Sunscreen Use Research Articles

The relationship between vitamin D levels in seasonal variations and Chinese patients with first-episode drug-naive depression

BackgroundVitamin D deficiency is highly prevalent worldwide and is associated with various diseases, including depression. Previous studies on vitamin D and depression have different conclusions. ObjectivesOur study aimed to examine the association between vitamin D levels in seasonal variation and depression. MethodsA total of 324 patients with first-episode depression aged 18–50 years were recruited for our study. Vitamin D levels were recorded, and PHQ-9 scale evaluation was performed in different seasons. Seasonal variations in vitamin D levels and depressive symptoms were examined. ResultsThe cohort comprised 77 males and 247 females. 98.1% of patients had insufficient or deficient vitamin D levels. The median vitamin D level was 12 ng/mL; 14.5 ng/mL in summer and 13 ng/mL in autumn, which was significantly higher than 9 ng/mL in spring, and the correlation between vitamin D level and PHQ-9 score was more significant in spring but not in summer and autumn. LimitationsOur study used cross-sectional data and could not examine the causal relationship of the vitamin D level and depressive symptoms. There are also some possible influencing factors, such as the dietary habits, outdoor sports, and the use of sunscreen were not investigated. ConclusionObservational data showed that the vitamin D level of depression is lower than the normal (30 ng/mL), and it is closely related to depressive symptoms in spring. The seasonal variations in vitamin D levels might play a critical role in Chinese patients with first-episode depression.

Photoprotection for people with skin of colour: needs and strategies.

Skin of colour or pigmented skin has unique characteristics: it has a higher eumelanin-to-pheomelanin ratio, more mature melanosomes, an increased amount of melanin distributed in the upper layers of the epidermis, and more efficient DNA repair compared with lighter skin. However, individuals with skin of colour are at a significant risk of skin damage caused by ultraviolet radiation, including the development of photodermatoses and photoageing changes such as uneven skin tone, and are predisposed to pigmentary disorders. In fact, one of the most common conditions leading to dermatology consultations by patients with skin of colour is photoexacerbated pigmentary disorders. Unfortunately, individuals with skin of colour may be less prone to engage in photoprotective measures, including the use of sunscreens. Physicians are also less likely to prescribe sunscreens for them. There is thus a clear need for better education on photodamage and for more efficient and suitable photoprotection in populations with skin of colour. However, this need has thus far only partially been met, and the development of sunscreen products designed to provide optimal photoprotection for people with skin of colour remains a challenge. Targeted sunscreens for individuals with skin of colour require optimal cosmetic appeal (leaving no white residue and not disrupting skin tone). They should include broad-spectrum [ultraviolet (UV)B/UVA] protection with high sun protection factor, as well as protection against long-wave UVA (UVA1) and visible light, as these wavelengths are capable of inducing or augmenting pigmentary disorders. They may also contain depigmenting agents for patients with pigmentary disorders.

A mini-review on limitations associated with UV filters

Ultraviolet light from the sun can produce long-term skin damage and cancer. The use of sunscreen products containing one or more UV filters is encouraged by health professionals for preventing the damaging effects resulting from sun exposure. However, recently there have been increasing concerns about the use of sunscreens and their safety for both humans and the environment. The sunscreen manufacturers should take the initiative in testing of the products for possible short-term skin toxicity and long-term health effects that might occur due to the absorption of UV filters through the skin. Published studies have shed light on this topic by investigating the harmful effects of UV filters such as oxybenzone on the hormone system of aquatic animals and humans. Currently, in vitro and in vivo animal models are being used to determine the mechanistic and cellular effects these products produce. With growing awareness of adverse effects posed by UV filters on the environment and exposed organisms, several jurisdictions are prohibiting their use in sunscreens. To our knowledge, very few reviews summarized the potential toxicities associated with UV filters. Therefore, the current reported findings are rather controversial due to the lack of nonclinical safety assessment data to determine the clinical significance of such exposure.

