Do sunscreen pills work — what the FDA said in 2018 and what the clinical trials actually measured

Do Sunscreen Pills Actually Work? Here’s What the Trials Measured

Search “sunscreen pills” and two completely different conversations come back. One is about sunscreen pilling, the little balls that roll up when sunscreen meets the wrong moisturizer. That one is a texture problem, and we handled it separately in why sunscreen pills up on oily skin. This article is about the other one: capsules you swallow, sold as dietary supplements, marketed as protection from the sun. So do sunscreen pills work? The FDA answered in 2018 by sending warning letters to four companies. The clinical trials answer differently, and more usefully, because they put a number on it.

The short version: In May 2018 the FDA sent warning letters to four supplement companies, naming “Advanced Skin Brightening Formula, Sunsafe Rx, Solaricare and Sunergetic”, and Commissioner Scott Gottlieb wrote that “There’s no pill or capsule that can replace your sunscreen.”[1] A warning letter is not a ban, and Sunsafe Rx is still selling in 2026.[13] The most-studied ingredient in these products, an extract of the fern Polypodium leucotomos, does raise the UV dose it takes to redden skin: from approximately 223 to 234 J/cm² in a five-day study,[4] by 23.8% over eight weeks in a trial of a multi-ingredient supplement,[3] and from 0.123 to 0.161 J/cm² in melanoma high-risk patients.[11] Put the largest of those ratios into the SPF formula, protected dose divided by unprotected dose, and it corresponds to roughly 1.3. That conversion is our arithmetic, not a figure any of those papers printed, and the AAD asks for SPF 30.[14] Meanwhile a 2026 randomized trial whose authors declared no conflicts of interest found the redness threshold rose 26% while DNA damage markers did not fall.[2]

What the FDA actually said, and what it did not

On May 22, 2018, FDA Commissioner Scott Gottlieb issued a statement on sun product regulation. The operative sentence, verbatim: “Today we sent warning letters to companies illegally marketing pills and capsules labeled as dietary supplements that make unproven drug claims about protecting consumers from the harms that come from sun exposure without meeting the FDA’s standards for safety and effectiveness.”[1]

Four products were named. The statement described these companies as “marketing products called Advanced Skin Brightening Formula, Sunsafe Rx, Solaricare and Sunergetic” and as “putting people’s health at risk by giving consumers a false sense of security that a dietary supplement could prevent sunburn, reduce early skin aging caused by the sun, or protect from the risks of skin cancer.”[1] A shorter line from the same statement: “There’s no pill or capsule that can replace your sunscreen.”[1]

Now the part that usually gets dropped. The FDA did not ban these products, order a recall, or rule the ingredients unsafe. It sent letters. The companies were, in the statement’s own words, “instructed to correct all violations” and “advised to review product websites and product labeling.”[1] The objection was to a marketing claim, not to the capsules themselves.

Why that distinction exists is a matter of regulatory category. American regulators treat sunscreen as an over-the-counter drug, which means a protection claim has to clear an evidence standard before the product reaches a shelf. A dietary supplement is not reviewed that way. So a supplement that advertises sun protection has, by making the claim, put itself in the drug category without clearing the drug standard. That is what the letters said.

Eight years later, Sunsafe Rx is still for sale. The wording changed rather than the product: the site now states that “Sunsafe Rx is not a sunscreen lotion. It is a nutritional supplement, taken orally,” alongside language about “demonstrated unprecedented skin protection” and the standard footer that “These statements have not been evaluated by the FDA.”[13] A warning letter changes the copy. It does not clear the shelf.

One more line from the same 2018 statement is worth separating from all of this, because it gets folded into the pill conversation by mistake: “We now have evidence that it’s possible for some sunscreen active ingredients to be absorbed through the skin.”[1] That sentence is about filters in a lotion crossing into blood, and we covered the absorption question in the sunscreen absorption study, explained. It has nothing to do with swallowing a capsule. Absorption through skin and absorption through the gut are different routes, different molecules, and different questions.

