The sun is here! What will you recommend?

Abstract

Spring and summer are just around the corner, and most areas accustomed to clouds and cooler temperatures will begin to experience a warming trend. This means folks will be spending more time in the sun. Pharmacists should be prepared to answer questions and make recommendations about sunscreen. Here's some important information to consider as you counsel patients on sun safety and the benefits of using sunscreen. The ultraviolet (UV) spectrum is divided into three major bands—ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC)—all of which may cause or exacerbate sun-induced skin disorders. UVA and UVB primarily are responsible for photodamage, as all UVC radiation is removed by the ozone layer. UVA and UVB both play a role in causing skin cancer. The only true therapeutic effect of UVB exposure is synthesis of vitamin D3 in the skin. Sun protection factor (SPF) is one parameter for determining a sunscreen's effectiveness for UV protection. Another parameter, minimal erythema dose, is used to calculate a sunscreen's SPF. SPF is calculated based on the time to skin burning with sunscreen compared with time to skin burning without sunscreen. For example, by using SPF 10, a person who usually stays in the sun for 10 minutes before starting to burn can prolong that time to approximately 100 minutes. Many dermatologists recommend using a product with SPF 30 or higher. Topical sunscreens can be divided into two major subgroups: chemical and physical. Chemical sunscreens absorb and thus block the transmission of UV radiation to the epidermis. Physical sunscreens are generally opaque; instead of absorbing UVR, they reflect and scatter it. Broad-spectrum sunscreens are designed to protect against both UVA and UVB rays. Many medications are associated with photosensitivity reactions. Review your patient's medication list and counsel patients to prevent any negative reactions. ▪For maximum effectiveness, apply sunscreens liberally to all sun-exposed areas of the body and reapply at least as often as the label recommends.▪Apply to dry skin at least 15 to 30 minutes before sun exposure if expecting to spend more than 20 minutes in the sun.▪Reapply every 2 hours at minimum, even on cloudy days.▪Reapply after heavy sweating, swimming, and toweling off. Reapplying doesn’t extend the length of time a person is protected from sunburn.▪When using sunscreen sprays, spray and rub into skin to ensure uniform coverage.▪If using insect repellent and sunscreen, apply sunscreen before insect repellent.▪Do not use on children younger than 6 months. Lotions are the preferred dosage form for children.▪For sufficient protection, the average adult in a bathing suit should apply nine portions of sunscreen of approximately ½ teaspoon each, or approximately 4.5 teaspoons (22.5 mL) total. Distribute the sunscreen as follows:–Face and neck (including ears): ½ teaspoon–Arms and shoulders: ½ teaspoon to each side of body–Torso: ½ teaspoon each to front and back–Legs and tops of feet: 1 teaspoon to each side of body As we consider the opportunities to counsel patients on appropriate sunscreen use, we shouldn’t assume they’re getting this advice elsewhere. Many people believe they’re knowledgeable about sunscreens and protection from the sun's harmful rays—until they get a sunburn. Because of the cost of sunscreen products and the need to apply them often and in sufficient amounts, users may apply substantially less sunscreen than is required to provide adequate protection. Find ways to educate your patients on optimal ways to protect against the potential dangers of the sun's UVA and UVB rays while still enjoying outdoor fun and activities. Shelf talkers and signage in the appropriate OTC sections of the pharmacy can facilitate dialogue. And don’t forget to practice what you preach!