Sun protection factor persistence during a day with physical activity and bathing

Background/purpose: The persistence of sunscreens during a day with physical activity and bathing is often debated. We wished to examine the durability of the protection achieved by one sunscreen application. Methods: Seven areas were marked on the back of 24 volunteers. One area was phototested to determine UV sensitivity. Six areas were treated with either an organic or an inorganic sunscreen (2 mg/cm²). The participants performed physical activities, were exposed to a hot environment and bathing during 8 h and were phototested with ultraviolet‐B (UVB) radiation 30 min, 4 and 8 h after sunscreen application. The minimal erythema dose (MED) was determined 24 h after irradiation. The sun protection factor (SPF) was calculated, as MED on protected skin/MED on unprotected skin. Results: The SPFs of the inorganic and organic sunscreen, respectively, were reduced by 38% and 41% after 4 h and by 55% and 58% after 8 h. Conclusion: One application of either an inorganic or an organic sunscreen reduced the erythema caused by UVB during a day with physical activity and bathing. After 8 h the sunscreens still provided approximately 43% of the initial protective effect. This might simulate what happens during a day at the beach.     

Sun protection factor: meaning and controversies

The Sun Protection Factor (SPF) is the most important data to quantify the effectiveness of a sunscreen, being universally accepted. The method is based on determining the minimum erythematous dose (MED), defined as the smallest amount of energy required for triggering the erythema, in areas of protected and unprotected skin. The SPF value is then calculated as the ratio between the MED of protected and unprotected skin. The first publication of a method for determining the SPF was presented in 1978 by the U.S. FDA agency, followed by other publications of FDA and other international regulatory agencies. Although considered the reference method for quantification of sunscreen efficacy of topical products, there are controversies in literature about the method for determining the SPF and the implications of the real conditions of use in the protection achieved in practice by users.     

Sun protection factor measurement of sunscreens is dependent on minimal erythema dose

This study investigates the influence of skin colour and minimal erythema dose (MED) on the in vivo determination of sunscreen sun protection factors (SPFs). The MEDs of groups of 10-20 subjects were measured on the lower back with a 1000-W solar-simulated xenon arc lamp. Five sunscreens, with commercially measured SPFs ranging from 4 to 30 + were then tested on the different groups, and their SPFs were correlated with volunteers' MEDs. We found that the sunscreens had higher SPF values when tested on subjects with lower MEDs and paler skin. The SPF values obtained with our ultraviolet (UV) source were lower than the SPF values reported with commercially used solar simulators. We conclude that while SPF tests with artificial UV sources and pale-skinned volunteers can and should be used to rank the efficacy of various sunscreens in preventing sunburn, they should not be interpreted as measures of a sunscreen's absolute level of sun protection. Factors such as the differences in skin colour and MED between subjects used for SPF testing and the general population, the spectral differences between sunlight and artificial UV, as well as the tendency of the public to apply only small amounts of sunscreen and to re-apply it infrequently, mean that laboratory and sunlight SPFs may be markedly different.     

Assessment of thickness of photoprotective lipsticks and frequency of reapplication: results from a laboratory test and a field experiment

BACKGROUND: The thickness of the sunscreen layer that is actually applied by consumers under usual conditions has been determined for photoprotective lotions and creams; however, this question is still unanswered for photoprotective lipsticks. OBJECTIVES: To assess lipstick thickness (area density) and frequency of application per day for two commercially available photoprotective lipsticks with different consistency. METHODS: The study consisted of a laboratory test and a field experiment. In the laboratory test the applied lipstick thickness was determined as area density in mg cm(-2) for a group of 28 panellists under standardized conditions. In a separate group of 18 subjects we assessed the area density and the frequency of application per day for two photoprotective lipsticks during a 6-day skiing course. RESULTS: In the laboratory test the median and 95% confidence interval of the area density was 0.98 mg cm(-2) (0.66-1.65) and 0.86 mg cm(-2) (0.63-1.40) for products A and B, respectively. The respective values of the field experiment were 1.58 mg cm(-2) (0.79-2.23) (product A) and 1.76 mg cm(-2) (1.16-3.50) (product B). Only 11% of all applications of lipstick A and 6% of all applications of lipstick B reached the reference area density of 2.0 mg cm(-2). The difference between the median of the area density for lipstick A (firm consistency) and lipstick B (soft consistency) was not statistically significant. No statistically significant influence on the area density was found for age, sex, photobiological skin type or regular lipstick use. The median daily frequency of application was 2.2 times for lipstick A and 3.0 times for lipstick B. CONCLUSION: Our investigation shows that photoprotective lipsticks are applied in a much thinner layer than recommended by international standards (2 mg cm(-2)). This results in a significant reduction of the photoprotective capacity. Furthermore, the frequency of application is too low for adequate protection. Therefore, we propose that the sun protection factor (SPF) should be assessed for an area density that reflects the actual usage patterns. As long as the test protocol is not adapted to the reduced area density, photoprotective lipsticks with high and ultrahigh SPF should be recommended, especially for individuals with increased risk for the development of lip malignancies.     