Sun protective behaviors in sun-sensitive individuals: a cross-sectional study examining for ethnic and racial differences.

The rates of non-melanoma skin cancer continue to rise in the United States. We investigated if differences exist in skin cancer preventive behaviors among sun-sensitive non-Hispanic whites and other racial and ethnic groups. The National Health Information Survey was used to perform the cross-sectional study. Outcomes of interest included multiple sun-protective methods. Individuals were determined to be sun-sensitive if Fitzpatrick skin phototype (SPT) I/II. Multivariable logistic regression was used to examine the associations between the use of sun-protective practices and race and ethnicity, SPT, and survey year. The study included 67,471 individuals. Adjusted prevalences of skin cancer preventive behaviors revealed that across all SPTs, non-Hispanic whites were more likely to use sunscreen, undergo physician-administered FBSE, and have multiple sunburns or tan indoors in the past year compared to corresponding SPT other racial and ethnic groups. In contrast, other racial and ethnic groups with any SPT were more likely to practice sun avoidance than corresponding SPT non-Hispanic whites. Additionally, other racial and ethnic groups with SPT III+ were more likely to wear sun-protective clothing than non-Hispanic white individuals with similar SPTs. For all SPT and racial and ethnic groups, there were significant increases in sunscreen use and decreases in past-year indoor tanning. Full body skin examination prevalence, regardless of sun sensitivity, increased for all non-Hispanic whites, but remained unchanged for sun-sensitive other racial and ethnic groups. Adjusted prevalence of multiple sunburns and use of protective clothing remained unchanged for all racial and ethnic groups across all SPT categories. There are differences in sun-protective behaviors among sun-sensitive individuals by race and ethnicity with the magnitude of some of these differences increasing. Future research and public health campaigns are needed on photosensitive individuals and the relationship between skin protective behaviors and race/ethnicity. When discussing sun protection, care providers should not only consider the influence of sun-sensitivity, but also race and ethnicity, and its impact on sun prevention behaviors.

Hydroalcoholic Extract of Encholirium spectabile Mart. (Bromeliaceae) in O/W Emulsions as an Additive against the UVB Radiation.

The use of sunscreen is one of the photoprotection measures most used by the population, so these products must offer broad-spectrum protection against UVA and UVB radiation. Encholirium spectabile, popularly known as "macambira-de-flecha," is a species characterized by its rocky outcrops and found in the Caatinga. This biome is known for extreme droughts and dry periods, and for this reason, its vegetation needed to develop resistance mechanisms. The aim of this work was to evaluate the use of E. spectabile incorporated in O/W emulsion as a potential photoprotective agent and their antioxidant activity. Four chemical constituents (ferulic acid, caffeic acid, p-coumaric acid and apigenin) were identified by HPLC-DAD analysis, and emulsions containing different concentrations (1%, 2.5% and 5%) of the extract without and with the addition of chemical filters (octyl methoxycinnamate and benzophenone-3) were prepared and submitted to the test of preliminary stability. The Q formulation demonstrated little variation in the preliminary stability test and was selected for estimated your protection against UVB and determination of invitro protection factor UVA. The formulations remained stable during the freeze-thaw cycle; the extract despite maintaining the UVA-PF and decreasing the wavelength showed an increase in FPS from 14.4 (control) to 18.8 (control+ Es-HA80).

Sun-Protective Behaviors in Patients with Melasma

Melasma is an acquired, chronic hyperpigmentation disorder exacerbated by hormone fluctuations, heat, inflammation, and sun exposure. Sun exposure is the greatest triggering and exacerbating factor, yet few studies investigate how patients with melasma practice sun-protective behaviors (SPBs). This mixed-methods project explored barriers to SPBs in patients with melasma. The demographic questionnaire and Sun Exposure and Protection Index (SEPI) survey were completed by 21 participants, and 13 participants were interviewed. Only 5 participants (23%) reapplied sunscreen every 2 hours as recommended. Interviews revealed a lack of knowledge and perceived risk regarding incidental sun exposures and proper sunscreen use.

