Published: 2021-12-24

Expert consensus on the use of sunscreen agents: Indian perspective

Mansukh Ghalla, Rasya Dixit, K. Srinivasa Murthy, Tina Priscilla Katta


Sunscreens have been widely known to play an integral part in photoprotection. Both physical and chemical sunscreens have been extensively used for prevention and management of several conditions induced by ultraviolet rays such as sunburn, photoaging, skin cancer, and phototoxic reactions. Currently, sunscreens are available in different formulations like creams, lotions, gels, sticks, and sprays. Forty experts in the field of clinical dermatology participated in the expert group meetings organized via teleconference webinar to discuss definitions, diagnoses, and management. Current evidence on the use of sunscreen agents along with clinical experience of experts was discussed. The application of an adequate amount of sunscreen with an appropriate sun protection factor is imperative, and must be in accordance to skin type and exposure pattern of an individual. As part of a complete sun protection regimen, the judicious use of sunscreens must be combined with avoidance of midday sun exposure and protective clothing. There is an undeniable need to improve public education and awareness regarding use of sunscreens. This review article provides a consensus clinical viewpoint of expert dermatologists on effective use of sunscreens to assist in clinical decision-making for healthcare professionals.


Sunscreen, Sun protection factor, Photostability, Photoprotection

Full Text:



Geoffrey K, Mwangi AN, Maru SM. Sunscreen products: Rationale for use, formulation development and regulatory considerations. Saudi Pharm J. 2019;27:1009-18.

Latha MS, Martis J, Shobha V, Sham Shinde R, Bangera S, Krishnankutty B, et al. Sunscreening agents: a review. J Clin Aesthet Dermatol. 2013;6:16-26.

Mancuso JB, Maruthi R, Wang SQ, Lim HW. Sunscreens: An update. Am J Clin Dermatol. 2017;18:643-50.

Ngoc LT, Tran VV, Moon JY, Chae M, Park D, Lee YC. Recent trends of sunscreen cosmetic: An update review. Cosmetics. 2019;6:64.

Sunscreens and photoprotection. Available at Accessed on 10 February 2021.

Ebrahimzadeh MA, Enayatifard R, Khalili M, Ghaffarloo M, Saeedi M, Yazdani Charati J. Correlation between sun protection factor and antioxidant activity, phenol and flavonoid contents of some medicinal plants. Iran J Pharm Res. 2014;13:1041-7.

Bens G. Sunscreens. Adv Exp Med Biol. 2014;810:429-63.

Pelizzo M, Zattra E, Nicolosi P, Peserico A, Garoli D, Alaibac M. In vitro evaluation of sunscreens: an update for the clinicians. ISRN Dermatol. 2012;2012:352135.

Kaimal S, Abraham A. Sunscreens. Indian J Dermatol Venereol Leprol. 2011;77:238-43.

Ou-Yang H, Stanfield J, Cole C, Appa Y, Rigel D. High-SPF sunscreens (SPF ≥ 70) may provide ultraviolet protection above minimal recommended levels by adequately compensating for lower sunscreen user application amounts. J Am Acad Dermatol. 2012;67:1220-7.

Snyder A, Valdebran M, Terrero D, Amber KT, Kelly KM. Solar ultraviolet exposure in individuals who perform outdoor sport activities. Sports Med Open. 2020;6:42.

Harrison SC, Bergfeld WF. Ultraviolet light and skin cancer in athletes. Sports Health. 2009;1:335-40.

Okon LG, Werth VP. Cutaneous lupus erythematosus: diagnosis and treatment. Best Pract Res Clin Rheumatol. 2013;27:391-404.

Fatima S, Braunberger T, Mohammad TF, Kohli I, Hamzavi IH. The role of sunscreen in melasma and postinflammatory hyperpigmentation. Indian J Dermatol. 2020;65:5-10.

Keyes E, Werth VP, Brod B. Potential allergenicity of commonly sold high SPF broad spectrum sunscreens in the United States; from the perspective of patients with autoimmune skin disease. Int J Womens Dermatol. 2019;5:227-32.

Kumari P, Suvirya S, Verma P, Pathania S, Shukla P. Sunscreens: The current scenario. JDA Indian J Clin Dermatol. 2019;2:01-6.

Singh LC. High altitude dermatology. Indian J Dermatol. 2017;62:59-65.

Isedeh P, Osterwalder U, Lim HW. Teaspoon rule revisited: proper amount of sunscreen application. Photodermatol Photoimmunol Photomed. 2013;29:55-6.

Taylor S, Diffey B. Simple dosage guide for suncreans will help users. BMJ. 2002;324:1526.

Diffey BL. When should sunscreen be reapplied? J Am Acad Dermatol. 2001;45:882-5.

Rungananchai C, Silpa-Archa N, Wongpraparut C, Suiwongsa B, Sangveraphunsiri V, Manuskiatti W. Sunscreen application to the face persists beyond 2 hours in indoor workers: an open-label trial. J Dermatolog Treat. 2019;30:483-6.