A more reliable index of sunscreen protection, based on life table analysis of individual sun protection factors

The efficacy indices of two representative sunscreen preparations were determined using life table analysis of individual sun protection factors (SPF), obtained by exposing a group of subjects to ultraviolet radiation (UVR) doses from 4 to 20 multiples of the control minimal erythema dose (MED). The ultimate efficacy index is expressed as the UVR dose under which a selected percentage of the population is safely protected by a sunscreen. This method takes into account several sources of bias in the current test procedure, in particular the considerable variability in individual responses. It also takes into account subjects in whom the MED of the protected skin is either higher or lower than the range of challenge doses to which they were exposed, thereby increasing the effective sample size. This method provides a more precise and comprehensive index of sunscreen protection, and enables statistical comparison of different preparations, or of the effect of other factors on their efficacy.     

Effect of sunscreen application on UV-induced thymine dimers

BACKGROUND: Exposure to UV radiation is a major risk factor for skin cancer, including malignant melanoma. Photocarcinogenesis is caused largely by mutations at sites of incorrectly repaired DNA photoproducts, of which the most common is the thymine dimer. Over the past decade, controversy has arisen over the use of sunscreens to prevent UV-induced skin cancer. OBJECTIVES: To determine if daily application of a broad-spectrum sunscreen with a sun protection factor (SPF) of 15 protects human skin against UV-induced DNA damage as determined by the formation of thymine dimers after repeated exposures to simulated solar light and, if so, to determine whether daily applications are required to achieve this protective effect. METHODS: Over 4 consecutive days, an SPF 15 sunscreen was applied homogeneously to each of 4 buttock sites of 18 women 30 minutes before exposure to 2 minimum erythemal doses of UV radiation. Of these 4 sites, 1 was treated with SPF 15 daily, and the remaining 3 were treated on 3 of the 4 irradiation days, skipping application on day 2, 3, or 4. A fifth site served as the untreated control and was also not irradiated. The number of cells per square millimeter positive for thymine dimer formation was determined using immunohistochemical and image analyses. RESULTS: There was no significant difference in thymine dimer formation between nonirradiated and irradiated skin when application of sunscreen preceded each irradiation. However, when sunscreen application was omitted even once prior to irradiation, a statistically significant increase in thymine dimer formation was apparent. At 48 hours after irradiation of unprotected skin, 50% of epidermal dimers present 24 hours after irradiation had been removed; at 72 hours, more than 75% were gone. CONCLUSIONS: Our study indicates that regular use of a broad-spectrum sunscreen is effective in preventing a major form of UV-induced DNA damage. Irregular and inadequate use of sunscreen during exposure to UV radiation results in thymine dimer formation, which may lead to mutation and subsequent cancer development.     

The Relationship of Sun Protection Factor to Minimal Erythema Dose,Japanese Skin Type,and Skin Color

The relationship of sun protection factor (SPF) to minimal erythema dose (MED), Japanese skin type, and skin color was investigated on the unexposed backs of 48 healthy subjects. SPF of a UVB-sunscreen was determined using sun lamps as a light source. A significant correlation was found between SPF and MED; subjects with lower MED showed higher SPF. The average SPF decreased with increasing skin type. There was no significant correlation between SPF and skin color (L*a*b* color system).     

