Sun Protection Research Articles

PD10 Objective evaluation of sunscreen in a patient with solar urticaria

Abstract Sunscreens are an important part of photoprotection for patients with photodermatoses, such as solar urticaria (SU). Despite long ultraviolet (UV)A and visible wavelength photosensitivity in many patients with SU, sunscreens can still be beneficial (Beattie PE, Dawe RS, Ibbotson SH, Ferguson J. Characteristics and prognosis of idiopathic solar urticaria: a cohort of 87 cases. Arch Dermatol 2003; 139:1149–54). However, unlike the objective assessment of photosensitivity by monochromator phototesting, formal evaluation of sunscreens’ effects is more challenging. We report a 32-year-old man with a 2-year history of immediate-onset photosensitivity, confirmed as SU on monochromator phototesting, with an action spectrum of UVB, UVA and visible light (305–460 nm). He had been using Nivea Sun SPF (sun protection factor) 50+ (Beiersdorf) and reported that this increased his tolerance of natural light from 10 to 60 min. Based on the sunscreen constituents, we were surprised to hear that it was so effective as there was no mineral constituent. Therefore, we evaluated his SU photosensitivity by UVA testing using a metal halide source [Honle UVASPOT 400 T; 24.09 mW cm−2; minimal urticaria dose (MUD) < 0.13 J cm−2] through his own sunscreen and, for comparison, Dundee Cream Beige (Tayside Pharmaceuticals) and LaRoche Posay Mineral One shade 01 (L’Oreal), both of which contain reflectant titanium dioxide. Three areas, measuring 15 × 10 cm, were marked out on his back and 0.15 mL of one sunscreen was applied to each. Each area was then irradiated through a Daavlin template using multiples (1×10) of the MUD and sites were observed for 30 min. As he was so severely photosensitive, none of the sunscreens affected the threshold MUD, but we noted delay in the induction of SU. Dundee Cream Beige offered minimal photoprotection, with urticaria occurring at 10 min vs. 5 min without sunscreen at 1 × MUD. LaRoche Posay SPF delayed the onset of SU to 30 min, and the reaction was less intense at 1 × MUD. However, the most marked effect was with his own Nivea SPF 50+. Urticaria induction was delayed to 30 min at 1 × MUD and was less intense, but it was also delayed to 15 min and less intense at a dose of 4 × MUD, confirming his impression that this sunscreen was of clinical benefit. We highlight this case to show how photodiagnostic testing can be employed to evaluate objectively the sunscreen effects in patients with photosensitivity. Conventionally, it is assumed that titanium dioxide-based products, such as the Dundee creams, are required in patients with longer UVA/visible light sensitivity, but with refinements in the development of new sunscreen products, this may not necessarily be the case.

Skin Cancer Prevention across the G7, Australia and New Zealand: A Review of Legislation and Guidelines.

Incidence rates of melanoma and keratinocyte skin cancers have been on the rise globally in recent decades. While there has been a select focus on personal sun protection awareness, to our knowledge, there is a paucity of legislation in place to help support citizens' efforts to protect themselves from the harmful effects of ultraviolet radiation (UVR). Given this, we conducted a comprehensive review of legislation and guidelines pertaining to a variety of sun protection-related topics in countries of the Group of Seven (G7), Australia and New Zealand. Australia was the only country to have banned tanning beds for individuals of all ages, while other select countries have instituted bans for minors. In workplace policy, there is very little recognition of the danger of occupational UVR exposure in outdoor workers, and thus very few protective measures are in place. With regard to sports and recreation, certain dermatological/professional associations have put forward recommendations, but no legislation was brought forward by government bodies outside of Australia and New Zealand. With regard to youth, while there are various guidelines and frameworks in place across several countries, adherence remains difficult in the absence of concrete legislation and standardization of procedures. Finally, only Australia and a few select jurisdictions in the United States have implemented sales tax exemptions for sunscreen products. In light of our findings, we have made several recommendations, which we anticipate will help reduce the rates of melanoma and keratinocyte cancers in years to come. However, minimizing UVR exposure is not without risk, and we, therefore, suggest the promotion of vitamin D supplementation in conjunction with sun protective practices to limit potential harm.

