Photoprotection for Skin Cancer: What's New

Background: Skin cancer is the most common malignancy worldwide. Although photoprotection is the cornerstone of skin cancer prevention, evidence regarding the role of other radiations different from the ultraviolet radiation and the efficacy of sunscreens, oral supplements, DNA-repair enzymes, and antioxidants continues to evolve. Objectives: To review the current evidence on photoprotective strategies and assess their role in preventing actinic keratoses (AK), keratinocyte carcinomas and melanoma. Methods: A narrative review of the literature was conducted using PubMed (2010-2025), including studies in English and Spanish. Search terms comprised "photoprotection," "sunscreen," "oral photoprotection," "skin cancer," "melanoma," "keratinocyte cancer," "UV radiation," "non-melanoma skin cancer" and related concepts. Articles were selected for clinical relevance. Results: Daily sunscreen use significantly reduces AK and cutaneous squamous cell carcinoma in high-risk individuals, although evidence for basal cell carcinoma and melanoma prevention remains heterogeneous. Balanced broad-spectrum protection, including UVA and visible light filtering, seems to be important, whereas high-energy visible light needs further investigation. DNA-repair enzymes have shown reductions in cyclobutane pyrimidine dimers and clinical improvement of AK. Antioxidants such as Polypodium leucotomos extract, topical and oral, exhibit preventive effects on actinic damage and carcinogenesis. Topical and especially oral nicotinamide demonstrate chemopreventive potential in immunocompetent patients. Vulnerable populations-including transplant recipients, XP patients, individuals with albinism, and outdoor workers-require tailored photoprotection strategies with demonstrated benefit. Conclusions: Photoprotection extends far beyond UV filters, encompassing biological ingredients, antioxidants, oral supplements, and broad-spectrum strategies that target the full exposome. Comprehensive, behaviour-based photoprotection programmes are essential for high-risk groups.