Improving compliance of daily sunscreen application by changing accessibility

Sunscreens are effective in preventing sunburn, skin cancers and signs of photoaging (1). Over the past decades, a sustained effort to educate the public on the benefit of sunscreen use and proper application techniques has been carried out by dermatologists, academia, industry and nonprofit organizations (2). Although the public understands the benefits of sunscreen use (3, 4), the vast majority do not use sunscreen on a routine basis due to a variety of reasons (5). The aim of this study was to investigate whether sunscreen compliance can be improved by changing accessibility and storage location. The study took place from February 2016 to May 2016. All eligible participants were randomized into two groups: group A (sunscreen only) and group B (sunscreen + toothpaste/storage unit). On the initial visit, all participants were educated regarding the benefits of daily sunscreen application and received a 2-month supply of broad-spectrum, SPF-30 sunscreen (Neutrogena Ultra-Sheer Dry-Touch Lotion – 3 fl oz) with instructions to apply it each morning to their face, neck, and hands. In addition, participants in group B received a storage unit and were instructed to place the sunscreen with their current toothpaste in the same storage unit in their bathroom. Participants also completed baseline questionnaires regarding demographics and skin characteristics. After 6 weeks, participants returned for followup, and the weight of each participant’s sunscreen was measured before and after the study. Descriptive statistics and graphical methods were used to describe the study population and intervention results. The outcome measure was the difference in weight of sunscreen preminus postintervention for each participant. Least squares regression was used to assess differences between intervention group, while controlling for participant age and skin type. All analyses were performed with Stata v.14.1, Stata Corporation, College Station, TX, USA. A total of 62 Caucasian women took part in the study. Overall mean age of the participants was 38.1 years (SD = 10.7), and no difference in age was observed between the groups. Of the participants, 16% (n = 10) were skin type I, 32% (n = 20) were skin type II, and 52% (n = 32) were skin type III. No appreciable difference in skin types was observed between intervention groups. The mean preweight of sunscreens was 112.2 g for all study participants. Overall sunscreen usage was 40.7 g (SD = 17.8), reflecting a 36.2% change from baseline, P < 0.001. Participants with skin type I used significantly more sunscreen (53.4 g, SD = 13.0) than type II (40.7 g, SD = 15.9) and type III (36.4 g, SD = 18.8) participants, P-values 0.05 and 0.009, respectively.