Cosmetic Agents and Skin Health of Young Females in Taichung, Taiwan

The use of cosmetic products has become increasingly popular among women, encompassing a wide range of items such as moisturizers, makeup, cleansers, and other beauty-enhancing substances. Cosmetic agents are substances found in cosmetic products that are used to improve the appearance and health of the skin, hair, and nails. They may be natural or synthetic, and their functions may include moisturizing, exfoliating, cleaning, and UV protection. Cosmetic agents play crucial role in the formulation of cosmetic products. Different skin types respond differently to cosmetic agents, so it is important to patch test new products before incorporating them into a daily routine. It is essential to consult a dermatologist before using any cosmetic products. The study utilized the descriptive research design. The target population was 250 Females in Taichung, Taiwan.  The study did sampling of 210 participants chosen from the target population of 250 Females in Taichung, Taiwan. Questionnaires were used to collect the data. The research concluded that cosmetic agents have become an essential part of daily skincare routines for many females worldwide. The effects of cosmetic agents on skin health among females are significant. Properly formulated cosmetic agents can provide a range of benefits to the skin, improving its appearance and health.  Properly formulated cosmetic agents can offer a range of benefits to the skin, like moisturization, sun protection, anti-aging effects, acne management, hyperpigmentation reduction, and exfoliation. It was recommended that different cosmetic agents work best for different skin types and concerns. Oily skin may benefit from a lightweight, oil-free moisturizer, while dry skin may require a heavier, more emollient-based moisturizer. Females should look for products that comprise beneficial components like antioxidants, peptides, and humectants. Avoid products that contain harmful components like fragrances, alcohol, and sulfates, as these may irritate the skin and cause damage over time. Keywords: Cosmetic Agents, Skin Health, Females, Taiwan

P-594 A prevalence study of vitamin D insufficiency among infertile women in Sweden, its determinants and IVF outcome.

Abstract Study question What is the prevalence and the determinants of vitamin D insufficiency and do women with insufficiency have worse IVF outcome compared with them with sufficiency? Summary answer Women from Non-Nordic countries, with avoiding sun behavior and low intake of vitamin supplementation have higher prevalence of vitamin D insufficiency but comparable IVF outcome. What is known already Vitamin D seems to have an important role in human reproduction and infertility. Vitamin D insufficiency is highly prevalent around Europe, yet studies from north latitude countries, where sunlight exposure is undetectable during the winter, describing the prevalence and determinants of this condition in women with infertility lacking. Moreover, there is still discrepancy in the existing evidence whether insufficient vitamin D status is associated with poor IVF/ICSI outcome and no published studies in this field exist from Nordic countries. Study design, size, duration Prospective cohort study that was conducted between September 2020 and August 2021 at Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg in Sweden. Gothenburg is a city located in southwestern Sweden (latitude 57.7o N) with highly variating duration of daylight between seasons. Participants/materials, setting, methods Women with infertility who were scheduled for IVF/ICSI treatment were included. Venous blood samples for measurement of serum 25(OH) vitamin D concentration and questionnaires assessing vitamin D intake and sun exposure habits were collected from 265 women. Main results and the role of chance The overall prevalence of vitamin D insufficiency was 27%, ranging from 7% in summer to 33% in winter. The odds for vitamin D insufficiency were higher for women originating from non-Nordic Europe (OR 3.33, 95% CI 1.26-8.80, adjusted p=0.015), Middle East (OR 14.46, 95% CI 5.20-40.20, adjusted p<0.001) and Asia (OR 6.46, 95% CI 1.79-23.27, adjusted p=0.004) compared with women originating from Nordic countries. It was more likely for women who did not use vitamin D supplements to have insufficiency compared with them using supplements (OR 3.48, 95% CI 1.69-7.20, adjusted p<0.001). The odds for vitamin D insufficiency were also higher for women staying “in the shade all the time” compared with women who were exposing themselves “in the sun all the time” (OR 3.65, 95% CI 1.43-9.27, adjusted p=0.007) and with them staying “both in the sun and shade” (OR 3.57, 95% CI 0.88-14.43, adjusted p=0.074). The reproductive outcome of IVF/ICSI treatment between women with serum 25(OH) vitamin D insufficiency and sufficiency was comparable. Limitations, reasons for caution The use of a questionnaire has intrinsic limitations (recall bias, low accuracy of the provided information). Moreover, the questionnaire did not include questions about sun protection factor usage during sun exposure. Blood sampling was underrepresented during summer due to limited resources during the summer months with closed IVF clinics. Wider implications of the findings Pre-IVF/ICSI treatment vitamin D serum concentration do not seem to influence IVF success. However, information about vitamin D should target women from non-Nordic countries and to advise them for supplementation and sun exposure. The aim is to avoid vitamin D insufficiency and the associated adverse long-term health consequences. Trial registration number not applicable

Sun protection, progress, myths, and inconsistencies (a proposal for the democratization of ISO 24443).

