Sunscreen Application Research Articles

A Review on Knowledge, Perception, Practice and Associated Factors of Sunscreen Usage among the Population

Background: The use of sunscreen is a critical component of skin cancer prevention and overall skin health. Nevertheless, inconsistencies in sunscreen knowledge, perceptions, and practices persist among different populations, which are influenced by various factors. This review aims to synthesise and analyse the existing literature on the knowledge, perceptions, and practices related to sunscreen use across different populations and regions. It explores the factors influencing sunscreen application and the barriers to proper sunscreen use. Methods: A comprehensive review of studies published between 2015 and 2023 was conducted, focusing on quantitative research on sunscreen knowledge, perceptions, and practices. Journals were obtained from EBSCo, Scopus and Mendeley databases. Results: The initial article obtained from databases was 1250 articles, and the final articles chosen for review is 32 articles. This review highlights significant knowledge gaps about sunscreen use, particularly the need for sunscreen on cloudy days and understanding SPF values. Despite high awareness of UV radiation's harmful effects, actual use remains inconsistent. Common misconceptions, such as believing sunscreen is unnecessary in winter or indoors, persist across demographics. Perceptions of sunscreen's efficacy vary. Factors like sex, skin phototype, age, and education level significantly influence use, with barriers including forgetfulness, discomfort, cost, and lack of habit. Conclusion: The findings underscore the need for enhanced educational campaigns to correct misconceptions and promote consistent sunscreen use. Targeted interventions should address specific barriers and tailor messages to different demographic groups to improve sunscreen practices and reduce the risk of UV-induced skin damage.

Relationship between antioxidant activity and ESIPT process based on flavonoid derivatives: A comprehensive analysis

Antioxidant activity, as a topic of current interest, is discussed together with the excited state intramolecular proton transfer (ESIPT) process for three flavonoid derivatives, based on density functional theory (DFT)and time-dependent DFT (TD-DFT) methods, as well as DPPH free radical scavenging assay. The potential energy curves and transition states demonstrate that the three molecules can undergo only single proton transfer in the excited state, and all of them are ultrafast ESIPT processes. The absorption spectra of all the molecules show effective protection against UV radiation with low fluorescence intensity, especially Baicalein (Bai), which demonstrates their great potential for sunscreen applications. The density of states, HOMO energy values, global and local indices reveal that the antioxidant activity of the molecules after ESIPT process is enhanced, with Bai having the highest antioxidant activity, which is significantly attributed to the number and position of phenolic hydroxyl groups. Moreover, by comparing the DPPH free radical scavenging activity under the dark and UV radiation conditions, the radical scavenging activity (RSA) value in the UV radiation is remarkably higher than that in the dark condition, in which Bai achieves RSA value of 93.4%. Overall, the antioxidant activity of all three ESIPT-based flavonoid derivatives, especially Bai, is significantly elevated in the keto* form, which reinforces the significant relationship between antioxidant activity and ESIPT process, and provides new application prospects for molecules with ESIPT properties.

Analysis Based on Three Aspects of Sunscreen

With the increasing awareness of health, people’s awareness of UV protection is also gradually improving. Sunscreen with UV protection has become an indispensable part of people’s daily lives. The market size of China’s sunscreen market will reach 74.2 billion yuan in 2023, and it is expected to grow to 95.8 billion yuan by 2026. The purpose of this paper is to analyze the safety, effectiveness, and environmental friendliness of sunscreen from three perspectives, and discuss the reliability of SPF human testing, improving the stability of sunscreen use, and the cost of new environmentally friendly materials. Through analysis, it is found that there are still shortcomings in the current SPF testing methods, production costs of environmentally friendly materials, and promotion of correct application methods for sunscreen. Subsequently, appropriate adjustments were made to the testing methods and material formulations of sunscreen, as well as recommendations for the selection and correct application of sunscreen. However, the long-term safety of nanomaterials still needs to be further explored. Due to the rapid development of research technology for sunscreen products and the diversification of market products, it is necessary to review the safety, effectiveness, and environmental friendliness of current sunscreen products.

A prospective study analyzing the use of free public sunscreen dispensers.

