Sunscreen use is recommended for the prevention of sunburn and skin cancer. Little is known regarding sunscreen availability in high versus low income communities. We analyzed sunscreen availability in three large metropolitan counties to determine the relationship between availability and community demographics. We included sun care products in all pharmacies and supermarkets open as of July 2013 in representative high and low income zip codes in Cook County, Illinois, Miami-Dade County, Florida, and San Diego County, California. We recorded the percentage of tanning oil, sunscreens with a sun protection factor (SPF)？<？15, SPF？>？15, physical sunscreens, spray sunscreens, mean price per ounce (PPO), and mean SPF. Of the total products assessed, 11.0% were tanning oils, with physical sunscreens accounting for only 3.4% of the available sunscreens and 46.2% of sunscreens being spray-on. A comparison between higher and lower income zip codes demonstrated a significantly increased percentage of sunscreens with SPF？<？15 in high income zip codes. Lower income zip codes had higher percentages of sunscreens with SPF？>？15 and higher PPO, even when taking into account SPF. Further studies of sunscreen usage patterns in different populations must take into account sunscreen availability and price, as these significantly differ based on the community demographic. 1. Introduction Both melanoma and nonmelanoma skin cancers (NMSC) are becoming increasingly prevalent [1, 2], with NMSC becoming the fifth most costly cancer in the United States [3]. Sunburn also accounts for a significant amount of lost work hours, resulting in an estimated economic impact for lost work and treatment in excess of $10 million [4]. Preventive measures against skin cancers and sunburn include sun avoidance during the peak hours, wearing protective clothing, and using sunscreen [5]. Broad spectrum sunscreen leads to a reduction in the formation of thymine dimers in vivo [6]. Routine use of sunscreen can prevent the development of NMSC [7, 8]. High sun protection factor (SPF) sunscreens have not been associated with increased sun exposure time in the general population [9]. Additionally, though controversial, regular sunscreen use may prevent the development of melanoma as well as nevi in fair-skinned children [10–12]. Sunscreen use habits can vary by region, education level, socioeconomic status (SES), racial/ethnic background, and age. Coups et al. found that young, Midwestern, non-Hispanic white (NHW), and less-educated males had the greatest number of skin cancer risk behaviors [13].
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