Schalka S, Steiner D, Ravelli FN, Steiner T, Terena AC, Marçon CR, et al. Brazilian consensus on photoprotection. An Bras Dermatol. 2014;89(6 Suppl 1):1-74.

Dale Wilson B, Moon S, Armstrong F. Comprehensive review of ultraviolet radiation and the current status on sunscreens. J Clin Aesthet Dermatol. 2012;5:18-23.

López-Jornet P, Camacho-Alonso F, Rodríguez-Espin A. Study of lip hydration with application of photoprotective lipstick: influence of skin phototype, size of lips, age, sex and smoking habits. Med Oral Patol Oral Cir Bucal. 2010;15:e445-50.

Sethi A, Kaur T, Malhotra SK, Gambhir ML. Moisturizers: The slippery road. Indian J Dermatol. 2016;61:279-87.

More BD. Physical sunscreens: on the comeback trail. Indian J Dermatol Venereol Leprol. 2007;73:80-5.

Li H, Colantonio S, Dawson A, Lin X, Beecker J. Sunscreen application, safety, and sun protection: The evidence. J Cutan Med Surg. 2019;23:357-69.

Nash JF, Tanner PR. Relevance of UV filter/sunscreen product photostability to human safety. Photodermatol Photoimmunol Photomed. 2014;30:88-95.

Gilaberte Y, Carrascosa JM. Sun protection in children: realities and challenges. Actas Dermosifiliogr. 2014;105:253-62.

Quatrano NA, Dinulos JG. Current principles of sunscreen use in children. Curr Opin Pediatr. 2013;25:122-9.

Shanbhag S, Nayak A, Narayan R, Nayak UY. Anti-aging and sunscreens: Paradigm shift in cosmetics. Adv Pharm Bull. 2019;9:348-59.

Lehmann P, Schwarz T. Photodermatoses: diagnosis and treatment. Dtsch Arztebl Int. 2011;108:135-41.

Medeiros VL, Lim HW. Sunscreens in the management of photodermatoses. Skin Therapy Lett. 2010;15:1-3.

Driscoll MS, Wagner RF Jr. Clinical management of the acute sunburn reaction. Cutis. 2000;66:53-8.

Lyons AB, Trullas C, Kohli I, Hamzavi IH, Lim HW. Photoprotection beyond ultraviolet radiation: A review of tinted sunscreens. J Am Acad Dermatol. 2020;20:S0190-9622.

Del Rosso JQ, Gold M, Rueda MJ, Brandt S, Winkelman WJ. Efficacy, safety, and subject satisfaction of a specified skin care regimen to cleanse, medicate, moisturize, and protect the skin of patients under treatment for acne vulgaris. J Clin Aesthet Dermatol. 2015;8:22-30.

Kohli M, Pant H, Dixit R, Parthasaradhi A. Expert consensus on defining sensitive skin and role of cosmeceuticals: an Indian perspective. Int J Res Dermatol. 2020;6:827-36.

Sarkar R, Garg VK, Jain A, Agarwal D, Wagle A, Flament F, et al. A randomized study to evaluate the efficacy and effectiveness of two sunscreen formulations on Indian skin types IV and V with pigmentation irregularities. Indian J Dermatol Venereol Leprol. 2019;85:160-8.

Sarkar R, Arora P, Garg KV. Cosmeceuticals for hyperpigmentation: What is available? J Cutan Aesthet Surg. 2013;6:4-11.

Verallo-Rowell V. The role of sunscreens in the therapy of melasma. Clin. Drug Invest. 1995;10:46-56.

Sardesai VR, Kolte JN, Srinivas BN. A clinical study of melasma and a comparison of the therapeutic effect of certain currently available topical modalities for its treatment. Indian J Dermatol. 2013;58:239.

Rendon MI, Berson DS, Cohen JL, Roberts WE, Starker I, Wang B. Evidence and considerations in the application of chemical peels in skin disorders and aesthetic resurfacing. J Clin Aesthet Dermatol. 2010;3:32-43.

Grajqevci-Kotori M, Kocinaj A. Exfoliative skin-peeling, benefits from this procedure and our experience. Med Arch. 2015;69:414-6.

Wanitphakdeedecha R, Phuardchantuk R, Manuskiatti W. The use of sunscreen starting on the first day after ablative fractional skin resurfacing. J Eur Acad Dermatol Venereol. 2014;28:1522-8.

Passeron T, Bouillon R, Callender V, Cestari T, Diepgen TL, Green AC, et al. Sunscreen photoprotection and vitamin D status. Br J Dermatol. 2019;181:916-31.

Agarwal SB, Godse K, Patil S, Nadkarni N. Knowledge and attitude of general population toward effects of sun exposure and use of sunscreens. Indian J Dermatol. 2018;63:285-91.

Vasicek BE, Szpunar SM, Manz-Dulac LA. Patient knowledge of sunscreen guidelines and frequency of physician counseling: A cross-sectional study. J Clin Aesthet Dermatol. 2018;11:35-40.