there were already many to begin with. In addition, significantly more sunscreens met all 3 AAD recommendations in 2017 compared with the sunscreens available in 2014 (P < .01). Furthermore, in accordance with the previous study, tanning and bronzing products were significantly less likely to comply with all 3 AAD guidelines recommendations than other sunscreens (19.0% and 20.0%) (P < .01) ( Table II ). This lack of adherence might be due to the targeted consumer population. Consumers may equate a higher SPF to receiving less of a tan.

Our study demonstrates that sunscreens available at major retailers more closely adhere to AAD guidelines in 2017 than in 2014, but there remains room for improvement: 34.7% of products sold at the largest retailer do not meet recommendations. In addition, tanning and bronzing products continue to fail to meet AAD criteria.