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. 2026 Mar 24;5(4):100495. doi: 10.1016/j.focus.2026.100495

Sunscreen Use Barriers in White U.S. Adults: Gender, Generation, and Skin Phototype Differences

Sarah M Hall 1,⁎, Mindy Steadman 2, Sarah Major 1, Mary-Frances Oldham 1, Hannah Mitchell 1
PMCID: PMC13207459  PMID: 42205304

HIGHLIGHTS

  • •

    An online panel survey in the U.S. identifies leading barriers to sunscreen use.

  • •

    Forgetfulness was the most common barrier.

  • •

    Cost and inconvenience were key practical barriers to sunscreen use.

  • •

    Younger cohorts had greater odds of reporting barriers than baby boomers.

  • •

    Gender, generation, and skin phototype differences emerged for various barriers.

Keywords: Sunscreening agents, skin neoplasms, preventive medicine, health behavior, health education, cross-sectional studies

Abstract

Introduction

Skin cancer remains a major public health concern, and White individuals carry the highest lifetime risk and mortality. Ultraviolet exposure and sunburn are well-established skin cancer risk factors, yet regular sunscreen use remains low among U.S. adults. Few studies have assessed barriers to sunscreen use in the U.S., and prior studies are often geographically or demographically limited, restricting comparability among subgroups.

Methods

A cross-sectional online panel survey of White U.S. adults (N=739) was developed and administered. Participants selected all personally relevant barriers, followed by their top barrier. Descriptive statistics summarized perceived barriers to sunscreen use. Separate multivariable logistic regression models explored the associations between demographic characteristics and barrier endorsement.

Results

Overall, 20.3% of participants reported no barriers. The most commonly endorsed barriers were forgetting to bring or apply sunscreen (52.1%), disliking the feel or smell (24.2%), cost (21.7%), inconvenience (20.3%), preference for being tanned (14.1%), and difficulty in selecting an appropriate sunscreen (12.6%). Younger cohorts had greater odds of reporting at least 1 barrier than baby boomers. Generational differences were observed for forgetfulness, inconvenience, product selection, and tanning preference. Men had lower odds of endorsing a preference for being tanned than women. Skin phototype was associated with differences in cost, tanning preference, forgetfulness, and product selection. Differences in barriers were also observed for marital status, education, and income.

Conclusions

Findings support audience-segmented approaches to improve sunscreen use by gender, generation, skin phototype, and socioeconomic factors. Individual-level strategies include integrating sunscreen into daily routines and using cues to action to support bringing, applying, and reapplying sunscreen. Multilevel approaches that shift tanning norms, improve product acceptability, strengthen product selection guidance, and reduce cost may further reduce barriers and support sustained use.

INTRODUCTION

Skin cancer is among the most prevalent cancers.1 In the U.S., approximately 5 million adults are treated for basal cell carcinoma or squamous cell carcinoma annually.2 The lifetime risk of basal cell carcinoma is estimated at ≥30% among White individuals.3 Although less common, squamous cell carcinoma carries a greater risk of metastasis.4 Melanoma is the deadliest form of skin cancer, with 104,960 new cases projected in 2025.5,6

White individuals have the highest lifetime risk and mortality rates,5 although non-White individuals may be more likely to experience poorer prognoses7,8 owing to socioeconomic and structural barriers that limit access to prevention, diagnosis, and treatment services related to skin cancer.9, 10, 11 Incidence rates have increased in recent decades, reflecting a combination of factors, including an aging population with a greater cumulative ultraviolet (UV) radiation exposure, environmental and behavioral influences, and increased screening and diagnosis.12,13

Cumulative lifetime UV exposure and a history of sunburns are well-established skin cancer risk factors among White individuals.14 Regular sunscreen use reduces skin cancer risk, yet usage remains low among U.S. adults.15, 16, 17 Several studies suggest that males and young people report lower usage,18,19 whereas others found no age-related differences20 or low usage among older adults.21,22 Individuals with sun-sensitive skin, higher education and income, and positive coexisting lifestyle behaviors tend to report greater usage, although much of the data are outdated.23, 24, 25

Prior studies on perceived sunscreen barriers in the U.S. are geographically or demographically limited: agricultural workers in Pennsylvania,26 dermatology patients in Iowa,27 low-income residents in San Antonio,28 collegiate athletes at Duke and Stanford,29 University of Arizona students,30 and parents of children with high melanoma risk.31 Thus, findings are not generalizable or comparable across subgroups. This study aims to identify reported barriers to sunscreen use and how they differ by demographic factors among White adults living in the U.S.