The actual numbers: how well do sunscreen pills work?

Polypodium leucotomos is a fern native to Central and South America, sold as an extract under names like Fernblock and Heliocare. It is not a Korean beauty ingredient, and we have not seen it in any Korean sunscreen formula we have covered. It does have human trials behind it, which is more than most supplements in this category can say.

Those trials measure something called the minimal erythema dose, or MED: the smallest dose of UV that produces visible redness on a patch of skin. Researchers find each person’s MED, give the supplement, and find it again. If the second number is higher, it took more UV to burn.

StudyWhat was givenMED before → afterRatioWhat limits it
Hussain 2025[4]PLE 240 mg twice daily, 5 days (Sol Defense Gummies)approximately 223 → 234 J/cm²1.05No placebo and no control group; 25 of 27 completed. Published as a research letter. Funded by Inner Glow, the gummy’s maker
Keršmanc 2025[3]Red orange extract + P. leucotomos + vitamins A, C, D and E, 8 weeks0.447 → 0.553 J/cm² (paper reports +23.8%)1.24Multi-ingredient, so the increase cannot be assigned to the fern. Funded by Tosla d.o.o. Not significant at 2 weeks, only at 8
Aguilera 2013[11]Oral P. leucotomos extract0.123 → 0.161 J/cm²1.31All 61 participants were melanoma high-risk patients, not healthy volunteers. Authors’ stated limits: “Reduced number of patients. No control population.” Partially supported by IFC, the capsule’s maker
Faisal 2026[2]Heliocare Advanced 480 mg daily, 30 days27.7 → 34.8 J/cm² (paper reports +26%)1.26This is a UVA threshold. SPF is defined on UVB, so this row does not belong in an SPF conversion

Only two of those papers printed a percentage of their own, Keršmanc’s 23.8% and Faisal’s 26%. The ratio column is division we performed on the published before-and-after values.

SPF has a formula: the minimal erythema dose on protected skin divided by the minimal erythema dose on unprotected skin. The MED ratios above are the same shape of number, which is what makes the comparison tempting. Take the largest UVB ratio in the table, Aguilera’s 0.161 divided by 0.123, put it into that formula, and the result corresponds to about SPF 1.3.

Two cautions travel with that figure. It is our arithmetic; none of these papers reported an SPF value, and no researcher here claimed one. And the SPF formula was written for a product spread across skin at 2 mg/cm² under a standardized lamp, so applying it to a swallowed capsule is an analogy rather than a measurement. Read 1.3 as a sense of scale, not as a rating.

Four things keep the scale rough:

  • Different labs, different lamps. Each study compared a person to their own earlier reading under its own protocol. These are not four measurements taken with one shared instrument.
  • MED is a redness endpoint. It tracks the dose that makes skin visibly pink. It does not track DNA damage, and it does not track cancer. The next section is about what happens when someone measures both at once.
  • Most of these have no control group. Aguilera’s authors wrote it into the paper: “Reduced number of patients. No control population.”[11] Before-and-after gaps absorb seasonal change, compliance, and measurement drift along with any real effect.
  • Everything here is small and short. Nine to sixty-one participants, from a single day’s dosing to two months. A 2025 systematic review of 47 studies on oral supplements and photoprotection reached the same verdict: “current evidence is limited by small sample size and short duration.”[9]

For scale: the American Academy of Dermatology’s baseline recommendation is broad-spectrum coverage, water resistance, and a minimum of SPF 30.[14]

Three older studies fill in the rest of the picture, and each is weaker than its reputation.

Middelkamp-Hup 2004 is the earliest human trial in this set. It found significantly less erythema (p<.01) and fewer cyclobutane pyrimidine dimers (p<.001) after oral P. leucotomos at 7.5 mg/kg.[7] It enrolled nine people, and there was no placebo group: each participant’s treated skin was compared against their own untreated skin.

