10 things about sunscreen that every pharmacist should know

By Neal Patel, RPS Head of Corporate Communications

OK, I’ll admit when I was told there may be things about sunscreen I didn’t really know I felt pretty sure that I was clear on how it worked and how to choose the right product. Sunscreen is simple, right? Sunscreen and actually the whole sun protection area is complex, and for those of us with little time to consider what the label actually means, may even be confusing. With skin cancer rates rising and a heatwave on the way, here’s a timely reminder about sun protection.

1 What’s the connection between sunlight and skin cancer?

The ultraviolet (UV) light in sunlight that reaches the earth is UVA and UVB both of which have effects on the skin. UVA is associated with skin ageing through having an effect on elastin, and can also cause skin cancer. UVB is mainly responsible for sunburn and has strong links to malignant melanoma and basal cell carcinoma.

2 How do sunscreens work?

Sunscreens generally contain a combination of organic filters of chemical sunscreens that absorb harmful UV radiation and inorganic filters or physical sunscreens e.g. titanium dioxide and zinc oxide that reflect UV radiation away from the skin. It is this combination of agents that provide protection from the sun and provided the sunscreen has been tested to demonstrate this there should not be any difference in the protective properties of expensive and less expensive products.

3 What does the SPF rating scale mean?

SPF stands for “sun protection factor” and indicates the level of protection a product gives to UVB. SPF can have levels up to 50+ with smaller numbers giving low protection and high numbers greater protection.

4 How do I know how much UVA protection sunscreen offers?

Protection to UVA is shown by the star rating system which goes from zero to five stars, with more stars giving greater protection. The star rating indicates how much UVA radiation is absorbed in comparison to UVB – it is therefore a ratio between UVA and UVB. This means that even if a product has a high star rating, it may not give significant UVA protection if the SPF of the product is low. Or put another way, for a given star rating, the UVA protection provided will increase as the SPF value of the product increases. Not quite as simple as I hoped.

5 What do low, medium and high sunscreen descriptions mean?

Recently published European Union recommendations for sunscreens rate SPF as low (6 to 14), medium (15 to 29), high (30 to 50) and very high (50+).The label may also include a UVA logo (the letters “UVA” in a circle) which indicates that the UVA protection is at least one third of the stated SPF level. Many, but not all, sunscreens now offer protection to both UVA and UVB and are called “broad spectrum” sunscreens. Although I can’t see why anyone wouldn’t want both UVA and UVB protection.

6 What is the most effective sunscreen, spray, cream or lotion?

The is no conclusive evidence that suggests one type of sunscreen product, such as spray, cream or lotion, is better than the other. Its more about how you use it, see later.

7 Talking of evidence what do NICE say about sunscreen?

NICE recommends a sunscreen with an SPF 15 provided the correct quantities are applied. However, the Drug and Therapeutics Bulletin recognises that people do not apply sunscreens correctly and in sufficient quantities and suggest using a higher SPF e.g.30 – or to apply two coats of SPF 15, one half an hour before the second half an hour after sun exposure. The British Association of Dermatologists also recommend SPF 30 and a high star rating as a satisfactory level of sun protection in addition to protective shade and clothing.

8 Whats the advice on sunscreen application – how much and how often?

Ensuring that sufficient sunscreen is applied is the biggest safety issue with about 30 mL sunscreen required to cover the average body of an adult. It is estimated that most people apply about a quarter of the amount to sunscreen used to determine the SPF level – insufficient sunscreen equals lower sun protection. Sunscreen should be applied every two hours. “Once a day” products are accidentally removed by water, sweating, abrasion and by towel drying, all of which reduce effectiveness. It is recommended by the British Association of Dermatologists that these products are also re-applied every two hours.

9 How does skin type affect sunscreen use?

Skin type is also important in determining the effects of sun exposure on skin. Type 1 skin is very fair, doesn’t tan and requires the regular application of a high SPF sunscreen. In contrast, Types 5 and 6 black or Asian skin require sunscreen only during periods of extreme sun exposure.

10 Apart from sunscreen what else can I do to protect against too much sun?

Skin should be protected with clothing (hat, t-shirt sunglasses) and exposure to sun between 11am and 3pm minimised by spending in the shade. Babies and young children should be kept out of direct sunlight.

That’s my 10. Any top tips you would like to share? Please include in the comments section below.

Plenty more on sun protection from our friends at NHS Choices and Cancer Research UK.

See also our media release – RPS calls for clearer labelling on sunscreens after survey reveals confusion

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