Perceived Usefulness and Recall of Sunscreen Label Information by Consumers

Key Points

Question

What is the consumer’s perceived importance and recall of the active ingredients in sunscreen when selecting a sunscreen product?

Findings

In this qualitative study of 47 participants, active ingredients were not reported to be the primary factor influencing consumers’ sunscreen selection. Consumers’ recall of active ingredients was low, and few reported typically looking at the active ingredients; most consumers considered the sun protection factor rating to be the most important information for selecting a sunscreen.

Meaning

Listing of active ingredients on the front label of sunscreen products may not be as useful to consumers for comparing and selecting sunscreens as previously thought.

This qualitative study assesses consumers’ perceived importance of the active ingredients when selecting a sunscreen product and their ability to recall active ingredients after viewing both a current and a proposed sunscreen label.

Abstract

Importance

In February 2019, the US Food and Drug Administration issued a proposed rule (84 FR 6204), an amendment to the Sunscreen Innovation Act of 2014, that would require listing active ingredients on the principal display panel of sunscreens to allow consumers to “more readily compare products and either select or avoid a given product accordingly.”

Objective

To understand consumers’ perceived importance of active ingredients in sunscreen and their ability to recall these ingredients when comparing, avoiding, or selecting sunscreen products.

Design, Setting, and Participants

In this qualitative study, participants were recruited from Fors Marsh Group and User Works, Inc consumer panels and interviewed in person in November and December 2019. Eligible participants were 18 years or older, reported sunscreen use in the past 12 months, and were residents of the Washington, DC, area. After viewing 2 mock sunscreen labels (1 that meets current US Food and Drug Administration requirements and 1 designed to meet proposed requirements), participants were asked questions to assess their perceived importance of active ingredients in sunscreen products, whether they could recall any of the active ingredients on the labels, and whether they typically looked for active ingredients on a sunscreen label.

Main Outcomes and Measures

The main outcomes were the sunscreen label information used by participants to select a sunscreen and their ability to recall the active ingredients after viewing 2 mock sunscreen labels.

Results

The mean (SD) age of the 47 participants was 42.8 (13.6) years, 32 (68%) were women, and 40 (85%) had a bachelor’s or graduate degree. Of the total, 13 (28%) participants stated that sunscreen ingredients influenced their sunscreen selection, but only 5 (11%) said it was the most important information. Instead, 34 (72%) participants stated that the sun protection factor rating was the most important information. After viewing the mock sunscreen labels, only 5 (11%) participants recalled any of the active ingredients, although 10 (21%) reported typically looking at active ingredients when choosing a sunscreen.

Conclusions and Relevance

This qualitative study investigated the US Food and Drug Administration’s proposed new rule requiring that active ingredients be listed on the front of sunscreen labels to facilitate product comparison for consumers. However, active ingredients were not reported to be a primary reason for consumers’ sunscreen selection. Recall of active ingredients was low, and few consumers reported typically looking at the active ingredients, which were more commonly used to avoid ingredients rather than to select a sunscreen. Therefore, listing active ingredients on the front label alone may not have the intended usefulness for consumers.

Introduction

Sunscreen use is a common sun protection behavior¹ that is often targeted by clinical interventions²; however, a recent study raised possible safety concerns regarding certain active ingredients in sunscreens.³ These concerns may be associated with consumer sunscreen selection. Therefore, it is important to understand how consumers use sunscreen label information, including active ingredients lists and sun protection factor (SPF) ratings.⁴

The goal of the US Food and Drug Administration (FDA) proposed rule (84 FR 6204),⁵ an amendment to the Sunscreen Innovation Act of 2014, is to ensure the continued safety and effectiveness of sunscreens. One revision would require manufacturers to list active ingredients on the principal display panel of the label. The FDA expects this change will allow consumers to “more readily compare products and either select or avoid a given product accordingly.”⁵ Although the Sunscreen Innovation Act was effectively ended by section 3854 of the Coronavirus Aid, Relief, and Economic Security Act⁶ (CARES Act) in March 2020, this change may aid consumers by more prominently displaying the active ingredients to facilitate product comparison.

This study aimed to determine whether consumers consider a sunscreen’s active ingredients to be useful information when selecting a sunscreen and whether they recall specific active ingredients after viewing a sunscreen label.

Methods

This was a qualitative study to assess consumer use and recall of sunscreen labels listing active ingredients. The study was conducted in November and December 2019 and recruited participants from Fors Marsh Group and User Works, Inc consumer panels. Eligible participants were 18 years or older, proficient in English, residing in the Washington, DC, area, and reported having used sunscreen in the past 12 months.

Prospective participants completed an online preinterview survey that collected demographic and sun-sensitivity information. Sun-sensitive participants were oversampled because they are more likely to need and potentially use sunscreen. After completing the survey, each participant was compensated with a $75 gift card. The National Institutes of Health institutional review board exempted this study from review because it was classified as benign behavioral research. Written informed consent was obtained from participants through the online presurvey.

Participants were invited to the Audience Research Laboratory at the National Cancer Institute for an on-site in-person interview of approximately 1 hour. Participants were asked questions to assess the importance of general information conveyed on a sunscreen product: (Q1) “When you are choosing a sunscreen to use, what (label) information do you use to make your decision?” and (Q2) “What information on the sunscreen labels is most important to you?”