Nestor 2015 has the cleanest design of the older set: double-blind, placebo-controlled, 240 mg twice daily for 60 days, with safety markers unchanged throughout.[5] It was sponsored by Ferndale Healthcare, and two of its three authors disclose consulting for the company.[5] Its MED result, though, is a headcount rather than a magnitude. At day 28, eight participants on the extract showed an increased MED against one on placebo (p=0.01); erythema intensity fell in ten against three (p<0.01); two participants on the extract had one or more sunburns against eight on placebo (p=0.04).[5] More people improved. By how much is not in the paper, so there is nothing here to convert.

Kohli 2017 tested 22 people with skin phototypes I to III and found UVB-induced changes reduced in 17 of them, and in all 22 on histology.[6] The authors named their own constraint plainly: “Only 2 doses of PLE were given.” Several of them disclosed working as investigators or consultants for Ferndale Laboratories, which distributes Heliocare in the United States.[5][6]

“Less red” does not mean “less damaged”

In 2026, a group in Denmark ran the trial this field needed. Fifty volunteers with phototypes I to III took either P. leucotomos extract at 480 mg daily or nicotinamide at 2,000 mg daily for 30 days, in a randomized intraindividual design where each participant served as their own comparison.[2] Every author declared no conflict of interest, the cleanest conflict-of-interest record among the trials cited here.

The redness result matched everything above. UVA MED rose 26% in both arms, from a median of 27.7 to 34.8 J/cm² (p=0.0002 for the fern extract, p=0.0008 for nicotinamide).[2] (If UVA ratings are unfamiliar territory, we explain what PA and PPD actually measure separately.)

Then they measured the other thing. Thymidine dimers are what forms when ultraviolet light fuses two adjacent thymine bases in a DNA strand, and they are a standard marker for UV damage reaching the genome. The researchers looked for them in skin and in urine. Neither arm showed a reduction. In skin the result was p=0.15 for both supplements; in urine it was p=0.30 for the fern extract and p=0.89 for nicotinamide.[2]

The redness threshold moved. The DNA damage marker did not.

There is a plausible mechanism for that split, and it is not flattering to the product. Erythema is inflammation, and an anti-inflammatory can reduce visible redness without reducing the UV that reached the skin underneath. If that is what happens here, the supplement does not filter photons; it mutes the response to them. Sunburn is a signal, and a signal is useful. Raising the threshold for it without lowering the underlying injury means you stay out longer with less to tell you when to stop.

Hold that conclusion loosely in one respect. A 2010 randomized trial reported that the UVA-induced “common deletion,” a different DNA endpoint, decreased in healthy volunteers after oral P. leucotomos.[12] It was published as a research letter and it measured something other than thymidine dimers, so it does not cancel the 2026 result. But the DNA picture is not uniformly blank, and saying so would overstate what has been shown.

What the 2026 trial does give is the scientific footing under the FDA’s sentence. A pill that raises your burn threshold by roughly a quarter while leaving DNA damage markers flat is not doing the job sunscreen does.

What about the other supplements?

Nicotinamide is the other half of that same 2026 trial, and it produced the same pattern: UVA MED up 26%, thymidine dimers unchanged in skin and urine.[2] Worth being precise about what that means, since the name looks familiar. This is nicotinamide swallowed at 2,000 mg a day for a month. It is not the niacinamide in your moisturizer or your sunscreen, which is applied to skin at low single-digit percentages. Different route, different dose, different question, and results from one do not transfer to the other.

