Ms. Terrie is a clinical pharmacy writer based in Haymarket, Virginia.
Pharmacists are in a unique position to increase patient awareness about the potential risk factors for the development of ultraviolet (UV) radiation-related problems. Two types of UV rays can damage the skin: UVA and UVB. UVA is mainly responsible for causing wrinkling and premature aging of the skin, while sunburn is the most prevalent dermatologic condition caused by excess exposure to UVB rays.1,2
According to statistics from the Skin Cancer Foundation, an estimated 1 million cases of skin cancer are diagnosed each year, and 90% of those skin cancer cases are the result of excessive exposure to the sun.3 An individual?s risk of developing skin cancer doubles if he or she has had 5 or more episodes of sunburn. One case of blistering sunburn during childhood may double a person?s risk for developing melanoma later in life.1,3 In addition to this, excessive exposure to UV radiation can cause premature aging of the skin (also known as photoaging). Statistics show that 50% to 80% of all photodamage to the skin happens by 20 years of age.1
Risk Factors
Certain risk factors make some
patients more susceptible to developing
sunburn than others. According the US
National Library of Medicine, those people
at greatest risk of sunburn include
the following groups4:
Sunscreen Products
When applied correctly, sunscreen
products can block most of the sun?s
harmful UV rays.1 Sunscreen products
are available in various forms, such as
lotions, creams, gels, and sprays, and
can come in water-resistant formulations
and various sun protection factor
(SPF) ranges. Sunscreens that provide
protection against both UVA and UVB
are referred to as broad-spectrum sunscreens.
The American Dermatology
Association recommends the use of a
broad-spectrum sunscreen with an SPF
of at least 15.1
Selecting from the wide variety of sunscreen products available may be overwhelming for some patients, so pharmacists should be prepared to assist in selecting a sunscreen product that suits the patient?s individual needs. Topical sunscreen products can be divided into 2 categories: chemical and physical. Chemical sunscreens block the transmission of UV radiation to the epidermis by absorbing it, while physical sunscreens are typically opaque and work by reflecting and then scattering UV rays.1 Chemical sunscreens may contain amino benzoic acid and its derivatives. Physical sunscreens are often used on small areas, such as the nose or top of the ears, and contain zinc oxide or titanium.1 Many products on the market contain a combination of ingredients.
In July 2006, the FDA approved an OTC sunscreen marketed as Anthelios SX that contains a new molecular entity called ecamsule, which is combined with avobenzone and octocrylene. This sunscreen has an SPF of 15 and is considered as having the highest protection against UVA rays.2,5
Factors to be considered when selecting a sunscreen product may include cost, skin type and complexion, reasons for using sunscreen, history of sunburn, and medication history, because some medications may cause photosensitivity. It is imperative that patients understand how to properly apply sunscreen products to ensure maximum and effective protection. Sunscreens should be applied liberally to all exposed areas at least 30 minutes before sun exposure. In general, an estimated one-half teaspoonful should be applied thoroughly to each exposed area1 every 2 hours and after swimming, towel drying, or excessive sweating. It also should be applied often during the day if a person works outdoors.1,6,7
Conclusion
Pharmacists are in a fundamental
position for identifying those patients at
risk for photosensitivity reactions due to
the use of certain pharmacologic agents
(ie, tetracyclines, antidepressants, antihistamines,
estrogens, sulfonamides,
nonsteroidal anti-inflammatory drugs,
etc). During counseling, it is imperative
to remind these patients about the importance
of UV protection, not only to
avoid or decrease the incidence of sunburn,
but to promote the overall integrity
and health of their skin.
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For more information on the importance of UV ray protection, please visit the following Web sites:
American Academy of Dermatology:
For a complete list of sunscreens that have earned the Skin Cancer Foundation's seal of approval, please visit: www.skincancer.org/component/option,com_virtuemart/Itemid,14. |
Classification of SPF |
|
SPF | Classification |
2-12 | Minimal sunburn protection |
12-30 | Moderate sunburn protection |
30 or higher | High sunburn protection |
SPF= Sun protection Factor |
|
Tips for Sun Protection |
SPF = sun protection factor; UV = ultraviolet. Adapted from reference 8. |
Examples of Sunscreen Products |
Aveeno Baby Continuous Protection Sunblock Lotion with SPF 55 |
Banana Boat Sunblock Lotion, Sport SPF 30 |
Bull Frog Sunblock, Quik Gel SPF 36 |
Coppertone ultraGUARD Lotion SPF 30 |
Hawaiian Tropic SPF 30 Plus Sheer Touch Sunscreen |
Neutrogena Ultra Sheer Dry-Touch Sunblock, SPF 70 |
Solar Sense Clear Zinc Advanced Sun Protection For Face SPF 45 |