There Is No Such Thing as a Healthy Tan: Sunburn, SPF, and Skin Cancer

Skin cancer is the most common cancer diagnosed in the United States, and most cases are preventable with consistent sun protection. As patients spend more time outdoors this summer, pharmacists are often the first and most accessible source of guidance on sunscreen selection and sun-safe habits, making these conversations a practical extension of routine counseling, not a separate clinical visit.¹

What Is a Sunburn, Actually, and Is a Tan Any Better?

A sunburn is not simply irritated skin; it is visible evidence that UV radiation has directly damaged the DNA inside skin cells. That redness and inflammation is the skin's acute injury response to this cellular damage, and this is the same DNA damage that drives skin cancer: when UV-induced mutations are not fully repaired, they accumulate in skin cells over time and can eventually lead to the uncontrolled cell growth that defines basal cell carcinoma, squamous cell carcinoma, and melanoma.²

This is why sunburn history matters clinically and not just cosmetically; a single blistering sunburn in childhood or young adulthood more than doubles a person's lifetime melanoma risk.²

Tanning is not a safer alternative. A tan reflects the same underlying mechanism, melanin production ramping up specifically because skin cells have sensed DNA damage and are trying to shield themselves from further harm. In other words, if the skin is visibly darker after sun exposure, damage has already occurred; there is no such thing as a "healthy" tan, and each additional tan or burn represents another round of accumulating mutational risk.²

What SPF Should Patients Be Using?

A broad-spectrum sunscreen with an SPF of at least 30 is the standard recommendation, since it blocks about 97% of UVB rays. Products should be labeled broad-spectrum, meaning they protect against both UVA and UVB radiation, since UVA exposure contributes to photoaging and skin cancer risk even without causing visible burning. Higher SPF values above 60 offer only marginal additional protection, so steering patients toward a well-tolerated SPF 30 to 50 product they will actually reapply is generally more useful than chasing the highest number on the shelf.^3-5

How Much Sunscreen Do Patients Need, and When Should They Apply It?

Most adults need about 1 ounce, roughly a shot glass full, to adequately cover exposed skin. Sunscreen should be applied 15 to 30 minutes before sun exposure so it has time to bind to the skin and reapplied every 2 hours or immediately after swimming or heavy sweating. Patients often underapply significantly, which is one of the most common gaps pharmacists can catch simply by asking how a patient is using the product they've already purchased.^1,6,7

Mineral or Chemical Sunscreen: Does it Matter Which One a Patient Picks?

Mineral sunscreens, formulated with zinc oxide or titanium dioxide, sit on top of the skin and are generally better tolerated by sensitive or reactive skin, though they can offer somewhat less cosmetic elegance than chemical formulations. Chemical sunscreens tend to absorb more easily and are less likely to leave a visible cast but carry a higher risk of irritation for some patients. The best sunscreen is ultimately the one a patient will use consistently, so tolerability and cosmetic preference should factor into the recommendation as much as SPF.⁶

Which Medications Increase a Patient's Sun Sensitivity, and Does This Matter for Oncology Patients Specifically?

This is an underrecognized counseling opportunity. Numerous drug classes are associated with photosensitivity, including antineoplastic agents, nonsteroidal anti-inflammatory drugs, certain antimicrobials, and cardiovascular medications, and reactions can present as an exaggerated sunburn-like response even after brief sun exposure. Within oncology, targeted therapies such as BRAF and MEK inhibitors, along with several cytotoxic chemotherapy agents, have documented photosensitizing effects, and patients should be counseled to use rigorous sun protection from the first day of treatment through several days after discontinuation, not just during active infusion visits.^7-9

Beyond Sunscreen, What Else Should Pharmacists Be Counseling On?

Sunscreen is only one layer of protection. Patients should also be advised to seek shade during peak UV hours of 10 am to 4 pm, wear a wide-brimmed hat and sunglasses, and consider UPF-rated clothing for extended outdoor exposure. Tanning beds should be discouraged entirely, since there is no such thing as a protective "base tan," and any pigment change from UV exposure reflects underlying skin damage rather than a form of protection.^1,6,9

Does Counseling Change for a Patient With a Personal History of Skin Cancer?

The core sun-protection principles stay the same, but the stakes and vigilance should be higher. Patients with a prior skin cancer diagnosis are at meaningfully increased risk for a second lesion, so pharmacists should reinforce daily sunscreen use regardless of season or weather, not just during peak summer months, and should have a lower threshold for recommending dermatology follow-up for any new or changing skin finding.¹

When Should a Pharmacist Recommend a Patient See a Dermatologist?

Pharmacists are frequently the first to hear about a "spot that looks different," which makes basic mole surveillance a valuable counseling point. Patients should be encouraged to watch for asymmetry, irregular borders, uneven color, and a diameter larger than a pencil eraser. Any new or changing lesion warrants a dermatology referral rather than a wait-and-see approach.¹

REFERENCES

1. Sun protection tips and skin cancer prevention. Pharmacy Times. Accessed August 11, 2026. https://www.pharmacytimes.com/view/preventive-care-for-skin-cancer

2. Viggiano T. The science of sunburns: why they happen and how to treat them. Mayo Clinic Press. Published October 31, 2022. Accessed August 25, 2026. https://mcpress.mayoclinic.org/living-well/the-science-of-sunburns-why-they-happen-and-how-to-treat-them/

3. Here comes the sun: counseling points on sunscreen use. Pharmacy Times. Published March 10, 2016. https://www.pharmacytimes.com/view/here-comes-the-sun-counseling-points-on-sunscreen-use

4. Gabros S, Patel P, Zito PM. Sunscreens and photoprotection. In: StatPearls. StatPearls Publishing. Updated March 28, 2025. Accessed August 25, 2026. https://www.ncbi.nlm.nih.gov/books/NBK537164/

5. Sunscreen: how to help protect your skin from the sun. FDA. Last Updated June 9, 2026. Accessed August 25, 2026. https://www.fda.gov/drugs/understanding-over-counter-medicines/sunscreen-how-help-protect-your-skin-sun

6. McFerran L. Skin cancer prevention for 2026 and beyond. Lehigh Valley Health Network. Published May 11, 2026. Accessed August 25, 2026. https://www.lvhn.org/news/skin-cancer-prevention-2026-and-beyond

7. Holmes M, Renaud A, Carter C, et al. Summertime medication sun safety tips. Pharmacy Times. Published July 27, 2022. Accessed August 25, 2026. https://www.pharmacytimes.com/view/summertime-medication-sun-safety-tips

8. Cancer treatment and photosensitivity. Moffitt Cancer Center. Published May 20, 2022. Accessed August 11, 2026. https://www.moffitt.org/taking-care-of-your-health/taking-care-of-your-health-story-archive/cancer-treatment-and-photosensitivity/

9. Kaminsky A, Suhl S, Sacknovitz Y, et al. Skin health in oncology: evidence-based skin care for cancer patients. The Oncologist. 2026;31(7):oyag194. doi:10.1093/oncolo/oyag194