True photoallergy to sunscreens is rare despite popular belief.

Background: Rising use of sunscreen products has led to increased reporting of adverse reactions to sunscreens.

Objective: To investigate possible photoallergic reactions in patients who identified themselves as "being allergic" to sunscreens.

Methods: Patients filled out questionnaires about types of sunscreens they used and timing of their "allergic" reactions. Next, they consented to be photopatch-tested with active sunscreen ingredients, including the new sunscreen Anthelios SX (containing Mexoryl SX) and the new ultraviolet filters Tinosorb M and Tinosorb S. Standard allergen patch testing was also done.

Results: Twenty-seven patients self-reported "sunscreen allergy." Photopatch testing is difficult for patients; hence, only 11 agreed to proceed with the testing. Eight patients had negative patch testing results. One patient reacted to benzophenone-2. Another had a prior reaction to titanium dioxide and titanium oxalate but did not react to the silicone-coated titanium in our study. Yet another patient had relevant photopatch reactions to benzophenone-3 and ethylhexyl dimethyl para-aminobenzoic acid (PABA). None reacted to the Tinosorbs or Anthelios SX. Few positive reactions to the standard allergens were not relevant.

Conclusion: Although small, this study parallels prior studies in concluding that true delayed type IV hypersensitivity (allergic contact dermatitis and photoallergy) to sunscreens is more infrequent than patients tend to believe.