The concept of modern human sun protection is no more than one hundred years, but real development of it, including protection against UVA + UVB radiation (and more recently also the IR and blue light), has been no more than 30 years. One fundamental issue while formulating sunscreens is the photostability of the UV filters, which is particularly feeble for the UVA. The gold standard for the determination of sunscreen UVA protection "in vitro" is ISO 24443:2021. Still, interlaboratory results are not as consistent as expected. The Technical Committee for Cosmetics (ISO TC 217) has tried to standardize the method with precise specifications for the materials and equipment used. In particular, the standardization of UV exposure sources based on Xe arc lamps. This fact requires expensive equipment out of the reach of many laboratories to achieve adequate temperature control on the samples. In this paper, it will be shown that, within the experimental error, satisfactory results were achieved with a cheap commercial LED source irradiating only in the UVA spectra. Evidence is presented to conclude that other more relevant factors must be considered as the main cause of uncertainties.

Biological potentialities and chemical composition of Tarenaya aculeata roots and stems

Plant extracts are rich in secondary metabolites responsible for numerous biological activities. This study aimed to evaluate the antioxidant, antibacterial and photoprotective potentials, toxicity and chemical composition of extracts and fractions of stems and roots of Tarenaya aculeata. Phytochemical analyses were performed at qualitative and quantitative levels to evaluate the classes of secondary metabolites. The sun protection factor (SPF) and antioxidant potentials were determined spectrophotometrically, the antibacterial activity was tested against seven bacteria and the toxicity was evaluated using Artemia salina assay. Phytochemical screening revealed the presence of alkaloids, phenolic compounds, flavonoids, glycosides, tannins and saponins. The levels of phenolic compounds, tannins and alkaloids, SPF and antioxidant potentials showed greater results in the stem (SF) and root (RF) fractions in relation to the stem (SE) and root (RE) extracts. All samples exhibited a broad spectrum of antibacterial activity, with MIC values ​​ranging from 31.25 to 250 μg mL-1. SE, SF and RF caused mortality in A. salina larvae, with LC50 of 347.06, 34.71 and 85.39 μg mL-1, respectively, whereas RE was non-toxic. Thus, T. aculeata is rich in bioactive secondary metabolites, although further studies will be needed to characterize its chemical constituents and investigate their adverse effects.

Rational Design and Synthesis of Lignin‐Derived Smart Sunscreens

AbstractLignin exhibits a long‐active UV‐blocking property due to its macromolecular aromatic structure and unique semiquione‐quione‐hydroquione transition. However, its poor absorbance in UVA region (320–400 nm) and irregular aggregation are still the obstacles. Herein, active spirapyrane (SP‐Br) is synthesized and covalently introduced into alkali lignin (AL) to construct photo‐stimulated UV‐absorbing enhancement sunscreen actives (AL‐SPn). The introduction of SP significantly improved the absorbance of AL in UVA region and its aggregation is effectively eased. When the optimal AL‐SP3 solution is exposed to UV irradiation, the color turned purple, and the absorbance in UVA region further improved as the unconjugated SP transformed into conjugated merocyanine (MC) structure. When the light is removed, the solution recovered light yellow. The antioxidant property of AL endow the reversible SP‐MC transformation with good cyclic stability. As‐prepared AL‐SP3 based sunscreen exhibit obvious photo‐stimulated enhancement effect. The sun protection factor (SPF) improved from 23 to 89 after 4 h irradiation, and can maintain the high performance for another 8 h. In addition, it exhibit low permeation and good biocompatibily in vitro and vivo, demonstrating its good potential in practical use.