Efficacy of broad-spectrum sunscreens against the suppression of elicitation of delayed-type hypersensitivity responses in humans depends on the level of ultraviolet A protection

Sunscreens have been designed to protect against sunburn and their efficacy has, therefore, been labeled by the so-called sun protection factor (SPF). Although this value is well determined using a standardized protocol and it affords a good evaluation of the protection against erythema it may be inadequate to provide a relevant measurement of efficacy against other biologic damages. This is particularly true when action spectra and threshold dose are different from those of erythema. In the case of ultraviolet (UV)-induced immune suppression, the action spectrum is not known, so it cannot be asserted that SPF may accurately predict the level of protection against this endpoint. We addressed this issue by measuring in human volunteers the ability of two broad-spectrum SPF 15 sunscreens with different ultraviolet A (UVA) protection levels, to prevent the alteration of the efferent phase of the local delayed-type hypersensitivity (DTH) response to recall antigens (Multitest Pasteur/Mérieux, Lyon, France) after acute solar-simulated UV exposure. We first determined the ultraviolet radiation (UVR) dose needed to induce a significant DTH inhibition in several groups of 15 volunteers. Two minimal erythemal doses (2 MED) were found to be the minimal immunosuppressive dose (MISD). As a result, the immune DTH response is reduced in average by 36%. The lower doses tested (0.5 and 1 MED) were ineffective. Sunscreen-treated groups were exposed to either 1 or 2 MED x SPF doses. As expected, no alteration in DTH response was observed in the groups exposed to 1 MED x SPF whatever the sunscreen applied. In contrast, after exposure to 2 MED x SPF, the DTH response remained unaltered in the group pretreated with the sunscreen product with the higher protection in the UVA range but was significantly suppressed by 55.7% in the group pretreated with sunscreen with a much lower protection in the UVA range. These data suggest that SPF may not be sufficient to predict the ability of sunscreens to protect from UV-induced immune suppression. Determining the level of UVA protection is particularly needed, as UVA seems to have a relatively low contribution to erythema but is highly involved in immunosuppression.     

Protective effects of sunscreening agents on photocarcinogenesis, photoaging, and DNA damage in XPA gene knockout mice

We investigated the protective effects of commercial sunscreening agents against UVB-induced photoresponses in group A xeroderma pigmentosum (XPA) model mice. XPA gene-deficient mice are defective in nucleotide excision repair and show a high incidence of skin tumors and severe acute inflammation in response to UVB irradiation, in a similar manner to XP patients. SPF 10 and SPF 60 sunscreens protected partially and almost completely, respectively, ear swelling responses produced by UVB up to 200 mJ/cm2 in (-/-) mice. XPA (-/-) mice were irradiated three times a week to a cumulative dose of 2.6 J/cm2 UVB for a period of 24 weeks with or without SPF 10 or SPF 60 sunscreen. UV-induced skin tumors had developed in all unprotected (-/-) mice (13.3 tumors per mouse) at the completion of UVB irradiation. The SPF 60 sunscreen afforded stronger protection against photocarcinogenesis (1.0 tumors per mouse) than the SPF 10 sunscreen (4.4 tumors per mouse). Regarding photoaging, SPF 60 sunscreen also protected against mast cell infiltration (79% inhibition), elastic fiber accumulation, and dermal cyst proliferation in XPA (-/-) mice compared with unprotected (-/-) mice. In (-/-) mice, the SPF 60 sunscreen provided stronger protection against cyclobutane pyrimidine dimer formation shown immunohistologically following irradiation with 200 mJ/cm2 UVB than the SPF 10 sunscreen. The XPA model mouse is a useful animal for the evaluation of the photoprotective ability of sunscreens because photoresponses, even chronic changes, can be easily and quickly induced experimentally.     

Sunscreen protection against cis-urocanic acid production in human skin

Commercial sunscreens may offer some protection from immunosuppression induced by ultraviolet (UV) radiation, but agreement concerning the degree of protection is lacking. Cis-urocanic acid, formed by the photoisomerization of transurocanic acid is considered an important mediator of the cutaneous immunomodulation resulting from exposure to UV radiation. We investigated the effect of sunscreens on the isomerization of urocanic acid in 17 human subjects. Two sunscreens containing chemical filters, sun protection factor (SPF) 4 and SPF 10, and a SPF 10 sunscreen with a physical filter were applied at a thickness of 2 mg/cm2. The effect of a thin layer (0.5 mg/cm2) of the chemical SPF 10 sunscreen was also evaluated, as the amount of sunscreen applied in practice may be considerably less than recommended. All areas were irradiated with a single UV dose of 3.6 SED (standard erythema doses). In irradiated unprotected skin the median net production of cis-urocanic acid was 52% (relative amount). In the sites treated with the chemical sunscreens, the production of cis-urocanic acid was 7.4% (SPF 4) and 3.5% (SPF 10), and isomerization was thus reduced more efficiently at a higher SPF (p<0.01). The physical sunscreen reduced the formation of cis-UCA to 15%, and was significantly less effective than both the chemical SPF 10 sunscreen (p<0.01) and the SPF 4 sunscreen (p<0.01). The production of cis-urocanic acid in the area treated with the thin layer of the chemical SPF 10 sunscreen was 22%. The protection against the production of cis-urocanic acid was therefore reduced significantly (p<0.01) when the sunscreen was applied in an amount lower than recommended.     

