Here Comes the Sun: Counseling Points on Sunscreen Use

Sunscreen can do a lot more than prevent painful sunburn.

Appropriate sunscreen use has been shown to reduce the incidence of sun-induced skin cancers.

While some may enjoy the “golden glow” from tanning, it’s actually the skin’s response to photodamage. Other forms of sun damage appear as wrinkles, skin discoloration, and freckles.

Photoaging and skin cancer are long-term risks of sun exposure. Meta-analysis data have shown that any sunburn is associated with an increased risk of skin cancer, and this risk can increase even more based on the number of sunburns that a patient experiences in his or her lifetime.

Fortunately, selecting the right sunscreen and using it appropriately has been shown to reduce the incidence of sun-induced skin cancers.

How to Select the Right Sunscreen

First, choose a broad-spectrum agent that protects against both UVA and UVB rays. Then, look for the number 15, which is the lower SPF that you should consider when selecting sunscreen. The American Academy of Dermatology recommends an SFP of at least 30, which blocks 97% of sunrays.

If the patient’s summer activities will involve water in any way, look for the phrase “water resistant” on the label.

Next, select one of the following forms of sunscreen:

• Creams and lotions offer more hydration and are best for dry skin.
• Gels work best for areas covered with hair such as the scalp.
• Sticks are good for applying on the face and around more sensitive areas of the body, or if the skin is oily.
• Sprays provide easy application and are best for use in children, but make sure that they aren’t inhaled.

Finally, don’t forget the lips! Select a lip balm with an SPF of at least 15.

How to Properly Apply Sunscreen

First, check the product’s expiration date, which is usually found on the bottle itself. Because the print can fade with use over time, patients should write the purchase date with a permanent market somewhere on the bottle. With proper storage, meaning no excessive heat or sun exposure, the product should be good to use for 3 years, though patients should inspect it for consistency and color change.

Once that’s in order, shake the bottle before squeezing any sunscreen out. Then, 15 to 30 minutes before sun exposure, apply 1 oz (a full shot glass) evenly to the entire body. Make sure to apply the product to all parts of the skin that will be exposed to the sun, especially the shoulders, head, ears, and back of knees and legs.

Coat the skin evenly and rub the product in thoroughly, using caution when applying it around the eyes. The last thing left to do is apply the lip balm before stepping outside.

When to Reapply Sunscreen

Sunscreen should be reapplied every 2 hours of sun exposure. When using a water-resistant product, reapply it after spending 40 minutes in the water.

Don’t forget to reapply the lip balm more frequently, especially after eating or drinking.

Other Sun Precautions

• Monthly head-to-toe self-examination is recommended. Look for any new or changing lesions on the skin, any open sores that don’t heal, and any moles that change in color, shape, or texture. An annual professional skin exam by a physician is also recommended.
• Limit sun exposure between 10 AM and 4 PM, which is when UV rays are strongest.
• Don’t let an overcast fool you. Clouds can’t block UV rays that cause skin damage.
• Use protective accessories such as sunglasses, umbrellas, and hats.
• Wear lightweight, protective clothing such as long pants and shirts with long sleeves.

Pharmacist Intervention in Sun Protection

Pharmacists can play an active role at every stage of the sun-protection process. For instance, pharmacists can teach patients safe sun habits and screen those at highest risk for photosensitivity.

The US Preventive Services Task Force concluded that patient counseling can increase sun-protective behaviors. Therefore, proper education on selecting and using sunscreen can have a major impact on skin cancer prevention.

Pharmacists can also inspect the patient’s skin type or ask about it, and then use that information to screen for sun sensitivity. They can also determine whether there is history of skin cancer or any other medical conditions that can affect which agent a patient uses for sun protection.

Pharmacists can ask about the activity a patient will engage in to determine whether a water-resistant product would be the most effective. They should also ask about the age of the individual using the product to make sure that infants younger than 6 months won’t use it, as the only recommendation for this age group is protection with clothing and shade and use of a physical blocking sunscreen on only exposed skin, if necessary.

Pharmacists can inquire about allergies and current medications, and then provide counseling on their effects. There are several photosensitizing medications that can cause a healthy individual to become more sensitive to the sun and more likely to burn.

Some of these medications include doxycycline, sulfonamides, fluoroquinolones, nonsteroidal anti-inflammatory drugs, thiazide diuretics, furosemide, lamotrigine, antihistamines, and isoniazid. When dispensing any of these medications, it’s important to counsel on not only proper use and side effects, but also the effect of sunrays while taking the medication. Make sure to provide appropriate recommendations on sunscreen and other actions that the patient can take to prevent sunburn.

So, when you spot a patient who’s anxious to soak up the sun, remember to recommend sun protection.