Nicotinamide does have one large trial behind it, and it repays reading closely because of what it actually tested. ONTRAC, published in the New England Journal of Medicine in 2015, randomly assigned 386 people to 500 mg of nicotinamide twice daily or to placebo for 12 months. Every participant had already had at least two non-melanoma skin cancers in the previous five years. At twelve months the rate of new non-melanoma skin cancers was “lower by 23% (95% confidence interval [CI], 4 to 38)” in the nicotinamide group than in the placebo group, P=0.02.[15] Broken into its parts the result gets more modest: squamous-cell carcinomas were 30% lower at P=0.05, and basal-cell carcinomas 20% lower at P=0.12, which did not reach significance. The authors also record that “there was no evidence of benefit after nicotinamide was discontinued.”[15] That is chemoprevention in a high-risk group under dermatological care, measured in tumor counts rather than in UV protection. It is not a finding about whether a healthy person can wear less sunscreen.

Beyond those two, the reviews are the honest summary. Natarelli 2025 pooled 47 studies on oral supplements and photoprotection and found the most evidence behind polyphenols, carotenoids, and P. leucotomos, and the weakest behind isolated vitamins and coenzyme Q, while concluding that “current evidence is limited by small sample size and short duration.”[9] The first sentence of its abstract is the one to keep in mind whenever a label gestures at research: photoprotective effects of nutritional components “have been demonstrated in animal and in vitro studies.”[9] A result in a dish or a mouse is a reason to run a human trial, not a substitute for having run one, and the distance between those two tiers is where a lot of supplement marketing lives. The review also flags that photosensitive conditions such as polymorphic light eruption may be where these supplements are most useful, which is a narrower and better-supported claim than general sun protection, and we are not going to shrink it just because it cuts the other way.

Zundell 2025 screened 152 papers on P. leucotomos for dermatologic use and included 21, eleven of them randomized trials, spread across photoaging and skin cancer (9), actinic keratosis (3), photodermatoses (3), vitiligo (3), melasma (2), and atopic dermatitis (1).[8] Its conclusion is that the extract has potential as “adjuvant therapy.”

Adjuvant is Zundell’s word. Natarelli’s review points the same way without using it: supplements “may promote enhanced photoprotection,” language that describes an add-on to sunscreen rather than a replacement. Alongside, not instead of.

One more wrinkle: a retracted study

One of the MED papers in this literature is no longer part of it. A 2016 study reporting that oral P. leucotomos increased anti-inflammatory and melanogenic responses to sun exposure was retracted the same year. The reason given in the retraction notice is not a data error: “the clinical trial reported in this manuscript was not approved by the local Ethics Committee.”[10]

We are not citing its results, and it is not evidence that the remaining trials are wrong. Ethics approval and data quality are separate matters, and every other paper here stands or falls on its own record.

What the retraction does show is how little there is to lose. This is a field where a thorough systematic review found 21 studies worth including out of 152 screened.[8] Two of the papers cited in this article, Hussain 2025 and Villa 2010, were published as research letters rather than full reports, a short format with less room for methods.[4][12] Pull one paper out of a pile that size and the pile is noticeably smaller.

That is the shape of the whole answer, really. Something is happening in these trials. There is not very much of it, and there is not very much of them.

FAQ

Does Heliocare actually work?

Heliocare’s active ingredient is Polypodium leucotomos extract, and Heliocare Advanced is the exact product used in the 2026 Danish trial. Measured effect there: the UVA redness threshold rose 26%, while thymidine dimers in skin and urine did not fall.[2] Across the UVB studies, MED increases run from about 5% to about 31%.[4][3][11] Feed the largest of those into the SPF formula and it corresponds to roughly 1.3, by our arithmetic rather than any paper’s. One systematic review describes the extract as a potential “adjuvant therapy,” and the other frames oral supplements as something that “may promote enhanced photoprotection.”[8][9] So it is not nothing, and it is not sunscreen.

Are sunscreen pills a scam?

