Photoprotection Strategies for Outdoor Athletes: Sunscreens, Clothing, and Behavioral Interventions

BACKGROUND Outdoor athletes accrue high ultraviolet (UV) exposure during training and competition yet demonstrate inconsistent sun-safety behaviors, resulting in frequent sunburn, actinic damage, and elevated lifetime skin-cancer risk. This narrative review evaluates photoprotection modalities relevant to athletes—topical sunscreens, photoprotective clothing, and behavioral/digital interventions—and translates the evidence into practical guidance for sport settings. METHODS We searched PubMed from inception through July 22, 2025, screened titles/abstracts with full-text verification, and synthesized eligible English-language studies addressing sunscreen formulation/use, clothing and ultraviolet protection factor (UPF), and behavioral or environmental strategies in outdoor sports. Data items included sport/setting, design, outcomes (UV dose, sunburn/photodamage, adherence, tolerability, cost), and key limitations. Fifty-eight records were narratively synthesized; certainty was communicated with design-based evidence symbols, and a PRISMA-style flow is provided in the manuscript. RESULTS Across sports, adherence to recommended practices was low: in trail runners, 66.5% reported sunburn and 49.7% never reapplied sunscreen; among NCAA golf/tennis teams, only 4.8% reported reapplication; and 35% of high-volume cyclists (>7 h/week) reported no sunscreen use. Clothing bench tests show >75% of modern technical polyester tops achieve UPF 40–50+, though protection diminishes with stretch and sweat. Athlete-preferred sunscreen characteristics include broad-spectrum SPF ≥ 30–50, water/sweat resistance, and low-residue, sting-minimizing formats (e.g., sticks around the periocular area). Behavioral measures—scheduling to avoid peak UV (10:00–16:00), structured shade breaks, dispenser availability, coach-led cues, and wearable/app nudges for reapplication—improve uptake; population-level programs suggest favorable economics (e.g., high return on prevention investment), though athlete-specific cost-effectiveness data remain sparse. Special considerations include pediatric/adolescent athletes (very low baseline use), athletes with darker skin tones (underrecognized risk and pigmentary concerns), aquatic sports (wash-off/reflection), and para-athletes (application and heat-management barriers). CONCLUSIONS Effective athlete photoprotection requires an integrated strategy: (1) generous, timely application and 2-hour reapplication of high-performance sunscreens; (2) first-line use of UPF 50+ apparel and sport-specific accessories; and (3) operationalized behavior change via scheduling, shade, team policies, and digital prompts. Priority gaps include athlete-specific randomized trials, sweat-stress SPF test protocols, longitudinal UV-dose/outcome registries, smart textiles that retain UPF under strain/sweat, and rigorous cost-effectiveness analyses for team and event interventions.