The relation between sun protection factor and amount of suncreen applied in vivo

BACKGROUND: The declared sun protection factor (SPF) is based on the use of a sunscreen layer of 2 mg cm(-2). However, only around a quarter (0 x 5 mg cm(-2)) of this amount is applied by sunbathers. Theoretical calculations have suggested that the effective SPF is related to sunscreen quantity in an exponential way but this was not confirmed in vitro and has not been studied in vivo. OBJECTIVES: To investigate the relation between SPF and sunscreen amount in vivo. SUBJECTS AND METHODS: On the backs of 20 healthy volunteers, five areas of 34 cm(2) each were marked. One area was phototested to determine the ultraviolet (UV) sensitivity. Four areas were treated with a sunscreen SPF 4 in different amounts: 0 x 5, 1, 2 and 4 mg cm(-2). Thirty minutes after sunscreen application a phototest was conducted on each area. The effective SPF was calculated 22-26 h after irradiation using the UV dose needed to produce just perceptible erythema (minimal erythema dose) on protected and unprotected skin. RESULTS: In all areas the mean SPF was significantly different from an SPF of 1 (no protection) (P 相似文献   

Quantity of sunscreen used by European students

BACKGROUND: The ability of sunscreen products to delay sun-induced skin erythema is indicated by the sun protection factor (SPF), which is measured using an internationally agreed sunscreen thickness of 2 mg cm(-2). OBJECTIVES: To determine the thickness of sunscreen used under practical conditions. METHODS: In two double-blind randomized trials performed in five different places in Europe in 1997 and 1998, 148 18--24-year-old students received either an SPF 10 or an SPF 30 sunscreen to be used during their summer holidays. RESULTS: Complete, detailed data on quantities of sunscreen used and skin areas on to which sunscreen was applied were available for 124 students. The median thickness of sunscreen applied was 0.39 mg cm(-2). We found no variation in sunscreen thickness according to sex, skin phototype, study place or SPF. CONCLUSIONS: Our results indicate that most consumers do not benefit from the SPF indicated on sunscreen bottles, and do not support the idea that thickness of sunscreen applied would be greater if these products were cheaper. We suggest that information on ability of a sunscreen product to prevent sunburn should be adapted in order to reflect actual usage patterns.     

Accumulated p53 protein and UVA protection level of sunscreens

Nuclear p53 expression is a sensitive parameter for the detection of ultraviolet (UV)-induced skin damage, and it has been used as an endpoint to evaluate the effectiveness of sunscreens. In this study, we compared the protection provided by two sunscreens having identical sun protection factors (SPF) but different UVA protection factors (UVA-PF) measured by the persistent pigment darkening method (PPD). The SPF of the sunscreens was 7 and the UVA-PF were respectively 7 and 3. Nuclear p53 protein was quantified in human skin biopsies treated with sunscreens and exposed 8 times to 5 MED of solar simulated radiation (SSR). The results showed that both sunscreens offered only partial protection against the increased expression of nuclear p53 protein induced by repetitive SSR exposures. However, a significantly lower level of p53-positive cells was found in areas protected with the sunscreen having the higher UVA-PF compared to the other sunscreen protected areas. In order to verify whether the difference in efficacy of these products was due to the difference in UVA absorption capacity, we quantified epidermal p53 protein accumulation after 8 exposures to either UVA (320-400 nm) or UVA1 (340-400 nm). We showed that as with SSR, repetitive exposures to 12.5 and 25 J/cm2 of UVA or UVA1 induced a significant increase in p53-positive cells in the human epidermis. These results confirmed that SPF determined on the basis of an acute erythemal reaction does not predict the level of protection against cumulative damage. They also showed that the protection provided by two sunscreens with different UVA protection factors is different (based on nuclear p53 protein accumulation), and that the PPD method can distinguish varying levels of sunscreen efficacy against UVA-induced cell damage.     