Ultraviolet exposure of competitors during a Tokyo Olympic Sailing Regatta Test Event.

Overexposure to sunlight is the main cause of skin cancer. Photoprotection practices and sunburn play a crucial role in skin cancer prevention. This study aimed to quantify the risk of sun exposure and to evaluate photoprotection practices in Spanish sailors during Olympic competitions. Solar daily ultraviolet (UV) radiation cycle, personal UV dosimetry, photoprotection practices and sunburn checking were followed during three consecutive days of competition among sailors from the Spanish Olympic Sailing Team during a Tokyo Olympic Regatta Test Event. A total of 13 sailors (7 women), with mean age of 27.6 ± 4.7 years and sports experience of 17.7 ± 5.4 years, were studied. The most common phototypes were type III (53.8%) and type II (38.5%). The rate of sunburn checked was high (46.2%). The mean daily personal UV exposure received was 761.0 ± 263.6J/m2 , 3.0 ± 1.1 minimal erythemal dose and 7.6 ± 2.6 standard erythemal dose, seven times greater than the maximum permissible UV light exposure values for an 8 h working day. The use of a T-shirt was the most common practice (94.2%), followed by the use of shade (50.2%), hat/cap (44.0%), sunglasses (26.1%) and sunscreen (11.8%). Olympic sailor's studies presented high levels of UV radiation received, high rate of sunburn and insufficient adherence to sun-protective behaviours (especially, to use of sunscreen) to prevent sunburn, the main cause of skin cancer. Sport Federations should develop educational campaigns addressing sun-related exposure habits and photoprotection behaviours to reduce the risk of skin cancer among these athletes.

The role of emotionally persuasive messages in the skin cancer prevention campaign

ABSTRACT Despite a multitude of social campaigns and widely publicized scientific evidence of how excessive, unprotected sun exposure damages the skin and is a key cause of the skin cancer, people continue to crowd the beaches, oftentimes without any sunscreen protection. Also numbers of those who use sunscreen on a daily basis remain low. In this study, we analyze how the attitudes toward tanning and behavior of sunscreen use change under the influence of persuasive messages. We compare the effectiveness of an emotionally neutral persuasive message to an emotionally negative persuasive message. We show that persuasive messages combining fear with other negative emotions are successful, however, those generating negative emotions are not significantly more effective than emotionally neutral messages. Furthermore, our results show that while persuasive messages can change the attitudes toward tanning, they do not directly lead to a behavioral change in terms of sunscreen use intentions. However, as we show, the tanning attitude mediates the relationship between persuasive message and the attitude toward sunscreen use and intentions to use it. The resulting change in the tanning attitude contributes to a change in the attitude toward use of sunscreen.

Cancer Incidence and Etiology in the Active Duty Population of U.S. Military.

As members of the military, all active duty service members (ADS) must meet physical fitness requirements and are provided with equal-access healthcare through the DoD. In addition, 92% of ADS are ≤40 years of age. Together, these characteristics suggest that ADS represent a healthy population that may have a low risk of cancer. Each year, however, >800 ADS are diagnosed with cancer and the resulting in time off for treatment, reassignment, or medical retirement may significantly impact force readiness. Relevant literature was identified by searching the PubMed database using search terms ACTIVE DUTY and CANCER. Only articles written in English were included. Melanoma is the most common cancer in ADS, while testicular cancer is the most common cancer in males and breast cancer is the most common in females. Cancer incidence patterns in ADS differ from those in the general U.S. population and from military veterans. Tumor etiology in ADS may be influenced by military-enriched exposures such as prolonged use of oral contraceptives, suboptimal use of sunscreen, exposure to volatile organic compounds, or germline predisposition/family history. The etiology of cancer within ADS remains largely unknown. A number of new research programs may provide the means to improve understanding of the etiology of cancer in ADS. Together, these efforts will improve prevention, early detection, and clinical management, thus improving the outcomes of ADS and preserving force readiness.