Sun protection and antibacterial activities of carotenoids from the soft coral Sinularia sp. symbiotic bacteria from Panjang Island, North Java Sea

Carotenoids have shown beneficial applications in cosmetology, pharmacology, and medicine. However, environmental stress in the marine environment can trigger the production of unique secondary metabolites, such as carotenoids. These compounds can also be sustainably produced by symbiotic bacteria. We hypothesized that the soft corals in tropical regions may produce diverse biological secondary metabolites, including carotenoids, both by the host organism and their bacterial symbiont. The unique carotenoids may provide promising biological activity such as antioxidant, UV photoprotector, and antibacterial activities. To this end, we isolated and characterized the carotenoids isolated from the bacterial symbiont of Sinularia sp., a soft coral from Panjang Island, North Java Sea, strain 19. PP.Sc.13. Bacterial identification was performed using DNA barcoding of the 16S rRNA region. Identification of carotenoids was carried out using a spectrophotometer, High-Performance Liquid Chromatography (HPLC), and attenuated total reflection fourier-transformed infrared (ATR-FTIR) spectroscopy. The antioxidant activity was estimated using the diphenylpicrylhydrazyl (DPPH) method, while the Sun Protection Factor (SPF) and % transmission of erythema and pigmentation were determined based on colorimetric methods. The antibacterial activity assay was carried out using the agar diffusion method against two multidrug-resistant bacteria. The bacterial symbiont was identified as Virgibacillus sp. and the carotenoids isolated from this symbiont exhibited significant antioxidant activity and extra sun protection effect, thus categorized as UVA sunblock. Furthermore, the isolated carotenoids exhibited antibacterial activities against Methicillin Resistant-Staphylococcus aureus (MRSA) and Multidrug-resistant (MDR) Escherichia coli. This study provides evidence of the carotenoids produced by the soft coral bacterial symbiont Virgibacillus sp., which may be used as an antioxidant, sun protection, and antibacterial agent. Further investigation of the de novo biological production of carotenoids by Virgibacillus sp. is warranted.

Создание комфортных условий эксплуатации выставочных комплексов в жарком климате

Purpose: To consider the possibility of using modern innovative coating materials, and in particular ETFE film, in the enclosure structures when designing public buildings in different natural and climatic conditions, with the example of regions with hot climates. Method: Generalization of design principles, including those for hot climates. Analysis of climatic parameters of hot climate regions which have a significant impact on comfortable conditions of people staying in public buildings, characterized by multifunctionality, large spatial dimensions, high occupancy rates, and other factor s. To show the possibility of providing favorable conditions for people staying in such buildings in different ways: through planning and design; improvement of adjacent areas; the location of the building. To carry out the analysis of domestic and foreign experience of application of means of sun protection of buildings. To develop space-planning and structural solutions of the exhibition complex. To evaluate the effectiveness of the proposed solution through a computational study. Results: The results of the research of a range of measures aimed at improving the conditions for comfortable stay of people in the exhibition complexes are presented. The constructive solution of sun protection of the exhibition complex taking into account physical and mechanical properties of the membrane system and climatic conditions of the construction areas has been proposed. Practical significance: The versatility of using dome structures as enclosures is demonstrated. The advantage of using innovative covering materials as an alternative to traditional materials is shown.

Antimicrobial, antioxidant, and sun protection potential of the isolated compounds from Spermacoce princeae (K. Schum)

BackgroundSpermacoce princeae (K. Schum) has been used in the treatment of bacterial skin infections in Uganda. Pharmacological studies revealed that extracts of S. princeae exhibited antibacterial, antioxidant, and sun protection potential. This study aimed at isolating and identifying pure compounds from the extracts based on comprehensive analytical characterization by multiple analytical techniques.MethodsThe plant samples were extracted by sequential maceration using n-hexane, ethyl acetate, methanol, and distilled water. The compounds were isolated using a combination of chromatographic techniques and their structures were elucidated by multiple spectroscopic techniques. The antibacterial and antifungal activity determination of the isolated compounds was carried out using an agar well diffusion and potato dextrose assay against Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Candida albicans, and Aspergillus flavus while the antioxidant activity was screened with the 2,2-diphenyl-2-picryl-hydrazyl (DPPH) radical scavenging assay. The sun protection factor was determined using a Shimadzu Ultra Violet-visible (UV–VIS) double beam spectrophotometer between 290 to 320 nm.ResultsEleven compounds; quercetin (1), kaempferol-3-O-rutinoside (2), rutin (3, 12), myo-inositol (4), asperulosidic acid (5), hexadecanoic acid (6), β-sitosterol (7), stigmasterol (8), campesterol (9), ursolic acid (10), and β-sitosterol glucoside (11) were identified in the S. princeae extracts. Compound 2 had good antifungal activity against C. albicans (zone of inhibition, 23.0 ± 0.1 mm). Compound 10 showed antibacterial and antifungal activity against S. aureus, P. aeruginosa, C. albicans, and A. flavus. Compound 2 had a good percentage radical scavenging effect (IC50 = 64.81 µg/ml) and a good sun protection factor (SPF = 26.83).ConclusionThis study reports the first-time isolation and identification of compounds 1 to 11 from S. princeae, which contribute to its antimicrobial, antioxidant, and sun protection potential.