Prevention of ultraviolet-induced skin pigmentation

BACKGROUND/PURPOSE: Exposure to ultraviolet (UV) radiation increases skin pigmentation and usually results in an even darkening of the skin. However, it may also occasionally lead to the development of hyperpigmented lesions due to a local overproduction of pigment. Skin pigmentation is induced both by UVB and UVA rays. METHODS: The in vivo protection by sunscreens against pigmentation was studied using the determination of a level of protection against pigmentation based on the standardized sun protection factor (SPF) test method. The method includes delayed UVB and UVA pigmentations. The level of prevention against pigmentation was determined 7 days after exposure to solar-simulated radiation by visual assessment. It was calculated using the ratio of the minimal pigmenting dose on protected skin to the minimal pigmenting dose on unprotected skin. Broadspectrum UVB/UVA filters, Mexoryl SX and Mexoryl XL, and complete formula were tested. RESULTS: Protection against pigmentation correlates with the concentration of Mexoryl SX. The levels of protection obtained show a synergetic effect of Mexoryl SX when associated with Mexoryl XL. When different products having the same SPF (same protection against erythema) and different levels of UVA protection are compared, only sunscreen products with a high level of UVA protection show a similar level of protection against sunburn and pigmentation. Products with low UVA protection have a lower capacity of preventing induced pigmentation compared with their efficacy against erythema. CONCLUSIONS: These studies have evidenced that SPF determination was not sufficient to account for the efficiency in preventing pigmentation and that UVA protection was an essential part of this prevention.     

The influence of the amount of sunscreen applied and its sun protection factor (SPF): evaluation of two sunscreens including the same ingredients at different concentrations

Background: To estimate labeled sun protection factor (SPF) for sunscreen, the amount of product applied on volunteers, according to food and drug administration (FDA) and International protocols, is 2 mg/cm². However, different studies have shown that consumers actually apply much less product when exposed to the sun. Previous studies have reported contradictory findings in an attempt to correlate the amount applied in relation to SPF. The objective of the present study was to estimate the influence of the quantity of sunscreen applied in the determination of SPF, according to the FDA methodology.
Subjects and methods: Forty volunteers were included in two groups (SPF 15 and 30). The selected sunscreen was then applied in four different quantities (2, 1.5, 1.0 and 0.5 mg/cm²). All areas were irradiated with a solar simulator. After 24 h, the minimal erythemal dose (MED) and SPF were determined.
Results: In both groups, we observed that the SPF decreased when the amount of sunscreen applied was decreased. The differences between the 2 mg/cm² area and the others were significant in both groups ( P <0.001). The correlation between specified SPF and applied amount grew exponentially.
Conclusion: The protection provided by sunscreen is related to the amount of product applied. It is essential to educate consumers to apply larger amounts of sunscreen for adequate photoprotection.     

A comparison of narrowband (TL-01) UVB-induced erythemal response at different body sites

In most dermatology centres where phototesting is performed, the starting dose is calculated as a proportion of the minimal erythema dose (MED). Previous studies have found significant differences in MED readings between forearm and back skin with both broadband and narrowband (NB) UVB. Our objective was to compare MEDs obtained from three body sites, the forearm, back and abdomen, to see if there was a significant difference in individuals. We recruited 20 healthy volunteers who were exposed to our standard dose series for phototesting with NB-UVB to three body sites: forearm, back and abdomen. MEDs were assessed 24 h post exposure. The median MED for the abdomen was 0.79 J/cm2, the back 0.95 J/cm2 and the arm 1.11 J/cm2. Friedman's analysis of variance by ranks showed that these differences were significant (P = 0.003). There was no correlation between skin type and MED for any of the three anatomical sites. Our results support phototesting for all patients prior to treatment with NB-UVB. Furthermore, we have shown that the abdomen is the anatomical site of choice for phototesting, as this will result in a reduced risk of burning episodes.     

The sunscreening effect of urocanic acid

Urocanic acid (UCA), present in the stratum corneum, is a major absorber of ultraviolet (UV) radiation and, on UV exposure, is induced to isomerize from the naturally occurring trans-isomer to the cis-isomer. Cis-UCA has been shown to have immunosuppressive properties, while trans-UCA may act as a natural sunscreen due to its UV-absorbing properties. The photoprotective capacity of UCA was investigated in this study. Minimal erythema dose (MED) was determined on normal buttock skin in 36 healthy subjects and the concentration of UCA isomers was measured on the skin adjacent to the test site. On the contralateral buttock, MED was determined 20 min after application of trans-UCA 5% in a cream base. The UCA cream gave a sun protection factor of 1.58. The amount of UCA applied was, however, 20–200 times higher than the amount of UCA found in normal skin, making a sunscreening effect of naturally occurring UCA very low This was further supported by a lack of correlation between naturally occurring UCA and the UV sensitivity of each subject determined by the MED.     