Low Incidence of Vitamin D Levels Deficiency in Anesthesiology Residents

Background: Vitamin D deficiency is now a major global health problem. The prevalence of vitamin D deficiency in Indonesia is 60–90% in various studies. Age, race, sunscreen use, medication, and malabsorption diseases are all factors that affect vitamin D levels. Recent studies also show the relation between COVID-19 and vitamin D deficiency in severity and disease mortality. Vitamin D deficiency causes skeletal and extra-skeletal consequences. With limited studies on vitamin D levels of anesthesiology residents in Indonesia, we aim to determine the average vitamin D level and the affecting factors in this population. Materials and Methods: Sixty-nine anesthesiology residents working in a tertiary care hospital were enrolled in this study. The participants were asked to complete the questionnaire, and blood samples were drawn to measure serum 25(OH)D. The factors that influence vitamin D levels were recorded for analysis. Statistical analysis was performed using SPSS version 20. Results: The mean vitamin D level in anesthesiology residents was 39.99 ng/mL. There were no significant relationships between vitamin D levels among anesthesiology residents with vitamin D consumption, high-calcium foods, frequency of exercise, history of COVID-19 infection, comorbidities, and duration of exposure to sunlight. Conclusion: Prevalence of vitamin D deficiency/insufficiency was low among anesthesiology residents. Vitamin D levels were optimal in professionals who are taking vitamin D supplements.

Correlation of skin cancer and actinic keratosis-related knowledge and sun protection behaviors and sunscreen use among a sample of Jordanian population.

The incidence of skin cancer and actinic keratosis has increased worldwide. Measuring the public awareness, attitude, and knowledge about these diseases and the skin protection behaviors are highly important to undertake preventive measures. To investigate skin cancer and actinic keratosis-related knowledge, sun protection behaviors, and sunscreen usage among Jordanians, a questionnaire was developed. The questionnaire was provided as a google form to individuals via social media and the data were analyzed using SPSS® 23. A total of 1277 individuals, aged 18-65 years filled the questionnaire. The median melanoma and actinic keratosis knowledge score were 7 (4-9) and 4 (0-9), respectively. The melanoma knowledge was higher among females, those with a medical background, a high level of education, and in the central region, whereas the AK knowledge was higher among those with a medical background. Overall, 75.9% of the participants used sunscreen at least often to prevent sunburn, uneven skin tone, or tanning, 72% were using sunscreen with an SPF of 30 at least. However, 45.3% and 49.2% of sunscreen users did not comply with application, and reapplication times, respectively. Moreover, 58.4% of participants applied less than the recommended amount of sunscreen. Our study revealed that public awareness of actinic keratosis is low among Jordanians. Although it was found that a high proportion of Jordanians use sunscreens there are deficits in sunscreen practice indicating an urgent need to design effective interventions to increase awareness of actinic keratosis and correct use of sunscreen via health campaigns or healthcare professions.

Application of a Reflectance Confocal Microscopy Imaging Analysis Score for the Evaluation of Non-Melanogenic Changes in Male Photoaged Skin.

The photoaging process is characterized by skin changes due to ultraviolet radiation exposure and is the principal environmental factor affecting skin aging. Reflectance confocal microscopy permits noninvasive skin imaging to understand how the photoaging process may change skin. Since men do not habitually use sunscreen, the application of skin imaging techniques is important to understand the influence of sunlight on their skin health. The aim of this study was to develop a score based on RCM imaging analyses to evaluate the morphological and structural changes in the photoaged skin according to literature data. The score was applied in order to determine possible correlations between chronological aging and sunscreen use behavior among men. Thus, 40 men aged 18 to 50 years were recruited, images from the frontal region of their skin were obtained and the score was applied. It was observed that habits are more important than age for the skin photoaging process. Men with photoprotection habits showed overall better skin morphological and structural characteristics regardless of age, demonstrating that sun protection behavior is a major key factor in the understanding of photoaging, so that men should be encouraged to start the use of cosmetic products and perform self-care.