This study evaluates the impact of sunscreen dispensers in increasing sunscreen usage and awareness in Summerside, Prince Edward Island, Canada. In June 2022, three touchless sunscreen dispensers offering free Health Canada-approved SPF 30 sunscreen were installed in areas of high pedestrian traffic. A team of four city workers gathered observational data over a 17-day span between July and August 2022. Seven days of monitoring took place at the city ballpark, seven at a children's park, and three at the city beachfront boardwalk. In total, 1202 individuals were observed near the dispensers, of whom 209 utilized the dispensers, yielding a usage rate of 17.4 per 100 persons. The usage rate varied by location, with the children's park recording a higher average (40.0 users per 100 persons), and was also weather-dependent, with increased usage on sunny days (average of 52.2 users per 100 persons). The majority of users were classified with a Fitzpatrick skin type of I or II. The sunscreen bags, designed for 2000 applications, did not require refilling during the observation period. The QR code associated with the dispensers was scanned 14 times. The findings of this study indicate that installing sunscreen dispensers in public spaces may increase the frequency of sunscreen application. Both the location of the dispensers and the perception of weather conditions seem to impact usage rates.

50559 Concurrent exposure to multiple environmental aggressors amplifies damage in an ex-vivo human skin model; and the topical application of antioxidant-enriched sunscreens protects from multi-aggressor insults

50559 Concurrent exposure to multiple environmental aggressors amplifies damage in an ex-vivo human skin model; and the topical application of antioxidant-enriched sunscreens protects from multi-aggressor insults

Improved Compliance of Daily Sunscreen Application Through a Simple, Daily, Goal-Setting Reminder: A Randomized Controlled Trial.

Improved Compliance of Daily Sunscreen Application Through a Simple, Daily, Goal-Setting Reminder: A Randomized Controlled Trial.

Contribution of Continued Dermal Exposure of PFAS-Containing Sunscreens to Internal Exposure: Extrapolation from In Vitro and In Vivo Tests to Physiologically Based Toxicokinetic Models.

Per- and polyfluoroalkyl substances (PFASs) are widely present in sunscreen products as either active ingredients or impurities. They may penetrate the human skin barrier and then pose potential health risks. Herein, we aimed to develop a physiologically based toxicokinetic (PBTK) model capable of predicting the body loading of PFASs after repeated, long-term dermal application of commercial sunscreens. Ten laboratory-prepared sunscreens, generally falling into two categories of water-in-oil (W/O) and oil-in-water (O/W) sunscreens, were subject to in vitro percutaneous penetration test to assess the impacts of four sunscreen ingredients on PFAS penetration. According to the results, two sunscreen formulas representing W/O and O/W types that mostly enhanced PFAS dermal absorption were then selected for a subsequent 30 day in vivo exposure experiment in mice. PBTK models were successfully established based on the time-dependent PFAS concentrations in mouse tissues (R2 = 0.885-0.947) and validated through another 30 day repeated exposure experiment in mice using two commercially available sunscreens containing PFASs (R2 = 0.809-0.835). The PBTK model results suggest that applying sunscreen of the same amount on a larger skin area is more conducive to PFAS permeation, thus enhancing the exposure risk. This emphasizes the need for caution in practical sunscreen application scenarios, particularly during the summer months.

Mono-n-hexyl phthalate: exposure estimation and assessment of health risks based on levels found in human urine samples

Mono-n-hexyl phthalate (MnHexP) is a primary metabolite of di-n-hexyl phthalate (DnHexP) and other mixed side-chain phthalates that was recently detected in urine samples from adults and children in Germany. DnHexP is classified as toxic for reproduction category 1B in Annex VI of Regulation (EC) 1272/2008 and listed in Annex XIV of the European chemical legislation REACH; thereby, its use requires an authorisation. Health-based guidance values for DnHexP are lacking and a full-scale risk assessment has not been carried out under REACH. The detection of MnHexP in urine samples raises questions about the sources of exposure and concerns of consumer safety. Here, we propose the calculation of a provisional oral tolerable daily intake value (TDI) of 63 µg/kg body weight/day for DnHexP and compare it to intake levels corresponding to levels of MnHexP found in urine. The resulting mean intake levels correspond to less than 0.2% of the TDI, and maximum levels to less than 5%. The TDI was derived by means of an approximate probabilistic analysis using the credible interval from benchmark dose modelling of published ex vivo data on reduced foetal testosterone production in rats. Thus, for the dose associated to a 20% reduction in testosterone production, a lower and upper credible interval of 14.9 and 30.0 mg/kg bw/day, respectively, was used. This is considered a conservative approach, since apical developmental endpoints (e.g. changed anogenital distance) were only observed at higher doses. In addition, we modelled various scenarios of the exposure to the precursor substance DnHexP from different consumer products, taking measured contamination levels into account, and estimated systemic exposure doses. Of the modelled scenarios including the application of sunscreen (as a lotion or pump spray), the use of lip balm, and the wearing of plastic sandals, and considering conservative assumptions, the use of DnHexP-contaminated sunscreen was highlighted as a major contributing factor. A hypothetical calculation using conservative assumptions for the latter resulted in a margin of safety in relation to the lower credible interval of 3267 and 1007 for adults and young children, respectively. Most importantly, it was found that only a fraction of the TDI is reached in all studied exposure scenarios. Thus, with regard to the reported DnHexP exposure, a health risk can be considered very unlikely.

