UV Radiation Protection

Ms. Terrie is a clinical pharmacy writer based in Haymarket, Virginia.

UV Radiation Protection

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:

• Children, if the skin is unprotected, since their skin is more sensitive
• Individuals with fair skin (although all types of skin complexions can burn)
• Individuals taking certain medications
• Individuals who use tanning beds
• Individuals exposed to the sun during peak hours without using UV protection

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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References

1. Caroll D, Crosby K. Prevention of Sun-induced Skin Disorders. Handbook of Nonprescription Drugs, 15th Edition. 817-837.
2. Stoppler M. Making Sense of Sunscreens. MedicineNet Web site. www.medicinenet.com/script/main/art.asp?articlekey=46376.
3. 2007 Skin Cancer Facts. The Skin Cancer Foundation Web site. www.skincancer.org/skincancer-facts.php.
4. Risk Factors for Sunburn. MedicineNet Web site. www.medicinenet.com/script/main/art.asp?articlekey=80495.
5. Anthelios Product Information Web site. www.anthelios.com.
6. Sunscreen: How To Select, Apply, and Use It Correctly. Centers for Disease Control and Prevention Web site. www.cdc.gov/MMWR/preview/mmwrhtml/rr5104a3.htm.
7. Sunscreens. MedlinePlus Web site. www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682787.html.
8. Prevention Tips. The Skin Cancer Foundation Web site. www.skincancer.org/prevention/scf-tips.html.