Acute dermal effects of solar UV irradiation and efficacy of sunscreen use

ABSTRACT The Global Solar Ultraviolet (UV) Index provides limited information on health effects due to over-exposure. This study investigated the change in skin physiology in response to solar UV irradiation and the protective efficacy of a sunscreen. Fourteen female participants were divided into two groups, sunscreen users and non-users, and for 8 weeks they received solar irradiation and were monitored for change in the erythema-index (E-index), melanin-index, skin capillary blood flow, skin moisture, transepidermal water loss (TEWL), and skin temperature. The E-index and TEWL responded proportionally to solar radiation and could serve as indices of acute health effects from UV exposure. In the sun-radiated area, the E-index and TEWL measured on the forearm of the non-users were 111.3% and 138.4% of the levels determined for the users, respectively. Although thermal sensation and thermo-physiology were correlated, physiological monitoring was preferred over thermal sensation survey in evaluating the impact of solar UV irradiation.

37-Year-Old Man With Headache and Nasal Congestion

37-Year-Old Man With Headache and Nasal Congestion

Prevalence and determinants of sunburns and sun protection behaviors among children: A nationwide cross-sectional survey in Switzerland

BACKGROUND: High exposure to solar ultraviolet radiation in early life increases the risk of developing skin cancer later, with increasing risk related to an increasing number of sunburns. Switzerland has high incidence rates of skin cancer compared to surrounding countries. We aimed to estimate the prevalence of sunburns and sun protection behaviors and their potential determinants among children in Switzerland. METHODS: In February 2019, we sent questionnaires to the parents of a random sample of 8,221 Swiss resident children. The questionnaires of 2,841 children were returned (response rate 35%). In spring and summer of the same year, follow-up questionnaires were sent to these children (response rate ~50%). Parents were asked about their child regarding protection measures, number of sunburns in the previous year, and skin phototype. We calculated the prevalence of sunburns and sun-protective behaviors (wearing a hat, seeking for shade, and use of sunscreen) by season, sociodemographic characteristics and skin phototype. RESULTS: Among participating children, 39.9% had at least one sunburn in the previous year, of whom 20.5% had a severe sunburn. When outside on a sunny day, 50.3% of the children wore a hat in summer (46.8% in spring), 21.1% (19.8%) sought shade more than half of the time, and 53.6% (43.5%) wore sunscreen. Prevalence of sunburns and of severe sunburns was higher among older children, boys, and children with sensitive skin. Protective measures were more frequent among younger children, girls, and children with sensitive skin. Prevalence of both outcomes varied substantially between regions. Sunburn prevalence was associated with lower use of sun protection. CONCLUSIONS: Compared to previous regional studies in Switzerland, we found a lower prevalence of sunburns and of protection behaviors, with important regional heterogeneity. Our results should help tailor sun exposure prevention measures to specific age groups and regions. KEYWORDS : sunburn, children, skin cancer