Safety and Tolerance Evaluation of a Suncare Product in Ethnically Diverse Children With Atopic Dermatitis-Prone Skin

Atopic Dermatitis (AD) is a common chronic inflammatory skin condition, with high prevalence in children. Sun protection is important for children with eczema and AD-prone skin, yet many sunscreens can cause skin irritation due to their formulations. In this study, we evaluated the safety and tolerance of an SPF 50 sunscreen in ethnically diverse children with a history of AD over 4 weeks of product use. A total of 45 children from diverse racial/ethnic backgrounds, aged 3 to 12 years old with skin phototypes I-VI, plus a history of eczema and perceived sensitive skin completed the study. All participants applied sunscreen daily on the face and body, at least 15 minutes prior to sun exposure and as needed. After 4 weeks, evaluations were performed by a dermatologist and by participants for tolerability. Product performance questionnaires were also completed by parents/guardians of pediatric participants. After 4 weeks of sunscreen application, tolerability assessments of skin dryness, peeling, erythema, and edema were all absent in children participants. Parent/guardian evaluations of sunscreen tolerability for their child also revealed no perceived skin issues. These results were consistent with no adverse event being observed throughout the study. Parents/guardians reported that sunscreen application on children was smooth and even, with the absence of a white cast appearance on children with skin of color. We conclude from this study that this SPF 50 sunscreen is safe to use in ethnically diverse children with a history of AD and sensitive skin. J Drugs Dermatol. 2024;23(8):669-673.  doi:10.36849/JDD.8282.

Understanding the causes of skincare product pilling.

Skincare and makeup "pilling" is an unsightly and undesirable phenomenon whereby skincare such as moisturizers or foundation ball up to form flakes on the skin. To date, the causes of skincare product pilling have not been studied. This study aimed to examine the relationship between skin physiology and pilling potential of sunscreen and foundation (the two products most reported by consumers to cause pilling). This study also examined the effects of product application methods on pilling. 528 female volunteers from Guangzhou, China, aged between 20 and 49 years, underwent various clinical skin assessments, followed by three steps of product layering. Pilling was assessed after each product application step. 217 volunteers (41%) experienced pilling. The majority of pilling (n=655 events) occurred following sunscreen application, while only a few pilling events (n=35) occurred with foundation. Foundation improved pilling caused by sunscreen in 98.9% of cases. Volunteers experiencing pilling with both sunscreen and foundation had significantly lower facial skin hydration and oiliness, higher pH, and smoother skin texture (P<0.05). Two application methods, rubbing of products in circular and linear motions, yielded the highest numbers of pilling events. This study has provided the first insights into the causes of pilling. Sunscreen is a promoter of pilling, while foundation may resolve sunscreen-induced pilling in many cases. Skin physiology, particularly drier, smoother skin with higher pH, and product application methods are likely contributing factors to this undesirable phenomenon.

Non-linear association between air pollutants and secondary sensitive skin in acne patients.

There is a growing number of patients suffering from sensitive skin secondary to acne, but its prevalence and influencing factors are not yet well-understood. The aim of this study is to investigate the nonlinear relationship between air pollutants and secondary sensitive skin in acne patients. A cross-sectional study comprising 4325 acne outpatients in China was carried out between September 2021 and December 2022, employing a simple random sampling approach. Air pollutants data was derived from the nearest air quality monitoring station corresponding to the subjects' residential locations. Furthermore, socio-economic characteristics, biological attributes, and lifestyle data of patients were acquired via questionnaire surveys. The data were subsequently analyzed utilizing the XGBoost machine learning model. A nonlinear relationship has been observed between secondary sensitive skin in acne patients and various factors, including particulate matter (PM2.5), inhalable particulate matter (PM10), ozone (O3), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), the severity of depression, different levels of exercise intensity, acne grading, frequency of sunscreen application, gender, and age. The occurrence of secondary sensitive skin in acne patients be mitigated through the implementation of measures such as the control of air pollutant emissions, regulation of negative emotions, and improvement of personal lifestyle.

