Contemporary Approaches To Protection Against Sun
Damage Of The Skin
Dr Ernst R Eiselen 2005
Introduction.
It is clear from the literature that application of chemical and
reflective sunscreens alone will not reduce the current growing
incidence of skin cancer.[8]
Meaningful reduction in light induced skin damage and cancer
will probably only come about as a result of altered
perceptions and approaches by education of children.
An integrated approach with clear definitions of all aspects of
influencing factors will be required to bring about meaningful
change. The fashionable image of tanning light skin initiated
by Coco Chanel in the 1920’s will have to be reversed if the
problem is ever to be “solved”.
With the present advances in longevity medicine the protection
against photo-damage of skin will become an increasingly
important subject simply because vulnerable skin will have to
be protected for many more years than before.
Topical Sunscreens.
International consensus about the use of SPF rated topical
sunscreens alone as sun protection may indirectly add to the
increased incidence of skin cancer. [2,3 ] Adequate UVA
protection is still lacking in sunscreens, in spite of the fact
that cumulative UVA doses may be responsible for more skin
cancer than UVB. [2, 3 ]
An integrated approach with active SAFE SUN practices and
an effective topical skin protector combined is required if the
damage caused by over-exposure to sunlight is to be limited.[ ]
Topically applied sunscreens alone will not do this for several
reasons:
1. Compliance in frequency and thoroughness of
application is normally sub-optimal.
2. Re-application rates are often sub-optimal.
3. Individual dislikes of properties of sunscreens.
4. Failure to reapply after swimming.
5. Serious short-comings in the formulations of
sunscreens to protect DNA.
RAD stands up to rigorous test in the Coastal Conservation
Hike. Nine months of continuous sun exposure without
sunburn or deterioration of skin condition in subjects with
type 1 and type 2 skins. The subject with type 6 skin serving
as a control who did not apply the RAD.
It confirms the value of added anti-oxidants and the reflectors
to prevent UVA damage.
There is a need for redefining the formulation and approach to
sunscreens if the damage of over exposure to UV radiation is
to be limited. It is probable that actual protection against DNA
and other forms of damage may have to be redefined in order
to arrive at a practical and rational protection factor other
than just the SPF scale.
Treating exposure of vulnerable skin to the sun with the
necessary respect is a far more practical and important aspect
in Photodamage prevention than promoting the use of topical
sunscreens per se.
More information on the exact genetic mechanisms of skin
cancer development is required before one can give a logical
answer to the ideal forms of prevention.
The combination of the two modalities is a rational and
practical approach to take to reduce the incidence of skin
cancer in an increasingly aging world.
References
1. Landow K; Do sunscreens prevent skin cancer? Postgrad Med.
2004 Jul;116(1):6.
2. Thompson L; Trying to look SUNsational? Complexity persists in
using sunscreens; FDA Consum. 2000 Jul-Aug;34(4):15-21.
3. Hill D; Efficacy of sunscreens in protection against skin cancer;
Lancet. 1999 Aug 28;354(9180):699-700.
4. Naylor MF, Farmer KC; The case for sunscreens. A review of their
use in preventing actinic damage and neoplasia; Arch Dermatol.
1997 Sep;133(9):1146-54.
5. Vainio H, Bianchini F; Cancer-preventive effects of sunscreens are
uncertain; Scand J Work Environ Health. 2000 Dec;26(6):529-31.
6. Wright MW, Wright ST, Wagner RF; Mechanisms of sunscreen
failure.
J Am Acad Dermatol. 2001 May;44(5):781-4.
7. Von Schirnding Y, Strauss N, Mathee A, Robertson P, Blignaut R
;Sunscreen use and environmental awareness among beach-goers
in Cape Town, South Africa.
8. Stanton WR, Janda M, Baade PD, Anderson P.
Primary prevention of skin cancer: a review of sun protection in
Australia and internationally.
Health Promot Int. 2004 Sep;19(3):369-78.
.
7.
Public Health Rev. 1991-92;19(1-4):209-17.
PMID: 1844269 [PubMed - indexed for MEDLINE]
8.
Prev Med. 2003 Dec;37(6 Pt 1):577-84.
Sun exposure and sun protection behaviours among
Australian adolescents: trends over time.
Livingston PM, White V, Hayman J, Dobbinson S.
PMID: 14636791 [PubMed - indexed for MEDLINE]