Development of Emulsion Gel Sunscreen Containing Olive Oil and Clove Oil

Sunlight contributes to the healing of multiple health conditions, including in respiratory diseases such as Covid-19, by boosting the immune system. Nevertheless, too much sun exposure can cause sunburn and lead to skin cancer. To minimize the harms of excessive sun exposure, the skin needs to be strictly shielded with the use of sunscreen. This study aimed to develop an olive oil and clove oil emulsion gel preparation and determine its sun protective factor (SPF) value. Olive oil was formulated into an emulsion gel with varying concentrations of 2%, 4%, and 6%, and then 5% of clove oil was added. Physicochemical properties such as organoleptic, homogeneity, pH values, viscosity, and spreadability were tested. Further, UV protection was examined based on determining the SPF value, and the stability of preparation was evaluated using real-time and freeze-thaw methods. The results showed that the preparation had a good physicochemicality, while the SPF value was 20.91 ± 0.29, 22.52 ± 0.52, and 23.39 ± 0.45, respectively. However, the results of the stability test showed a significant change in the pH and SPF value after storage. It can be concluded that the emulsion gel of olive oil and clove oil preparation could be considered to have a medium level of protection of sunscreen.
 Keywords: olive oil, clove oil, emulsion gel, sunscreen, UV protection, stability

Benzophenone-3 and antinuclear antibodies in U.S. adolescents and adults ages 12-39 years.

BackgroundBetween 1988 and 2012, prevalence of antinuclear antibodies (ANA) increased in the U.S., especially in adolescents and non-Hispanic Whites. Female predominance of ANA suggests a role for hormonal factors, including xenobiotic exposures that may disrupt endocrine signaling. Benzophenone-3 (BP-3) is one such chemical with increasing exposure through sunscreen use. We investigated whether urinary BP-3 levels were related to ANA in adolescents and young adults.MethodsIn a sample of 1,785 individuals ages 12-39 years in the National Health and Nutrition Examination Survey (NHANES; 2003-4, 2011-12), we examined cross-sectional associations of ANA (N=192; 3+ or 4+ at the 1:80 dilution, measured by HEp-2 immunofluorescence) with urinary BP-3, and other phenols bisphenol-A, triclosan, and parabens. Adjusted prevalence odds ratios (POR) were calculated in season-stratified models [winter (November-April) and summer (May-October)], given differences in sunscreen use and BP-3 concentrations.ResultsBP-3 concentrations (detected in >98.5% of individuals) did not differ by ANA positivity in the summer (geometric mean, GM 30.6 ng/ml ANA-positive vs. 35.3 ANA-negative; GM ratio 1.15), but in winter were higher among ANA-positives (50.2 vs. 20.1 ANA-negative; GM ratio 2.50). ANA was associated with log10BP-3 in winter (POR 1.57; 95%CI 1.07-2.30 per unit increase) but not summer (0.94; 0.61, 1.44; interaction p=0.09). Triclosan, parabens, and bisphenol-A levels were unrelated to ANA overall or by season (ORs 0.64 to 1.33).ConclusionsThe association of urinary BP-3 with ANA in the winter may reflect different exposure patterns or unmeasured confounders. Findings warrant replication in prospective studies and including past and year-round exposures.

Cytotoxicity of BP-3 and BP-4: Blockage of extrusion pumps, oxidative damage and programmed cell death on Chlamydomonas reinhardtii

The health concern associated with the dangers related to exposure to UV radiation has led to an increase in the use of sunscreens containing UV-filters that can reach aquatic environments and possibly affect ecosystems. Benzophenone-3 (BP-3) and benzophenone-4 (BP-4) are two of the most used UV-filters. In the present work, the microalga Chlamydomonas reinhardtii was exposed to several concentrations of both chemicals. To evaluate their potential cytotoxicity on microalgal cells, different parameters were analysed including fast response biomarkers (increase in intracellular free Ca2+) as well as biomarkers related with the presence of oxidative stress (lipid peroxidation), energy metabolism (photosynthetic yield and cytoplasmic lipid accumulations), cell division (proliferation and F-actin content), programmed cell death (PCD) (caspase activation and DNA fragmentation) and possible mechanisms of resistance to xenobiotics (operation of extrusion pumps and presence of autophagic vacuoles). Results showed an increment of the percentage of cells with cytosolic free Ca2+ that could act as a secondary messenger in response to the stress. A decrease in photosynthetic yield and an increase in cytoplasmic lipid accumulations and lipid peroxidation levels were also detected. In addition, a decrease in cell proliferation was observed, linked to a decrease in the percentage of cells with F-actin. The increase observed in the microalgal population with caspase activity, together with the DNA fragmentation and the alterations in the cytoskeleton, suggested the induction of processes linked to PCD. Moreover, a blockage of extrusion pumps, which could be related to the toxicity mechanism of these compounds, and an increase in autophagic vacuoles, as an attempt to repair the damage caused by benzophenones, were detected. Overall, these biomarkers indicate that both UV-filters can be a serious threat to non-target photosynthetic microorganisms in aquatic environments, although BP-3 affected C. reinhardtii more markedly.