New metabolites of 2-ethylhexyl salicylate in human urine after simulated real-life dermal sunscreen application

2-Ethylhexyl salicylate (EHS) is an organic UV filter which is used in sunscreen and other personal care products. The dermal uptake of EHS was studied in several dermal-exposure experiments. This paper aims to coherently assess urine samples after dermal exposure for the biomarkers EHS, 5OH-EHS, 5oxo-EHS, and 5cx-EPS as well as further biomarkers of interest, specifically 4OH-EHS, 4oxo-EHS, 2OH-EHS, and 6OH-EHS, for the first time. Samples from 18 participants of a pre-existing dermal exposure study under real-life conditions were reassessed using a comprehensive LC-MS/MS method. EHS accounts for 34 % of the cumulative excretion of all analytes within 24 h after exposure, followed by 5OH-EHS (19 %), 5cx-EPS (18 %), 4OH-EHS (15 %) and 5oxo-EHS (11 %). Further metabolites were only quantified in minor amounts. EHS as the most prominent excretion parameter in this study demonstrates the missing first-pass effect after dermal absorption. Furthermore, the applied novel comprehensive analytical procedure revealed oxidation at the ω (5cx-EPS, 6OH-EHS), ω-1 (5OH-EHS, 5oxo-EHS), and ω-2 positions (4OH-EHS, 4oxo-EHS) in the main chain of the ethylhexyl group as well as oxidation in the side chain (2OH-EHS). The presented data are of high relevance for a reliable toxicological risk assessment of dermal exposure to EHS.

Know Your Sunscreen

Ultraviolet(UV) radiation from the sun has significant adverse effects on the skin, including sunburns, premature aging (photoaging), tanning, and many skin cancers. Sunscreens protect from harmful UV radiation. This article delves into the fundamentals of solar radiation, focusing on the UV spectrum, its effect on the skin, various types of sunscreens, and their mechanism of action to offer protection from harmful rays. UV exposure depends on factors like geographic location, altitude, time of day, season, and surface reflectivity. Sunscreen efficacy is measured by the Sun Protection Factor (SPF), which indicates how well a sunscreen can protect against UVB-induced sunburn. SPF ratings of 15, 30, and 50+ correspond to 93%, 96%, and 98% UVB blockage, respectively. In contrast, UVA protection lacks a standardized measure, with various in vitro and in vivo indices used globally. Sunscreens are categorized as organic (chemical) or inorganic (physical), each with distinct mechanisms and properties. Proper application of sunscreen, involving adequate coverage and reapplication, maximizes its protective benefits, significantly reducing the risk of UV-induced skin damage and cancers. Despite minor side effects like potential allergies, the advantages of sunscreen use, including prevention of sunburn, tanning, premature aging, and skin cancers, far outweigh the drawbacks. UV radiation from the sun poses significant risks to skin health. Understanding the nature and effects of UV radiation is crucial in appreciating the importance of protective measures such as sunscreen. The role of sunscreens in providing comprehensive protection cannot be overstated.

Therapeutic effect of NEO400, perillyl alcohol conjugated to linoleic acid, in a mouse model of UV-induced skin damage.

Excessive exposure to ultraviolet radiation (UVR) causes harmful effects on human skin. Pre-exposure application of sunscreen can be protective, but not after damage already has occurred. There is a need for agents that can be applied post-UVR exposure to repair the damage. We investigated a novel compound, NEO400, that appears to meet this medicinal need. NEO400 was created by conjugating linoleic acid to perillyl alcohol. UVR was repeatedly administered to the skin of mice over several weeks, where it caused the typical signs of UV damage, including scaling of the skin, DNA damage, and elevated levels of inflammatory cytokines. However, when NEO400 was applied immediately post-UVR, it triggered the appearance of markers for dermal stem cell proliferation, and no signs of skin damage emerged. Furthermore, when NEO400 was applied to skin that already had incurred significant damage, it accelerated skin healing. When applied individually, linoleic acid and perillyl alcohol were ineffective, indicating that they had to be conjugated in order to exert therapeutic efficacy. None of these skin-protective effects could be achieved with Aloe vera gel, a popular and widely used post-exposure remedy. Our study suggests that NEO400 holds potential as a regenerative treatment for excessively UVR-exposed skin.

Clinical Applications of Sunscreens and Formulation Advancements.

