Sunscreen Allergy: A Review of Epidemiology, Clinical Characteristics, and Responsible Allergens

Elyse Scheuer; Erin Warshaw


Dermatitis. 2006;17(1):3-11. 

In This Article

Risk Factors

Sunscreen use by the general public has increased markedly over the last 20 years as the photocarcinogenic and photoaging properties of UV radiation have become recognized. Chemical absorbers are frequently incorporated not only into dedicated sunscreens but also into personal products such as moisturizers, lip care products, and foundations.[4,5,10]

The risk factors for sunscreen allergy are largely unknown but may include gender, preexisting photodermatoses, outdoor occupation, and atopy. In their retrospective study, Schauder and Ippen found that of individuals with relevant allergic or photoallergic contact dermatitis, 65% (52 of 80) were female.[14] They postulated that this could be due to either a higher use of sunscreen and cosmetic products by women or greater use of dermatologic services among women.

Several studies have demonstrated an increased prevalence of sunscreen allergy in patients with idiopathic photodermatoses.[13,14,18,19] In Schauder and Ippen's study, 59% (47 of 80) of individuals with allergy had known photodermatoses;[14] not surprising, diagnosis varied by gender. Sixty-eight percent of men (19 of 28) with demonstrated allergy had photodermatoses; the most common condition was chronic actinic dermatitis (16 of 19 [84%]). Among women, 53% (28 of 52) had known photodermatoses; polymorphous light eruption (PMLE) was the most common condition (18 of 28 [64%]). Bilsland and Ferguson evaluated 45 patients with chronic actinic dermatitis (CAD) and 54 patients with PMLE and patch-tested them with benzophenones, dibenzoylmethanes, aminobenzoates, cinnamates, and Eusolex 6300 (Merck KGaA, Darmstadt, Germany).[18] One hundred fifteen nonphotosensitive subjects served as controls. Ten (22%) of the 45 patients with CAD and 2 (3.7%) of the 54 patients with PMLE demonstrated sunscreen allergy on patch tests. Only 4 (3.4%) of the 115 controls demonstrated allergy (p = .0001). Benzophenones accounted for most of the positive results. Photopatch tests were not performed in this study.

Other potential patient risk factors for sunscreen sensitization include the use of sunscreen products on previously damaged skin, a history of atopic dermatitis, and an outdoor occupation.[13,20,21]