Sunscreen Ingredient Octocrylene's Potency to Disrupt Vitamin D Synthesis.

Octocrylene is a widely used ingredient in sunscreen products, and it has been observed that the use of sunscreen has been increasing over the last few decades. In this paper, we investigated the way in which sunscreen’s ingredient octocrylene may disrupt normal vitamin D synthesis pathway, resulting in an imbalance in vitamin D levels in the body. The key techniques used for this insilico investigation were molecular docking, molecular dynamic (MD) simulation, and MMPBSA-based assessment. Vitamin D abnormalities have become very common in human health. Unknown exposure to chemicals may be one of the important risk factors. In molecular docking analysis, octocrylene exhibited a binding energy of −11.52 kcal/mol with vitamin D binding protein (1KXP) and −11.71 for the calcitriol native ligand. Octocrylene had a binding potency of −11.152 kcal/mol with the vitamin D receptor (1DB1), and calcitriol had a binding potency of −8.73 kcal/mol. In addition, octocrylene has shown binding energy of −8.96 kcal/mol with CYP2R1, and the calcitriol binding energy was −10.36 kcal/mol. Regarding stability, the root-mean-square deviation (RMSD), the root-mean-square fluctuation (RMSF), the radius of gyration, hydrogen bonding, and the solvent-accessible surface area (SASA) exhibited that octocrylene has a stable binding pattern similar to calcitriol. These findings revealed that incessant exposure to octocrylene may disrupt normal vitamin D synthesis.

32867 Association of sun-protective behaviors with bone mineral density and osteoporotic bone fractures in the United States: National Health and Nutrition Examination Survey 2017-18

Introduction: Despite the reassuring emerging evidence on the lack of causality between sun protection and vitamin D deficiency, scarce data exist on whether multimodal sun protection is associated with the adverse bone-related outcomes. This may lead to excessive worry and suboptimal sun protection on the part of patients. We aimed to investigate the association of sun-protective behaviors (shade stay, wearing long-sleeved clothing, and sunscreen use) with bone mineral density (BMD) and the prevalence of osteoporotic fractures. Methods: In a population-based, cross-sectional setting, sampled participants’ data (n = 3418) representative of the United States adult population (aged ≥20 years old) were accessed from the National Health and Nutrition Examination Survey 2017-18 and analyzed. Results: The use of individual sun-protective modalities was not associated with diminished site-specific and total BMD z-scores in the multivariate models (estimate [95% confidence interval, P value] = frequent shade stay: −0.225 [−0.466 to 0.017, .182], wearing of long sleeves: −0.076 [−0.269 to 0.117, .724], and sunscreen use: −0.098 [−0.321 to 0.125, .153]). Moderate-to-frequent stay in the shade correlated with reduced prevalence of spine fractures in the multivariate model (odds ratio [95% confidence interval] for frequent shade stay: 0.193 [0.044 to 0.857], P = .017). Conclusions: Routine use of sun-protective modalities was not associated with decreased BMD or the osteoporotic fracture risk. Sun protection may be associated with a modest decrease in the prevalence of osteoporotic fractures, possibly due to risk-averse behaviors. These reassuring findings add to the growing body of evidence on the safety of sun protection, with no significant negative impact on bone health.