Sunscreens cover the big market ratio in terms of cosmetic applications, but the therapeutic necessity of sunscreen still needs to be uncovered in the clinical context. Clinically, sunscreens are being employed more often nowadays as a result of the rising consequences of skin malignancies and the photodamaging effects of UV radiation. Sunscreens are essential to prevent aging by shielding the skin from the harmful effects of ultraviolet (UV) radiation. Over the recent decades, there has been a significant evolution in the usage of sunscreens as photo protectants. The demand for sunscreen formulations will inevitably rise as more people become aware of the protection that sunscreens provide against tanning, photoaging, non-melanoma skin cancers, premalignant skin lesions, and skin melanomas. The novel contemporary formulation techniques are also beneficial in enhancing the product's aesthetic look and quality. Recently, regulatory agencies have also started paying attention to the regulation of the clinical application, efficacy, and safety parameters related to sunscreen. This review underlines the pathophysiological response of UV exposure with the therapeutic applications of sunscreen in various dermatological conditions and the recent formulation advancements in the development of sunscreen.

Are Welsh primary schools Sunproofed? Results of a national survey, part 2: sun protection practices in primary schools in Wales.

Skin cancer rates are on the rise globally. School sun safety programmes are recommended by the World Health Organization to reduce the risk of future skin cancer at the population level; however, these are encouraged but not mandated in Wales. To explore current sun protection practices and sun safety education in primary schools in Wales and whether these are linked to the existence of a formal sun safety policy. An online survey to all 1241 Welsh primary schools asking about sun safety practices, education and formal policies was undertaken. In total, 471 (38.0%) schools responded. A minority (22/469, 4.7%) of responding schools reported they had sufficient shade for most activities. In the spring and summer terms, almost two-thirds of schools encourage hat wearing (304/469, 64.8%) and sunscreen (296/468, 63.2%). Although nearly all schools reported that parents were encouraged to apply sunscreen to students before school (449/469, 95.7%), there was wide variation in other sunscreen application practices. Less than one-third of schools (129/445, 29.0%) reported that they include sun protection education in the curriculum in every year group, with 11.7% (52/445) including this in certain years only. Schools with a formal policy were more likely to report more comprehensive sun protection practices, including having sufficient shade [odds ratio (OR) 1.51, 95% confidence interval (CI) 1.04-2.19; P = 0.03], having spare hats for pupils to wear (OR 1.59, 95% CI 1.07-2.37; P = 0.02), providing guidance for staff (OR 5.87, 95% CI 3.05-11.28; P < 0.001), encouraging them to model sun safe behaviours (OR 1.82, 95% CI 1.18-2.80; P = 0.007) and teaching sun protection education as part of the curriculum in every year group (OR 2.56, 95% CI 1.76-3.71; P < 0.001). With respect to sunscreen, the existence of a formal policy did not seem to affect a school's practice. Although in most cases, the existence of a formal policy suggests more comprehensive sun protection practices and education in schools, sun protection measures and education need improvement across the primary school sector in Wales to reverse rising skin cancer rates.

Ultraviolet-Protective Clothing and Sunscreen: Sun-Protection for Healthy Skin

Introduction Prolonged exposure to ultraviolet (UV) radiation from the sun poses numerous risks to the skin, ranging from premature aging to serious health conditions such as skin cancer. UV radiation can penetrate the skin's surface, causing damage to its cells and DNA, which can lead to the formation of wrinkles, sunspots, and other signs of aging. Therefore, consistent and effective sun protection is essential for maintaining the health and vitality of the skin, as well as reducing the risk of sun-related skin damage and diseases. Aim of the study The objective of the study is to conduct a thorough investigation into different aspects of photoprotection and its effects on the skin. This entails assessing the effectiveness and safety of sunscreens, as well as evaluating the impact of sun-protection clothing on skin health. Materials and methods The purpose of this review is to assess the current literature of the effectiveness of the various sun protection measures. The literature was reviewed in the Pubmed, Google Scholar data base. Results Prolonged UV exposure incites photoaging, carcinogenesis, and immunosuppression, amplifying the risk of skin malignancies. Sun-protective clothing, with adequate UPF ratings, emerges as a pivotal element in mitigating UV-induced skin damage, notably reducing the development of pigmented moles and melanoma. Furthermore, effective sunscreen usage, coupled with broad-spectrum protection, is essential in averting UV-induced skin damage and curbing the incidence of skin cancer. These findings emphasize the imperative of comprehensive photoprotection strategies, integrating sunscreen application, sun-protective clothing, and individual risk assessment, to safeguard against solar-induced skin damage and mitigate the prevalence of skin cancer.

