Sunscreen Use Barriers in White U.S. Adults: Gender, Generation, and Skin Phototype Differences.

Introduction: Skin cancer remains a major public health concern, and White individuals carry the highest lifetime risk and mortality. Ultraviolet exposure and sunburn are well-established skin cancer risk factors, yet regular sunscreen use remains low among U.S. adults. Few studies have assessed barriers to sunscreen use in the U.S., and prior studies are often geographically or demographically limited, restricting comparability among subgroups. Methods: A cross-sectional online panel survey of White U.S. adults (N=739) was developed and administered. Participants selected all personally relevant barriers, followed by their top barrier. Descriptive statistics summarized perceived barriers to sunscreen use. Separate multivariable logistic regression models explored the associations between demographic characteristics and barrier endorsement. Results: Overall, 20.3% of participants reported no barriers. The most commonly endorsed barriers were forgetting to bring or apply sunscreen (52.1%), disliking the feel or smell (24.2%), cost (21.7%), inconvenience (20.3%), preference for being tanned (14.1%), and difficulty in selecting an appropriate sunscreen (12.6%). Younger cohorts had greater odds of reporting at least 1 barrier than baby boomers. Generational differences were observed for forgetfulness, inconvenience, product selection, and tanning preference. Men had lower odds of endorsing a preference for being tanned than women. Skin phototype was associated with differences in cost, tanning preference, forgetfulness, and product selection. Differences in barriers were also observed for marital status, education, and income. Conclusions: Findings support audience-segmented approaches to improve sunscreen use by gender, generation, skin phototype, and socioeconomic factors. Individual-level strategies include integrating sunscreen into daily routines and using cues to action to support bringing, applying, and reapplying sunscreen. Multilevel approaches that shift tanning norms, improve product acceptability, strengthen product selection guidance, and reduce cost may further reduce barriers and support sustained use.