METHODS

Study Sample

Final data collection was conducted through email invitations sent from an online panel provider (Qualtrics Panels, Provo, UT) to a national sample of participants. Participants who provided informed consent proceeded to eligibility screening questions. Eligible participants were aged at least 18 years, resided in the U.S., and self-identified as White/Caucasian. Participants not meeting 1 or more of these criteria were screened out and exited from the survey.

Quota sampling ensured balanced representation by gender (≥45% male and female) and generational cohort (≥20% per cohort). Generational cohorts were defined as baby boomers (born between 1946 and 1964), Gen X (born between 1965 and 1980), Millennials (born between 1981 and 1996), and Gen Z (born between 1997 and 2012).

Data were extracted and cleaned in Microsoft Excel to exclude respondents who (1) did not meet eligibility screening criteria, (2) failed 1 or more attention-check items, or (3) did not complete the full survey (n=74). Of 813 participants who initiated the survey, 739 comprised the final analytic sample.

Measures

A cross-sectional online survey was developed and approved by an IRB at a university in the Mountain West region of the U.S. The survey included informed consent, eligibility screening, demographic questions, and perceived barriers to sunscreen use. Multiple-choice demographic questions were informed by study aims and prior literature, including gender, generational cohort, Fitzpatrick skin phototype, ethnicity, marital status, highest educational attainment, employment status, and annual household income.30,32

Perceived barriers to sunscreen use were assessed using items adapted from prior research.27,33,34 Barrier endorsement was defined as selecting a barrier as personally relevant. Participants were asked to endorse all applicable barriers (select all that apply) and then identify their single most significant barrier (multiple choice). An open-ended item solicited additional barriers not captured by the predefined list; this item was included in both the pilot survey and the final survey. Attention-check items were embedded throughout to enhance data quality by identifying inattentive responding and reducing the influence of speeders.

The survey was created within Qualtrics and optimized using ExpertReview. Digital review recommendations were resolved until the survey reached a 100% score for both mobile and computer viewing. The survey was piloted with a convenience sample (n=82) recruited through the study team’s social media accounts and email distribution lists to assess clarity, flow, programming, and barrier response items. The pilot survey used the same platform and procedures as the final survey. Pilot responses did not indicate a need for substantive revisions, and no additional barriers emerged from the open-ended responses. The survey took approximately 10–15 minutes to complete.

Statistical Analysis

Data were analyzed in Stata 18.0 (StataCorp LLC, College Station, TX). Descriptive statistics summarized participant characteristics and sunscreen barrier prevalence, including (1) barriers endorsed in the select-all-that-apply item and (2) the single most significant barrier selected in the multiple-choice item.

Separate multivariable logistic regression models estimated the odds of endorsing each barrier reported by ≥10% of the sample, including sunscreen cost, inconvenience, forgetfulness, disliking the feel or smell, difficulty in selecting an appropriate product, preference for being tanned, and lack of knowledge of sunscreen's protective role in skin cancer prevention; a separate model also examined endorsement of no barriers. Barrier endorsement was coded as 1=endorsed and 0=not endorsed. Independent variables included gender, generational cohort, Fitzpatrick skin phototype, ethnicity, marital status, highest educational attainment, and annual household income. Employment status was excluded owing to multicollinearity. Results are presented as ORs with 95% CIs.