Types of ultraviolet filters and their combination used in sunscreen determine the appropriate sun protection factor values in vivo

Background The application of sunscreen has been shown to prevent the detrimental effects of ultraviolet. The effectiveness of a sunscreen formulation protection against ultraviolet B is measured by sun protection factor (SPF) and its value determined by in vivo testing is still the gold standard. The consistency between the in vivo and in vitro SPF values is still interesting to investigate, including the influencing factors. Objective To analyze the correlation between the products’ manufacturer estimation in vitro SPF value with the in vivo SPF value and assessing determinant factors that may influence the in vivo SPF value. Patients and methods Ten sunscreen products from various manufacturers were tested in vivo using The European Cosmetic Toiletry and Perfumery Association (COLIPA) method. All the tested products in this study have the manufacturer’s estimated SPF value determined based on in vitro test conducted by the manufacturer. The Spearman correlation test was used for data analysis. Results All sunscreen products had the estimated SPF values of 30 and 50, for five products each. Nine products were in cream formulations and one in lotion formulation, as ‘day cream’ and ‘BB cream,’ respectively. Six sunscreen products had lower in vivo SPF values compared with the manufacturer’s SPF value estimation, whereas four products had shown higher values. Although statistical analysis showed P value of 0.63 that indicates no significant correlation between both of the SPF values. Several products with the appropriate and higher in vivo SPF values contain octocrylene as a photostabilizer and additional coating materials such as stearic acid, aluminum hydroxide, and alumina. Conclusion This study demonstrated that the appropriateness of the in vivo SPF value to in vitro-estimated SPF value may be influenced by the photostabilizer substance and combination with additional coating materials also can increase stability and efficacy of the products.

The full utilization of bagasse via deep eutectic solvent pretreatment for low-condensed lignin and cellulose smart indicator film

Full utilization of biomass after fractionation of its components is an effective way to maximize the value of biomass. Herein, in this study, a new acetal-mediated deep eutectic solvent (DES) was explored and its excellent performance in separating lignin from biomass as well as retarding lignin condensation has been observed. Subsequently, the separated lignin and cellulose-rich residue were used to prepare sunscreen and transparent food indicator films, respectively. The results showed that the acetal-mediated DES pretreatment can reduce the recalcitrance of bagasse, stabilize lignin (β-O-4 content of 68.6% in the lignin), and retain most of the cellulose (ie. 83.43%). Besides, the pretreatment enhanced the subsequent hydrogenolysis of lignin, and the higher β-O-4 content of the lignin contributed to the high yield of aromatic monomers (40.94%). In addition, regenerated lignin was attractive for sunscreen applications due to its lighter color and excellent UV-blocking properties. Furthermore, cellulose smart indicator film was highly sensitive, biodegradable, has excellent physical properties, and allows visual real-time monitoring of seafood spoilage using smartphones. Meanwhile, the yield of the removed hemicellulose converted to xylose in the pretreatment process reached 99.24%. In general, this work proposed a sustainable bio-refinery approach for the full upgrading of biomass.

Basal Cell Carcinoma: Diagnosis, Management and Prevention

Basal cell carcinoma (BCC) is a slow-growing, locally aggressive, rarely metastasizing, low-grade cutaneous neoplasm that arises from the epidermal basal layer and invades the adjoining tissues. It is the most common skin cancer. It is fairly common in fair Caucasians and quite uncommon in dark-skinned populations. It contributes to 65–75% of cutaneous malignancies in whites and 20–30% in Asian Indians. The most important causal factors appear to be radiation exposure and genetic predisposition. It may present as a nonhealing lesion that occasionally bleeds or as a pruritic lesion with no symptoms. Tumours rarely spread to regional lymph nodes. The clinical appearances and morphology of BCC are diverse. Clinical types include nodular, cystic, superficial, pigmented, morphoeaform, (sclerosing), keratotic and fibroepithelioma of Pinkus. Most of the lesions appear on the head and neck, usually above the line joining the tragus and the angle of the mouth. A biopsy should be performed on all lesions suspected of BCC. The primary aim of treatment is the complete excision of the tumour tissue. Other treatment modalities include cryotherapy, immunomodulatory drugs, laser treatment or locally applicable chemotherapeutic agents. Prevention consists of lifestyle changes such as avoiding sunburn, tanning beds and prolonged direct sun exposure, shade seeking, sunscreen application on the skin, and physical barrier methods such as protective clothing, hats and sunglasses. Regular sunscreen use in childhood and adolescence seems more beneficial than in adulthood.