What is the role of sunscreen in the prevention of basal cell carcinoma (BCC)?

Updated: Mar 02, 2020
  • Author: Robert S Bader, MD; Chief Editor: William D James, MD  more...
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Answer

Regular application and reapplication of sunscreen is recommended prior to sun exposure. People who use sunscreens have a 40% reduction in skin cancer incidence versus nonusers.

The sun protection factor (SPF) ratings of sunscreens correspond to their ability to protect the skin from harmful UVB rays. The Centers for Disease Control and Prevention (CDC) recommends use of a sunscreen with an SPF rating of at least 15, [54] while the American Academy of Dermatology (AAD) advises use of a sunscreen with an SPF rating of at least 30. [55] Both organizations recommend use of a broad spectrum sunscreen, which will also provide protection against UVA radiation.

Emphasize also that sunscreens must be applied generously, 20-30 minutes before going outside, and reapplied about every 2 hours, more often if swimming or sweating; the AAD recommends use of water resistant sunscreen, which maintains its SPF for 40 minutes of immersion (or, in the case of "very water resistant products, for 80 minutes). For lip protection, a lip balm with an SPF of 15 or higher should be applied.

Instruct parents to protect their children's skin with sunscreen or protective clothing to reduce the risk of BCC later in life. It has been estimated that intensive sun protection before age 18 years can reduce nonmelanoma skin cancer by 78%.

Advise parents not to expose children younger than 12 months to direct sunlight and to cover up children aged 12-24 months with a hat, shirt, and a small amount of sunscreen on the remaining exposed areas. Similarly, for children older than 2 years, instruct parents to consider using sunscreens, covering the child's skin with clothing, and, when possible, restricting the child to shaded areas.


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