RESULTS

Table 1 summarizes the characteristics of the final analytic sample. Gender and generational cohort distributions were relatively balanced owing to quota-based sampling. To ensure adequate cell sizes for analysis, Fitzpatrick skin phototypes were grouped as types I–II (always or usually burns), type III (sometimes burns, sometimes tans), and types IV–VI (rarely or never burns, tans easily). Approximately half of participants (51.7%) were married or living with a partner, whereas the remaining 48.3% were single, separated, divorced, or widowed.

Table 1.

Participant Characteristics (N=739)

Variable Frequency Percentage
Gender
 Male 355 48.0
 Female 382 51.7
 Other 2 0.3
Generation (year born)
 Gen Z (1997–2012) 186 25.2
 Millennial (1981–1996) 196 26.5
 Gen X (1965–1980) 173 23.4
 Baby Boomer (1946–1964) 184 24.9
Skin phototype
 Always/usually burns 251 34.0
 Sometimes burns/sometimes tans 257 34.8
 Rarely/never burns 231 31.3
Ethnicity
 Hispanic/Latino 48 6.5
 Non-Hispanic/Latino 691 93.5
Marital status
 Single, not living with partner 257 34.8
 Married 298 40.3
 Not married, living with partner 84 11.4
 Divorced, widowed, or separated 100 13.5
Highest educational attainment
 High school or less 320 43.3
 Some college/technical/trade school 159 21.5
 Bachelor's degree 148 20.0
 Graduate or postgraduate degree 112 15.2
Employment status
 Unemployed, looking for work 82 11.1
 Employed full time 326 44.1
 Employed part time 78 10.6
 Full-time student 53 7.2
 Retired 152 20.6
 Stay-at-home parent 48 6.5
Annual Household income (before tax)
 <$25,000 125 16.9
 $25,000–$49,999 191 25.9
 $50,000–$74,999 131 17.7
 $75,000–$99,999 93 12.6
 >$100,000 148 20.0
 Prefer not to respond 51 6.9
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Note: Totals may not equal 100% owing to rounding.

Figure 1 presents the prevalence of perceived barriers to sunscreen use, including all endorsed barriers and the single most significant barrier. Overall, 20.3% of participants reported no barriers to sunscreen use. Among all participants, the most frequently endorsed barrier in the select-all-that-apply item was forgetting to bring or apply sunscreen (52.1%), followed by disliking the feel or smell of sunscreen (24.2%), cost (21.7%), inconvenience of bringing or applying sunscreen (20.3%), a preference for being tanned (14.1%), uncertainty about how to select an appropriate sunscreen (12.6%), lack of awareness of sunscreen’s role in skin cancer prevention (11.0%), disliking the appearance of sunscreen on the skin (9.2%), and the belief that sunscreen is unnecessary (8.1%). A small proportion of participants (4.1%) endorsed other barriers. Open-ended responses included concerns about allergic reactions, looking pasty, vitamin D deficiency, sunscreen ingredients or toxic chemicals, forgetting to purchase sunscreen, and beliefs that sunscreen causes skin cancer. In the single-response item assessing the most significant barrier, the most frequently cited items were forgetting to bring or apply sunscreen (27.9%), followed by disliking the feel or smell (10.4%) and cost (10.0%). All other barriers were selected by fewer than 10% of participants as their primary barrier.

Figure 1.

Figure 1 dummy alt text

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Self-reported barriers to sunscreen use.

Table 2 reports regression results. Males had lower odds of citing a preference for being tanned than females (OR=0.61; 95% CI=0.38, 0.97; p=0.04). All younger generations had lower odds of selecting no barriers (e.g., were more likely to report at least 1 barrier) than baby boomers (Gen Z: OR=0.39; 95% CI=0.21, 0.75; p<0.001, millennials: OR=0.49; 95% CI=0.28, 0.84; p=0.01, Gen X: OR=0.56, 95% CI=0.33, 0.95; p=0.03). Millennials (OR=1.84; 95% CI=1.11, 3.37; p=0.04) and Gen X (OR=1.94; 95% CI=1.07, 3.50; p=0.03) had higher odds of reporting inconvenience. Gen Z (OR=1.88, 95% CI=1.13, 3.14; p=0.02) and millennials (OR=1.68; 95% CI=1.07, 2.63; p=0.02) had higher odds of reporting forgetfulness. Gen Z had higher odds of not knowing how to select sunscreen (OR=2.57; 95% CI=1.16, 5.70; p=0.02). Gen X had greater odds of citing tanning preferences (OR=2.60; 95% CI=1.29, 5.23; p=0.01).