“Scam” implies nothing happens, and something does happen. Randomized, placebo-controlled trials have recorded measurable increases in the UV dose needed to redden skin.[5][3] What the FDA objected to in 2018 was the marketing claim rather than the existence of the capsules: the warning letters targeted “unproven drug claims about protecting consumers from the harms that come from sun exposure.”[1] The real problem is the gap between an effect around 1.3 on the SPF scale and the SPF 30 the AAD recommends.[14] Nobody buying one of these is being foolish. They are working from a claim that never had the effect size printed next to it.

Can I skip sunscreen on a day I take one?

No. The measured protection corresponds to roughly SPF 1.3 by our arithmetic, against the SPF 30 or higher the AAD asks for.[14] And the trial whose authors all declared no conflicts of interest found that even where the redness threshold rose 26%, DNA damage markers stayed flat.[2] The FDA put it in one sentence: “There’s no pill or capsule that can replace your sunscreen.”[1] If you already wear SPF 50+ daily, which is the default for most people using Korean sunscreen, a supplement adds very little to a total the topical product is already carrying.

We’re not doctors or dermatologists, and none of this is medical advice. Oral supplements are not inert: they can interact with prescription medication, and a photosensitive condition, a history of skin cancer, or a pregnancy changes the calculation in ways a blog post cannot account for. Anyone in that position should be having this conversation with a physician instead of reading it here.

