Protection against UV radiation (ACBS)
RAG rating
Document type
Decision document
Hertfordshire and West Essex ICB
Output type
Pharmacy / Prescribing


Use of sunscreens for approved indications:

1. Rationale:

Sunscreen should be prescribed in line with Advisory Committee on Borderline Substances (ACBS) approved indications. Sunscreens marked as ACBS in the British National Formulary are regarded as drugs when prescribed for skin protection against UV radiation in abnormal cutaneous photosensitivity resulting from genetic disorders or photodermatoses, including vitiligo and those resulting from radiotherapy; chronic or recurrent herpes simplex labialis1. Prescribing for other indications is not permitted on FP10.

2. Costs:

Table 1: ACBS approved sunscreens and cost per pack1,4


Cost per original pack

Anthelios XL Cream

Spf 50+

50mL = £11.40

Sunsense Ultra Lotion

Spf 50+

50mL roll-on = £5.09

125mL bottle = £8.26

500mL pump = £18.43

Uvistat Sun Cream

Spf 30

125mL = £7.66

Uvistat Sun Cream

Spf 50

125mL = £8.68

Uvistat Lipscreen

Spf 50

5g = £2.99

3. Clinical evidence:

The National Institute for Health and Care Excellence (NICE) Guideline NG34 "Sunlight exposure: communicating the benefits and risks to the general population” does not give specific guidance on the use of sunscreens in abnormal skin photosensitivity from photodermatoses, genetic disorders, vitiligo, radiotherapy or rosacea2.

The European Dermatology Guidelines for photo-protection acknowledge the efficacy of broad-spectrum, high protection sunscreens in the prevention of polymorphic light eruption. However, they also report on the lack of compliance among patients suffering from photodermatoses and that this may account for the variable effect of sunscreens3.

In one study, the median application thickness was found to be only 0.5mg/cm2which reduced a declared SPF 50+ into an effective SPF of 2-3. The patients in this study reported only slight protection from previous use of sunscreens but after the study, and its consequent education of this patient group, much better protection was reported3.

The key to the management of photodermatoses is photoprotection, which includes seeking shade; wearing photoprotective clothing, wide brimmed hats, and sunglasses; and applying sunscreens. Sunscreens with a SPF over 30 that incorporate photostabilized UVA filters are usually the appropriate choice for adequate photoprotection3.

4. Options to review therapy

Encourage all prescribers to:

  • Ensure all patients prescribed sunscreens on FP10 prescriptions meet the ACBS criteria1.
  • The only ACBS approved indication is for skin protection against UV radiation in abnormal cutaneous photosensitivity. This includes genetic disorders, photodermatoses, vitiligo from radiotherapy and chronic or recurrent herpes simplex labialis2.
  • Discontinue any prescribing for:

1. Sunscreens other than the five products listed in table 1 as these are the only sunscreen products which meet ACBS criteria.

2. Patients who do not meet ACBS criteria. Advise these patients to purchase an appropriate sunscreen over-the-counter (OTC) instead. Further information on sun safety for patients is available from the British Association for Dermatologists and NHS Choices.

  • Prescribing of sunscreens is governed by the Advisory Committee on Borderline Substances. FP10s ordering sunscreens should be endorsed "ACBS”. All other prescribing should be discontinued and OTC purchase advised for those who wish to continue using them. Substantial savings can be achieved by reviewing prescribing.

5. References

1. Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. March 2019 Accessed 26/04/2019.

2. National Institute of Health and Care Excellence. NICE Guidelines NG34. February 2016, Sunlight exposure: Risks and benefits. Accessed 26/04/2019.

3. PrescQIPP. Use of sunscreens for approved indications. Accessed 26/04/2019.

4. C&D Data. Accessed 26/04/2019.

Version number
2.1 Harmonisation of Hertfordshire Medicines Management Committee (HMMC) guidance and West Essex Medicines Optimisation Programme Board (WEMOPB) guidance updates include: • Rebadging with HWE ICB and removal of ENHCCG header • Review date removed and replaced with standard statement.
Developed by
Approved by
Date approved / updated
Approved April 2017, updated and noted May 2019
Review date
The recommendation is based upon the evidence available at the time of publication. This recommendation will be reviewed upon request in the light of new evidence becoming available.
Superseded version