Table 2.

Odds of Selected Barriers to Sunscreen Use

Cost Inconvenience Forgetfulness Dislike smell/feel Product selection knowledge Lack of awareness Prefer to be tanned No barriers
Variables OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI)
Gender
 Female (ref) — — — — — — — —
 Male 0.87 (0.59, 1.29) 1.15 (0.77, 1.71) 0.92 (0.67, 1.26) 0.76 (0.53, 1.11) 1.14 (0.70, 1.85) 1.68 (1.00, 2.83) 0.61 (0.38, 0.97)* 1.21 (0.81, 1.80)
Generation
 Baby boomer (ref) — — — — — — — —
 Gen X 1.29 (0.73, 2.27) 1.94 (1.07, 3.50)* 1.49 (0.96, 2.31) 1.36 (0.81, 2.29) 1.27 (0.62, 2.63) 0.90 (0.43, 1.89) 2.60 (1.29, 5.23)* 0.56 (0.33, 0.95)*
 Millennial 1.47 (0.84, 2.59) 1.84 (1.11, 3.37)* 1.68 (1.07, 2.63)* 1.06 (0.62, 1.83) 1.74 (0.85, 3.54) 1.17 (0.57, 2.40) 1.55 (0.73, 3.30) 0.49 (0.28, 0.84)*
 Gen Z 1.85 (0.98, 3.49) 1.81 (0.94, 3.51) 1.88 (1.13, 3.14)* 1.41 (0.78, 2.55) 2.57 (1.16, 5.70)* 1.03 (0.44, 2.41) 1.92 (0.87, 4.24) 0.39 (0.21, 0.75)***
Skin phototype
 Always / usually burns (ref) — — — — — — — —
 Sometimes burns / sometimes tans 0.51 (0.33, 0.78)*** 0.82 (0.52, 1.27) 0.89 (0.62, 1.27) 0.81 (0.54, 1.23) 0.86 (0.51, 1.43) 0.90 (0.51, 1.59) 3.16 (1.67, 5.96)*** 1.11 (0.71, 1.74)
 Rarely/never burns 0.45 (0.28, 0.71)*** 0.73 (0.46, 1.16) 0.65 (0.45, 0.95)* 0.71 (0.46, 1.10) 0.54 (0.30, 0.97)* 0.79 (0.43, 1.45) 4.16 (2.21, 7.84)*** 0.90 (0.56, 1.44)
Ethnicity
 Not Hispanic/Latino (ref) — — — — — — — —
 Hispanic/Latino 1.89 (0.97, 3.65) 1.33 (0.66, 2.70) 1.16 (0.63, 2.13) 1.04 (0.51, 2.09) 1.21 (0.51, 2.87) 1.86 (0.81, 4.29) 0.62 (0.24, 1.57) 0.81 (0.34, 1.89)
Marital status
 Single/no coresident partner (ref) — — — — — — — —
 Married 1.23 (0.72, 2.12) 0.61 (0.35, 1.04) 0.99 (0.64, 1.53) 0.79 (0.48, 1.31) 1.57 (0.80, 3.08) 1.41 (0.67, 2.93) 0.57 (0.30, 1.09) 1.20 (0.70, 2.08)
 Living with partner 1.49 (0.81, 2.77) 0.96 (0.51, 1.79) 1.25 (0.74, 2.11) 0.78 (0.42, 1.45) 1.37 (0.63, 3.00) 2.70 (1.26, 5.80)* 1.39 (0.71, 2.74) 1.00 (0.49, 2.04)
 Widowed, divorced, separated 1.57 (0.81, 3.07) 1.00 (0.50, 2.00) 1.18 (0.68, 2.04) 1.10 (0.58, 2.07) 1.64 (0.67, 3.99) 1.32 (0.51, 3.44) 1.14 (0.51, 2.57) 1.19 (0.61, 2.31)
Education
 High school or less (ref) — — — — — — — —
 Some college 0.84 (0.51, 1.40) 1.09 (0.65, 1.84) 1.09 (0.73, 1.62) 1.21 (0.76, 1.93) 1.06 (0.57, 1.99) 0.61 (0.29, 1.25) 0.85 (0.46, 1.56) 0.73 (0.44, 1.20)
 Bachelor’s degree 1.55 (0.92, 2.61) 2.05 (1.23, 3.42)* 1.12 (0.73, 1.71) 1.89 (1.18, 3.04)* 1.08 (0.56, 2.10) 0.72 (0.34, 1.50) 1.18 (0.65, 2.14) 0.68 (0.39, 1.18)
 Grad degree 1.74 (0.92, 3.29) 1.65 (0.87, 3.11) 0.80 (0.48, 1.34) 1.20 (0.65, 2.21) 1.52 (0.72, 3.22) 1.25 (0.57, 2.73) 0.99 (0.47, 2.09) 0.98 (0.52, 1.83)
Annual household income
 <$25,000 (ref) — — — — — — — —
 $25,000–49,999 0.66 (0.38, 1.13) 0.54 (0.30, 0.97)* 1.32 (0.82, 2.10) 1.18 (0.68, 2.05) 0.98 (0.48, 1.99) 0.99 (0.46, 2.11) 2.21 (1.05, 4.65)* 0.53 (0.28, 0.97)*
 $50,000–74,999 0.66 (0.35, 1.21) 0.81 (0.43, 1.53) 1.19 (0.70, 2.01) 1.05 (0.56, 1.96) 0.51 (0.21, 1.23) 0.81 (0.34, 1.96) 1.28 (0.53, 3.07) 1.21 (0.65, 2.25)
 $75,000–99,999 0.33 (0.15, 0.73)*** 0.82 (0.40, 1.67) 1.25 (0.69, 2.26) 1.36 (0.69, 2.71) 0.62 (0.24, 1.61) 0.71 (0.26, 1.96) 2.21 (0.91, 5.37) 0.78 (0.37, 1.65)
 ≥$100,000 0.45 (0.21, 0.96)* 0.87 (0.42, 1.79) 1.10 (0.60, 1.99) 1.06 (0.52, 2.16) 1.14 (0.47, 2.78) 1.15 (0.44, 3.03) 2.19 (0.88, 5.47) 0.82 (0.39, 1.74)
Pseudo R2 0.05 0.04 0.02 0.02 0.04 0.04 0.09 0.04
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Note: Boldfaces indicate statistical significance (***p<0.001, **p<0.01, and *p<0.05).