Effects of sunscreen on human skin's ultraviolet radiation tolerance

Purpose To observe the alteration ultraviolet radiation (UVR) of skin’s tolerance after its exposure to the small dose of UVR under the protection of sunscreen. Methods Eleven subjects who applied sunscreen were exposed to 0.75 dose minimal persistent pigment darkening (MPPD) and minimal erythema dose (MED) by the Phototherapy Unit for 4 weeks. Each week their MPPDs and MEDs were measured by solar simulator. Meanwhile, SPECTCOLOMETER^® and VISIOSCAN VC98^® were used to detect the test areas and control areas. Results The values of MPPD and MED increased significantly after the exposure to UVR. But there were no visible changes on the surface of skin’s texture. Conclusion With the protection of sunscreen, the UVR tolerance of skin was greatly increased after the skin’s exposure to the small dose UV.     

Effect of daily versus intermittent sunscreen application on solar simulated UV radiation-induced skin response in humans

BACKGROUND: Acute and chronic skin damage occurs as a consequence of solar UV radiation exposure. To diminish such skin damage, the dermatologic community advocates the daily use of sunscreens as part of a sun avoidance strategy. OBJECTIVE: We determined the effectiveness of a sunscreen product with a sunscreen protection factor (SPF) of 15 applied daily in preventing UV-induced histologic damage in human skin compared with the protection afforded by sunscreens with equal or higher SPF applied intermittently. METHODS: Twenty-four subjects were exposed to 2 minimal erythema doses of solar-simulated UV on 4 consecutive days. Three sunscreen products were applied to the buttock of each subject. One SPF 15 product was applied daily before exposure to UV and, to simulate intermittent product use, an SPF 15 or SPF 29 product was applied on 3 of 4 days, with one missed application on days 2, 3, or 4. Skin biopsy specimens were taken and processed for routine and immunohistochemical staining. Changes in number of sunburn cells and Langerhans cells as well as degree of inflammatory infiltrate and lysozyme immunostaining were determined. RESULTS: There was a statistically significant increase in the number of sunburn cells, degree of inflammation, and intensity of lysozyme staining, and there was a decrease in the number of Langerhans cells at sites where sunscreen application was missed as compared with unirradiated control and daily SPF 15 sunscreen-treated sites. CONCLUSION: Our data suggest that daily use of a sunscreen reduces the skin damage produced by UV exposure compared with intermittent use of equal or higher SPF products. The daily application of sunscreens in appropriate quantities reduces the harmful effects of solar UV radiation on skin. Compliance is essential for maximal benefit of sunscreens.     

Minimal erythema dose in UV-shielded and UV-exposed skin predicted by skin reflectance measured pigmentation

Aims: To investigate the relationships between epidermal thickness, age, skin pigmentation and UV sensitivity in sun-exposed skin and skin not exposed to the sun in healthy people without skin cancer or skin diseases. Methods: Phototesting with a xenon arc solar simulator was performed in 137 healthy Caucasians in buttock skin un-exposed to UV (27 children, 34 young adults and 32 older adults) and in skin of the back exposed to UV (44 young adults). The pigmentation of the phototest sites was measured objectively by a skin reflectance spectrometer before phototesting. Thickness of the stratum corneum and the cellular epidermis were measured in skin biopsies from the phototest sites. All measurements were performed in the winter and spring months. Results: Stratum corneum and cellular epidermis were thinner at the back than at the buttocks (P<0.01). Thickness of the stratum corneum at the back or the buttocks was not related to the degree of skin pigmentation (P=0.62 and P=0.20, respectively). Thickness of the stratum corneum at the buttocks was unaffected by gender (P=0.42) and age (P=0.83) whereas cellular epidermis decreased with age (P<0.01) and was thinner in females than in males (P<0.01). In spite of the higher pigmentation at the back than at the buttocks, the minimal erythema dose (MED) was lower at the back than at the buttocks (x=2.7 and x=2.2 SED's, respectively; P=0.04). Given the same degree of skin pigmentation, there was no difference in the MED in buttock skin in children, young adults and older adults un-exposed to UV (P= 0.61). Prediction of the MED in un-exposed buttock skin and in exposed skin of the back by a theoretical model based on an exponential function of the measured skin pigmentation was found to provide good estimates of the MED determined by phototest. Conclusion: Skin pigmentation at un-exposed buttock skin can reliably predict the constitutive UV sensitivity in healthy Caucasian children and adults and is recommended in surveys where phototesting cannot be performed.