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Skin Care and Diseases

Gimme Shelter - How to Stay Protected Against the Sun

Skin cancer is a leading cause of cancer death in the United States according to the US Preventative Services Task Force.1 Sun exposure is a major risk factor for the development of melanoma and non-melanoma skin cancers.2,3  Proper sun protection is crucial in the fight against skin cancer.  Most children and adults are not properly educated about the risks of sun exposure and the basic ways in which they can use sunscreen.4

 

Sun protection will have the greatest impact if achieved as early as possible in life.5,6 Previous studies have found that approximately 80% of lifetime sun exposure occurs before age 18 years.7 Early education of the harmful effects of exposure to the sun and ultraviolet (UV) radiation can establish healthy behaviors early in life that are more likely to be practiced into adulthood.8

So, parents -- teach your children from an early age and lead by example by following these general guidelines . . .

General Guidelines for Sunscreen Use

  1. Select a sunscreen that has both UVA and UVB protection. Currently, sunscreen labels are required to carry a "Sunburn Protection Factor" (SPF) that informs potential users about how well each product protects against UVB light. The FDA has proposed a regulation to expand sunscreen labeling to provide a four-star rating (with four stars being the best) that informs consumers about the UVA protection as well. According to the FDA, only sunscreen products that protect against both UVB and UVA will be labeled broad spectrum. This is important as both UVB and UVA are associated with skin cancer formation and other harmful effects of UV light. 9
  2. Look for ingredients that cover UVA spectrum and not just the UVB spectrum. These include zinc oxide, titanium dioxide, avobenzone.
  3. You should choose a sunscreen that has at least an SPF of 30. Very high SPF sunscreens are currently available, but the FDA recommends capping the SPF value at 50, and those that have SPF above 50 may simply be designated as 50+.
  4. Apply sunscreen 15 to 30 minutes prior to exposure and allow to dry; reapply every 1-2 h hours during outdoor activities.
  5. Select a water-resistant sunscreen for beach or outdoor activities associated with perspiring. In the future, this selection will be aided by better labeling rules in which the substantivity of the sunscreen will be specified.
  6. Reapply sunscreen immediately after swimming, or exercising.
  7. All children should be protected from excessive sun exposure through avoidance of midday sun (10AM to 3PM) and use of sun-protective clothing and sunscreens.
  8. Children less than 6 months of age should use protective clothing mainly as a form of protection. 
  9. To minimize eye stinging and irritation, use a sport gel formula and avoid the benzophenones.
  10. For maximum eye protection against UV, pick wrap-around sunglasses that fit close to the forehead and absorb up to 400 nm in the UVA, UVB, and blue light range. Polarizing lenses help to cut the glare from reflective surfaces but do not add UV blocking properties. The Skin Cancer Foundation has a Seal of Recommendation for sunglasses that meet its criteria to block 99% of UVA and UVB.
  11. Sunscreens in lipstick and lip gloss are generally available but often overlooked as part of a sun protection program. These may be helpful in minimizing skin cancer and sun damage on the lips and may also be helpful in decreasing the potential for sun-activation of oral herpes simplex.

References

1U.S. Preventive Services Task Force. Counseling to prevent skin cancer: recommendations and rationale of the U.S. Preventive Services Task Force. MMWR Recomm Rep 2003;52(RR-15):13-17.
2Thompson J, Menzies S, Shaw H, Scolyer R and Kefford R. Cutaneous melanoma. Lancet 2005;365(9476):2004-2005.
3Lim JL, Stern RS. High levels of ultraviolet B exposure increase the risk of non-melanoma skin cancer in psoralen and ultraviolet A-treated patients. J Invest Dermatol 2005;124(3):505-513.
4Wesson KM, Silverberg NB. Sun protection education in the United States: what we know and what needs to be taught. Cutis 2003;71(1):71-4, 77.
5Armstrong BK, Kricker A. The epidemiology of UV induced skin cancer. J Photochem Photobiol B 2001;63(1-3):8-18.
6Tucker MA, Goldstein AM. Melanoma etiology: where are we? Oncogene 2003;22(20):3042-3052.
7Stern RS, Weinstein MC and Baker SG. Risk reduction for nonmelanoma skin cancer with childhood sunscreen use. Arch Dermatol 1986;122(5):537-545.
8Center for Disease Control MMWR Weekly. Survey of the Knowledge of and Awareness of Melanoma:May 03, 1996 / 45(17);346-349. 2001; 2005.
9FDA Proposes New Rule for Sunscreen Products:Highlights Include New UVA Rating System, Sun Warning Information. August 23, 2007.

This article is based on information provided by the Executive Health Supplement to Inside Business Magazine, and was adapted for use on NetWellness with permission, 2011.

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Last Reviewed: Aug 26, 2013

Elma D Baron, MD Elma D Baron, MD
Associate Professor of Dermatology
Director, Skin Study Center
School of Medicine
Case Western Reserve University