Separate multivariable logistic regression models were estimated for each barrier (1=yes, 0=no).

Those who sometimes burn/sometimes tan had lower odds of citing cost barriers (OR=0.51; 95% CI=0.33, 0.78; p<0.001) and higher odds of preferring to be tanned (OR=3.16; 95% CI=1.67, 5.96; p<0.001) than those who usually/always burn. Those who rarely/never burn were less likely to perceive cost (OR=0.45; 95% CI=0.28, 0.71; p<0.001), forgetfulness (OR=0.65; 95% CI=0.45, 0.95; p=0.03), and product selection barriers (OR=0.54; 95% CI=0.30, 0.97; p=0.04) and were more likely to report preferring to be tanned (OR=4.16; 95% CI=2.21, 7.84; p<0.001). Participants living with a partner (but not married) had higher odds of reporting lack of awareness of sunscreen’s role in preventing skin cancer (OR=2.70; 95% CI=1.26, 5.80; p=0.01). Those with bachelor’s degrees had greater odds of reporting inconvenience (OR=2.05; 95% CI=1.23, 3.42; p=0.01) and disliking the smell or feel of sunscreen (OR=1.89; 95% CI=1.18, 3.04; p=0.01) than those with a high-school education or less. Those with higher incomes had lower odds of reporting cost barriers ($75,000–$99,999: OR=0.33, 95% CI=0.15, 0.73, p<0.001; ≥$100,000: OR=0.45, 95% CI=0.21, 0.96, p=0.02). Those with lower income ($25,000–$49,999) had greater odds of preferring to be tanned (OR=2.21; 95% CI=1.05, 4.65; p=0.02) and reduced likelihood of reporting inconvenience (OR=0.54; 95% CI=0.30, 0.97; p=0.03) and no barriers (OR=0.53; 95% CI=0.28, 0.97, p=0.03).

