What Patients Should Know About Sunscreen Allergies, With Glenn Kolansky, M.D.

As sun exposure increases during the warmer months, dermatologists often field patient concerns about sunscreen use. While sunscreens remain a cornerstone in skin cancer prevention, a small subset of patients — especially those with eczema or sensitive skin — may experience allergic reactions. Glenn Kolansky, M.D., assistant professor at Hackensack Meridian School of Medicine and a double board-certified dermatologist and Mohs surgeon, emphasizes that understanding the cause and appropriate management of sunscreen allergies is key to helping these patients stay protected.

Sunscreen-related allergic reactions can manifest as redness, itching, blistering or even hives. Though relatively uncommon, these reactions are more frequently seen in individuals with underlying skin sensitivities. The most frequent offender is oxybenzone (benzophenone-3), a widely used chemical UV filter. However, reactions may also stem from added fragrances, preservatives or colorants, making it important to review the full ingredient list when patients report symptoms.

Product formulation changes can also lead to new sensitivities, even when patients believe they’re using the same sunscreen they’ve tolerated previously. Manufacturers are not always required to notify consumers when making minor changes to fragrance blends or preservative systems, which can contribute to confusion and misattribution of symptoms.

For patients with known sensitivities, mineral-based sunscreens containing zinc oxide or titanium dioxide offer a safer alternative. These physical blockers provide broad-spectrum UVA and UVB protection and are generally less likely to trigger allergic reactions. Products labeled “hypoallergenic” and “fragrance-free” are preferable for this population.

In addition to choosing the right formulation, reinforcing best practices for sun protection is essential. Sunscreen should have an SPF of at least 30 and be reapplied every two hours, especially after swimming or sweating. Since regulatory changes, sunscreens are now labeled “water-resistant” rather than “waterproof,” with reapplication recommended every 40 to 80 minutes for water exposure.

Sun-protective clothing, including UV-blocking shirts (often made of polyester fabrics) and wide-brimmed hats, provides an additional layer of defense. Patients should also be advised to limit sun exposure during peak UV radiation hours, typically from 9 a.m. to 4 p.m.

Long-term sun exposure without adequate protection remains a significant risk factor for basal cell carcinoma, squamous cell carcinoma and melanoma. Even a history of three or more sunburns markedly raises melanoma risk. Beyond cancer, cumulative UV damage contributes to photoaging, including skin laxity and solar lentigines.