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      Reduction of Solar Keratoses by Regular Sunscreen Use

      , ,
      New England Journal of Medicine
      Massachusetts Medical Society

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          Abstract

          The incidence of and mortality from skin cancer are increasing in many countries. In view of the added concern about ozone depletion, many organizations are promoting the regular use of sunscreens to prevent skin cancer, despite the absence of evidence that these products have this effect. Solar (actinic) keratosis is a precursor of squamous-cell carcinoma of the skin. We conducted a randomized, controlled trial of the effect on solar keratoses of daily use of a broad-spectrum sunscreen cream with a sun-protection factor of 17 in 588 people 40 years of age or older in Australia during one summer (September 1991 to March 1992). The subjects applied either a sunscreen cream or the base cream minus the active ingredients of the sunscreen to the head, neck, forearms, and hands. The mean number of solar keratoses increased by 1.0 per subject in the base-cream group and decreased by 0.6 in the sunscreen group (difference, 1.53; 95 percent confidence interval, 0.81 to 2.25). The sunscreen group had fewer new lesions (rate ratio, 0.62; 95 percent confidence interval, 0.54 to 0.71) and more remissions (odds ratio, 1.53; 95 percent confidence interval, 1.29 to 1.80) than the base-cream group. There was a dose-response relation: the amount of sunscreen cream used was related to both the development of new lesions and the remission of existing ones. Regular use of sunscreens prevents the development of solar keratoses and, by implication, possibly reduces the risk of skin cancer in the long-term.

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          Most cited references16

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          Generalized Linear Models

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            Nonmelanoma cancers of the skin.

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              MALIGNANT TRANSFORMATION OF SOLAR KERATOSES TO SQUAMOUS CELL CARCINOMA

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                Author and article information

                Journal
                New England Journal of Medicine
                N Engl J Med
                Massachusetts Medical Society
                0028-4793
                1533-4406
                October 14 1993
                October 14 1993
                : 329
                : 16
                : 1147-1151
                Article
                10.1056/NEJM199310143291602
                8377777
                bab46780-9f8d-4008-aa96-f3a5e4fce096
                © 1993

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