DISCUSSION

The majority (79.9%) of participants reported at least 1 barrier to sunscreen use. In terms of practical and logistical barriers, forgetting to bring or apply sunscreen was the most frequently cited barrier (52.1%), consistent with prior research among niche populations.26,29,31 Behavioral or environmental nudges such as placing sunscreen near personal items, text reminders, UV index widgets, wearable devices, apps with UV timers, or stickers with UV-sensitive ink may serve as reminders to apply or reapply sunscreen, although these strategies may be insufficient when used on their own.35, 36, 37, 38

Inconvenience was reported by 20.3% of participants, although a prior study found higher rates among collegiate athletes (41%).29 Habit-stacking strategies (e.g., applying after brushing teeth) or integrating sunscreen into existing routines (e.g., daily facial moisturizers) may reduce barriers related to initial application.39,40 For individuals with extended outdoor exposure, interventions may also need to support reapplication.

Cost of sunscreen was reported by 21.7% of participants, consistent with prior research among lower-income individuals.28 Providing subsidized sunscreen or free sunscreen dispensers in public areas (e.g., parks, pools, sports venues, schools) may increase access.41,42 Promoting health savings account (HSA) or flexible spending account (FSA) eligible sunscreen purchases may help offset costs.43

In terms of motivational, attitudinal, and knowledge barriers, disliking the feel, smell, or appearance of sunscreen was common (24.2%), as found in prior studies.27,31 Sensory attributes such as thickness, greasiness, slipperiness, stickiness, and residue may influence use.44 Sunscreen manufacturers should prioritize clinically effective improved formulations (e.g., lightweight, nongreasy, fragrance neutral) and emphasize these attributes in product labeling and marketing.45

A desire to be tanned was reported by 14.1% of participants in the sample, although prior research suggests higher rates in various U.S. subpopulations (e.g., 39% to >50% among university students).29,30 Sociocultural ideals of beauty influence sunscreen use through media, peers, and body image, particularly among women.46, 47, 48 Appearance-focused communication (e.g., sunscreen prevents wrinkles, sagging, sunspots) may be effective for this population.49 Photoaging technology simulating long-term sun damage on the face may motivate sun protection behaviors.50,51 Visual education, such as images of skin cancer surgeries, may further influence behavior.52

Consistent with prior research,15 most participants were aware of UV protection provided by sunscreen. Educational communication grounded in behavioral theory (e.g., Health Belief Model, Protection Motivation Theory, Theory of Planned Behavior) may further shift perceptions.53 To address sunscreen selection barriers, public health messaging should emphasize broad spectrum, sun protection factor (SPF) ≥30, and water resistance.54 Policy reforms requiring UVA/UVB protection and clearer labeling modeled on international standards may reduce consumer selection barriers.55,56

Six participants cited concerns about toxic chemicals in sunscreen.57 Mineral sunscreens with zinc oxide and/or titanium dioxide are generally considered safe and effective,58 whereas effects of chemical sunscreen ingredient absorption (e.g., oxybenzone, octinoxate, and others) are less well understood.59,60 Clinicians can guide patients in risk/benefit analyses.