Sources:
[1] US Food and Drug Administration. Statement from FDA Commissioner Scott Gottlieb, M.D., on new FDA actions to keep consumers safe from the harmful effects of sun exposure, and ensure the long-term safety and benefits of sunscreens. May 22, 2018. Source for the warning letter sentence, the four named products (“Advanced Skin Brightening Formula, Sunsafe Rx, Solaricare and Sunergetic”), “There’s no pill or capsule that can replace your sunscreen,” the instructions to correct violations and review labeling, and the sentence on filters being absorbed through skin. The page has been removed from fda.gov, so we link the Internet Archive snapshot we read. https://web.archive.org/web/20190503132147/https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-new-fda-actions-keep-consumers-safe-harmful-effects-sun
[2] Faisal A, Lerche CM, Douki T, et al. Changes in ultraviolet A radiation-induced thymidine dimers and erythema after oral nicotinamide or polypodium leucotomos extract in healthy volunteers: a randomized intraindividual trial. Photochem Photobiol Sci. 2026;25(5):845-852. PMID 41838346. DOI 10.1007/s43630-026-00884-2. Fifty volunteers, phototypes I-III, Heliocare Advanced 480 mg/day or nicotinamide 2,000 mg/day for 30 days. Source for UVA MED rising 26% in both arms (median 27.7 to 34.8 J/cm², p=0.0002), for thymidine dimers showing no reduction in skin (p=0.15) or urine (p=0.30), and for the authors’ declaration of no conflict of interest. https://pubmed.ncbi.nlm.nih.gov/41838346/
[3] Keršmanc P, Pogačnik T, Žmitek J, Hristov H, Točkova O, Žmitek K. Effects of Eight-Week Supplementation Containing Red Orange and Polypodium leucotomos Extracts on UVB-Induced Skin Responses: A Randomized Double-Blind Placebo-Controlled Trial. Nutrients. 2025;17(7):1240. PMID 40218997. DOI 10.3390/nu17071240. PMCID PMC11990338. n=54, 27 per group. Source for UVB MED rising 23.8% (0.447±0.096 to 0.553±0.142 J/cm², p<0.05), erythema intensity down 46.2%, the absence of significance at two weeks, the multi-ingredient composition (red orange extract, P. leucotomos, vitamins A, C, D, E), and the Tosla d.o.o. funding disclosure. https://pubmed.ncbi.nlm.nih.gov/40218997/
[4] Hussain A, Thakker S, Galaria N. Effectiveness of an oral supplement containing Polypodium leucotomos in enhancing sun protection: a clinical evaluation of minimal erythema dose pre- and post-consumption. Arch Dermatol Res. 2025;317(1):580. PMID 40095119. DOI 10.1007/s00403-025-04055-8. Research letter. PLE 240 mg twice daily for five days (Sol Defense Gummies), 27 enrolled and 25 completed, no placebo or control group. Source for the mean MED increasing “from approximately 223 J/cm² to 234 J/cm².” The paper reports different success rates by measurement method: 64% by blinded visual assessment, 80% by colorimeter, 44% by quantitative MED increase, with 20% showing no improvement. Funding statement in the paper: “This study was funded by Inner Glow,” the maker of the gummies. https://pubmed.ncbi.nlm.nih.gov/40095119/
[5] Nestor MS, Berman B, Swenson N. Safety and Efficacy of Oral Polypodium leucotomos Extract in Healthy Adult Subjects. J Clin Aesthet Dermatol. 2015;8(2):19-23. PMID 25741399. PMCID PMC4345929. Double-blind, placebo-controlled; PLE 240 mg twice daily for 60 days. Source for safety markers showing no change, and for the day 28 results reported as participant counts rather than magnitudes: MED increased in 8 subjects versus 1 on placebo (p=0.01), erythema intensity decreased in 10 versus 3 (p<0.01), and one or more sunburns occurred in 2 versus 8 (p=0.04). The paper states “This study was sponsored by Ferndale Healthcare” and that “Drs. Nestor and Berman are consultants for and receive research grants from Ferndale Healthcare.” https://pubmed.ncbi.nlm.nih.gov/25741399/
[6] Kohli I, Shafi R, Isedeh P, et al. The impact of oral Polypodium leucotomos extract on ultraviolet B response: A human clinical study. J Am Acad Dermatol. 2017;77(1):33-41.e1. PMID 28341348. DOI 10.1016/j.jaad.2017.01.044. PMCID PMC5730054. n=22, phototypes I-III. Source for UVB-induced changes decreasing in 17 of 22 participants and in all 22 histologically, for the authors’ stated limitation “Only 2 doses of PLE were given,” and for the disclosures identifying several authors as investigators or consultants for Ferndale Laboratories. https://pubmed.ncbi.nlm.nih.gov/28341348/
[7] Middelkamp-Hup MA, Pathak MA, Parrado C, et al. Oral Polypodium leucotomos extract decreases ultraviolet-induced damage of human skin. J Am Acad Dermatol. 2004;51(6):910-8. PMID 15583582. DOI 10.1016/j.jaad.2004.06.027. n=9, PL at 7.5 mg/kg, no control group. Source for the significant reduction in erythema (p<.01) and in cyclobutane pyrimidine dimers (p<.001). This is the earliest human trial cited here. https://pubmed.ncbi.nlm.nih.gov/15583582/