Participants were shown, in random order, a sunscreen bottle with a label that met current FDA guidelines and then a bottle with a label designed to meet the proposed FDA guidelines (Figure). The current label was adapted from a commercially available sunscreen to represent a fictitious sunscreen brand. The proposed label was further adapted to meet most but not all of the new requirements⁵ while remaining almost identical to the current label in all other aspects. After viewing each label, participants were asked to recall any active ingredients: (Q3) “Do you remember seeing anything about active ingredients in the product?”

Figure. Mock Sunscreen Labels That Meet Current and Aim to Meet Proposed US Food and Drug Administration Guidelines .

Lastly, to assess whether participants generally look for or try to avoid any active ingredients, they were asked: (Q4) “Do you typically look for the active ingredients when choosing a sunscreen?” and (Q5) “Do you seek out or avoid certain active ingredients?” Participants provided free-form responses to all questions, which were coded (yes/no), audio recorded, and noted in writing by a researcher (C.P.T. or A.K.J.). Descriptive frequencies were analyzed using SAS, version 9.4 (SAS Institute Inc).

Results

In all, 47 participants were eligible to participate; their mean (SD) age was 42.8 (13.6) years, 32 (68%) were women, and 40 (85%) had a bachelor’s or graduate degree (Table). Participants reported a mean (SD) of 2.0 (0.7) sunburns in the past 12 months, and 40 (85%) reported sun sensitivity. Before viewing the mock sunscreen labels, 13 (28%) participants mentioned that ingredients listed on labels influenced their sunscreen selection (Q1). Ingredients were the most important label information for 5 (11%) participants (Q2), while the SPF was the most important for 34 (72%) (Table).

Table. Characteristics of Participants Interviewed to Assess the Usefulness and Recall of Active Ingredients on Sunscreen Labels by Consumers.

Characteristic	No. (%)
Total No.	47 (100)
Women	32 (68)
Age, mean (SD), y	42.8 (13.6)
Sunburns in previous 12 mo, mean (SD)	2.0 (0.7)
Education
<High school	1 (2)
High school diploma	3 (7)
Some college or associate degree	3 (7)
Bachelor’s degree	21 (44)
Graduate degree	19 (41)
Label information that influences sunscreen selection
Ingredients	13 (28)
Other information	34 (72)
Most important sunscreen label information
Ingredients	5 (11)
Sun protection factor	34 (72)
Other	8 (17)

After viewing both sunscreen labels, a combined 5 (11%) participants could recall any of the active ingredients from either label (Q3); however, 10 (21%) participants reported that they usually looked at the active ingredients on sunscreen labels (Q4). Among this group, the reasons reported for usually looking at sunscreen labels were avoiding allergens (n = 1), seeking a specific ingredient (n = 1), avoiding ingredients harmful to personal health (n = 5), seeking environmentally safe ingredients (n = 1), did not know (n = 1), or product comparison (n = 2) (Q5).

Discussion

This study aimed to assess how important sunscreen ingredients are in sunscreen product selection. Active ingredients were not a primary factor in sunscreen selection for most of the sample; SPF was the most important factor. Among the few participants who reported ingredients to be an important factor in sunscreen selection, active ingredient recall was limited. Participants stated that ingredients were a reason to avoid rather than to select a sunscreen. This finding of ingredient avoidance among a few participants suggests that some may be mistrustful of active ingredients because of perceived adverse effects.⁷

A strategy to broadly inform consumers of the safety of active ingredients, in conjunction with their placement on the front of sunscreen products, may increase the desired response to the FDA proposed rule.⁵ An information strategy for active ingredients may be modeled on the “Don’t Fry Day” sun safety campaign organized by the National Council on Skin Cancer Prevention.⁸ This strategy may leverage multiple levels of government, public health professionals and educators, and nonprofits to communicate key active ingredient knowledge through traditional and social media channels.

The finding that active ingredients were a low priority for most consumers, compared with other features on a sunscreen label, was similar to previous research. An analysis of product reviews of highly rated sunscreens⁹ found that cosmetic elegance (ie, how easily the product rubs in) was the most cited positive feature, followed by product performance (ie, effectiveness). Only about 10% of reviews in that study mentioned ingredients (eg, natural and/or organic ingredients), whereas in the present study, 28% of participants identified ingredients as being important. Nevertheless, a previous study found that sunscreen ingredients (organic/conventional) were not associated with being a best-selling sunscreen online.¹⁰ Unlike those studies, which relied on product reviews, we directly asked consumers about the importance of active ingredients in sunscreen.

Limitations

This study had 4 main limitations. First, the mock proposed label was an interpretation of the language of the FDA proposed rule and may differ from what the FDA may require and determine when it inspects actual sunscreen labels. Second, the study sample was small and did not reflect the average educational status or geography of the US general population. Third, the laboratory setting may have influenced participants’ stated importance of active ingredients, that is, sunscreen label and active ingredient use may differ in a retail setting. Finally, purposeful oversampling for sun-sensitive individuals may have contributed to greater attention to sunscreen information than in the general population.

Conclusions

Although SPF is conveyed by active ingredients in sunscreen and is likely the most important factor in consumers’ sunscreen selection, the active ingredients themselves were not stated as being the primary factor in their decision-making. Consumer recall of active ingredients was low, and few typically look at active ingredients on sunscreen labels. It is unclear if listing active ingredients on the principal display panel of the sunscreen label alone will help consumers compare and select sunscreens.