Differences were found according to demographic variables. Appearance-focused communication may be an effective public health messaging strategy, especially for women.34 Whereas prior studies suggest that men are less engaged in sunscreen use owing to gender expectations, male-to-male body contact norms, less social support, and reduced encouragement from family and peers to apply sunscreen,61, 62, 63 other work suggests that men are more likely to use sunscreen when they understand sunscreen’s role in cancer prevention.20

Gen X was more likely to report tanning preferences, perhaps reflecting the peak popularity of tanning in the 1980s. Gen Z’s engagement with prejuvenation and skincare culture, fueled by social media and skinfluencers in the wake of the Zoom Boom phenomenon, offers a strategic entry point for early sun safety messaging.64 Interventions could emphasize that the cosmetic benefits of sunscreen outweigh the inconvenience. Because Gen Z participants were less likely to know how to select appropriate sunscreen, targeted information disseminated through digital platforms such as YouTube, Instagram, and TikTok may be most effective,65 whereas Facebook may better reach older generations.66

Individuals with sun-sensitive skin were less likely to report tanning preferences and more likely to report cost, forgetfulness, and product selection knowledge barriers. A prior study found higher regular sunscreen use and greater perceived cost burden among individuals with sun-sensitive skin.67 Sun-sensitive individuals are more likely to sunburn during incidental outdoor exposure, which could heighten awareness of their forgetfulness and uncertainty about selecting effective sunscreens. They may also purchase sunscreen more frequently to prevent sunburn, potentially increasing perceived cost barriers. Individuals prone to tanning may perceive less risk of pain or negative appearance associated with sunburns and may therefore prioritize aesthetics over prevention. Messaging should emphasize that people who do not burn easily can still develop skin cancer.68

Contrary to prior studies linking higher education levels to sunscreen use,69 participants with a bachelor's degree reported greater inconvenience and sensory issues than those with a high school degree or less, possibly reflecting indoor occupations, professional appearance concerns (e.g., greasiness, residue, incompatibility with makeup), or higher levels of product critique (e.g., quality, clean, green). Cohabitating unmarried individuals were more likely to report lack of awareness than single individuals. This is an unexpected finding, given previous results related to sunscreen use and romantic partnerships.70

Limitations

This study has several limitations. The sample was limited to White adults, reflecting an at-risk population but reducing generalizability. Future research should assess sunscreen barriers in more diverse racial groups and other higher-risk populations (e.g., Native Americans).71 The use of an online panel may have introduced selection bias by underrepresenting those with limited internet access. Barrier measures relied on self-report and may be subject to recall or social desirability bias.

Future studies should incorporate additional perceived barriers found in the open-ended response (e.g., concerns about sunscreen ingredients, allergic reactions, vitamin D deficiency). Qualitative or mixed-methods designs could gather richer detail on how and why barriers arise and identify participant-suggested strategies for overcoming them.

CONCLUSIONS

This U.S.-based online panel survey identified key barriers to sunscreen use among White adults, with patterns varying by gender, generation, skin phototype, and other demographic characteristics. Improving sunscreen use requires a multilevel approach that combines tailored health communication strategies; changes in social norms surrounding the desirability of tanning; and product and policy strategies that address common barriers, including forgetfulness, disliking the feel or smell of sunscreen, cost, inconvenience, tanning preferences, and difficulty in selecting an appropriate sunscreen. At the individual level, behavioral strategies include integrating sunscreen into daily routines and using cues to action such as technology reminders and prompts. Improved product formulations, clearer labeling, and product selection guidance may improve uptake. Policy changes such as cost reduction strategies and ingredient standards may further reduce barriers and support sustained sunscreen use, ultimately contributing to lower skin cancer risk.

Acknowledgments

ACKNOWLEDGMENTS

Funding: Funding for this study was provided by Brigham Young University and Utah Valley University.

Declaration of interest: None.

CRediT AUTHOR STATEMENT

Sarah M. Hall: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing - original draft, Writing - review & editing. Mindy Steadman: Data curation, Formal analysis, Investigation, Resources, Software, Validation, Writing - review & editing. Sarah Major: Investigation, Visualization, Writing - original draft, Writing - review & editing. Mary-Frances Oldham: Investigation, Visualization, Writing - original draft, Writing - review & editing. Hannah Mitchell: Visualization, Validation, Writing – review & editing.

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