[8] Zundell MP, Katz A, Shah M, Burshtein J, Rigel D, Zakria D. The Utility of Oral Polypodium Leucotomos Extract for Dermatologic Diseases: A Systematic Review. J Drugs Dermatol. 2025;24(4):346-351. PMID 40196953. DOI 10.36849/JDD.8410. Source for 152 papers screened and 21 included (11 randomized controlled trials), for the distribution across photoaging and skin cancer (9), actinic keratosis (3), photodermatoses (3), vitiligo (3), melasma (2) and atopic dermatitis (1), and for the conclusion describing the extract as a potential “adjuvant therapy.” https://pubmed.ncbi.nlm.nih.gov/40196953/
[9] Natarelli N, Aflatooni S, Stankiewicz K, Correa-Selm L, Sivamani RK. Oral Supplements and Photoprotection: A Systematic Review. J Med Food. 2025;28(6):519-541. PMID 39804624. DOI 10.1089/jmf.2024.0023. Forty-seven studies included. Source for polyphenols, carotenoids and P. leucotomos carrying the most evidence, for the conclusion that “current evidence is limited by small sample size and short duration,” and for the note that photosensitive conditions such as polymorphic light eruption may benefit most. https://pubmed.ncbi.nlm.nih.gov/39804624/
[10] Retraction: “Oral Polypodium leucomotos increases the anti-inflammatory and melanogenic responses of the skin to different modalities of sun exposures: a pilot study.” Photodermatol Photoimmunol Photomed. 2016;32(5-6):331. PMID 27870132. DOI 10.1111/phpp.12254. Source for the retraction and its stated reason, “the clinical trial reported in this manuscript was not approved by the local Ethics Committee.” The retracted article is PMID 26408963, DOI 10.1111/phpp.12209; we cite the notice and not the article’s results. https://pubmed.ncbi.nlm.nih.gov/27870132/
[11] Aguilera P, Carrera C, Puig-Butille JA, et al. Benefits of oral Polypodium Leucotomos extract in MM high-risk patients. J Eur Acad Dermatol Venereol. 2013;27(9):1095-100. PMID 22849563. DOI 10.1111/j.1468-3083.2012.04659.x. Source for MED rising from 0.123 to 0.161 J/cm² and for the authors’ stated limitations, “Reduced number of patients. No control population.” All 61 participants were melanoma high-risk patients (familial or multiple melanoma 25, sporadic melanoma 20, atypical mole syndrome 16), not healthy volunteers, which is why we do not describe this result as applying to the general population. The paper states it “was partially supported by Industrial Farmaceutica Cantabria (IFC),” whose capsule was the extract used, and, in the paper’s own wording, that one author “serve as consultant to” IFC. https://pubmed.ncbi.nlm.nih.gov/22849563/
[12] Villa A, Viera MH, Amini S, et al. Decrease of ultraviolet A light-induced “common deletion” in healthy volunteers after oral Polypodium leucotomos extract supplement in a randomized clinical trial. J Am Acad Dermatol. 2010;62(3):511-3. PMID 20159320. DOI 10.1016/j.jaad.2009.05.045. Research letter. Source for the reduction in the UVA-induced “common deletion,” a DNA endpoint distinct from the thymidine dimers measured in reference [2]. https://pubmed.ncbi.nlm.nih.gov/20159320/
[13] Sunsafe Rx official website, read directly on 2026-08-20. Source for the product remaining on sale eight years after the FDA warning letters and for the current wording quoted in the text: “Sunsafe Rx is not a sunscreen lotion. It is a nutritional supplement, taken orally,” the “demonstrated unprecedented skin protection” language, and the disclaimer “These statements have not been evaluated by the FDA.” https://www.sunsaferx.com/
[14] American Academy of Dermatology Association. Sunscreen FAQs. Read 2026-08-20. Source for the recommendation of broad-spectrum protection, SPF 30 or higher, and water resistance. We checked this page and the AAD’s sunscreen statistics page for guidance on oral supplements and found none, so nothing in this article should be read as an AAD position on ingestible sun products. https://www.aad.org/public/everyday-care/sun-protection/shade-clothing-sunscreen/sunscreen-faqs
[15] Chen AC, Martin AJ, Choy B, et al. A Phase 3 Randomized Trial of Nicotinamide for Skin-Cancer Chemoprevention. N Engl J Med. 2015;373(17):1618-26. PMID 26488693. DOI 10.1056/NEJMoa1506197. The ONTRAC trial: 386 participants, each with at least two non-melanoma skin cancers in the previous five years, randomized to nicotinamide 500 mg twice daily or placebo for 12 months. Source for the rate of new non-melanoma skin cancers being “lower by 23% (95% confidence interval [CI], 4 to 38)” with P=0.02, for the component results (squamous-cell carcinomas 30% lower at P=0.05; basal-cell carcinomas 20% lower at P=0.12, not significant), and for “there was no evidence of benefit after nicotinamide was discontinued.” The population was high-risk patients under dermatological follow-up, which is why we do not present this as a general-population sun protection result. https://pubmed.ncbi.nlm.nih.gov/26488693/

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