Formulation, characterization of Quercus infectoria (Olivier) emulsions, and in vitro, in vivo evaluation as cosmeceutical formulation.

Pharmacological properties of Quercus infectoria Olivier (galls) have been determined to be astringent, antidiabetic, antipyretic, anti-tremor, local anesthetic, and anti-parkinsonism. The galls of Quercus infectoria have been used for millennia in traditional oriental medicine in Asian nations to treat inflammatory illnesses. The study's objective was to create a Quercus infectoria Olivier gall extract in stable water in oil (w/o) emulsion and to check its effects on the mechanical properties of skin and antiaging effects. The galls were macerated in absolute methanol. Quercus infectoria Olivier gall extract's antioxidant property was evaluated using the 2, 2-diphenyl-1-picrylhydrazyl (DPPH) technique. Stearic acid, cetyl alcohol, KOH, glycerin, and distilled water were used to create the emulsion. The test (with extract) and control (without extract) emulsions were made, respectively, using the same process. Stability tests (color, liquefaction, microscopy, phase separation, and pH) are performed in in vitro, lasted 72 days at four distinct storage temperatures that is 8°C, 25°C, 40°C, and 40°C + 75% RH for both the control and test formulations. By using spectrophotometry, the (SPF) sun protection factors of the two formulations were calculated at various concentrations. Extract from Quercus infectoria underwent phytochemical investigation as well. The results showed that Quercus infectoria Olivier has antioxidant and (SPF) sun protection properties, reduce sebum, increases elasticity and stable emulsion containing 04% Quercus infectoria gall extract which might be used as topical antiaging formulation.

Novel Green Synthesis of UV-Sunscreen ZnO Nanoparticles Using Solanum Lycopersicum Fruit Extract and Evaluation of Their Antibacterial and Anticancer Activity

This work aimed at the green synthesis of multifunctional zinc oxide nanoparticles (ZnO NPs) using Solanum Lycopersicum (SL) fruit juice to act as antibacterial/cancer/UV sunscreens. The obtained ZnO NPs were examined for optical properties, cytotoxicity of human lung fibroblast (WI-38) and hepatocellular carcinoma (HePG2) cell lines, and antibacterial activity against Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus. The antioxidant activity and in vitro sun protection factor (SPF) of the synthesized nanoparticles were carried out by spectrophotometric methods. The formation of pure phase structure and characteristic functional group of the synthesized ZnO NPs were confirmed by XRD, FTIR, and UV–Vis diffuse reflectance analysis. SEM image showed that the ZnO NPs have a quasi-spherical shape with a size of about 39 ± 12 nm. ZnO NPs showed high potency as sunscreens (in vitro SPF = 16.8) and as mild antioxidant agents. Notably, ZnO NPs enhanced the cytotoxic activity against hepatocellular carcinoma cells and confirmed their antibacterial activity against pathogenic bacteria. SL fruit juice can play a triple role by acting as a solvent, reducing agent and stabilizer which facilitates the synthesis of ZnO NPs sunscreen that has antibacterial and anti-carcinogenic properties.

Dual Functional Titanium Hydride Particles for Anti‐Ultraviolet and Anti‐Oxidant Applications

AbstractTiO2 is a typical anti‐ultraviolet agent in sunscreen cream, but it suffers from a lack of anti‐oxidant activity for scavenging reactive oxygen species. Other traditional sunscreen ingredients, such as C60 and ferulic acid, have moderate antioxidant and UV protection capabilities, and the products do not provide further UV protection. Herein, titanium hydride (TiH1.97) particles with dual functions of anti‐oxidant and anti‐ultraviolet are presented as an active material to remove the highly oxidizing and harmful hydroxide free radicals from the skin surface. Owing to the active hydrogen in TiH2, it shows great potential to eliminate hydroxyl radicals, and the rate is roughly proportional to the exposed surface area (50% /20 min). Together with the biocompatibility of the in situ formed TiO2, which has a strong ability to absorb ultraviolet light during OH radical scavenging. At the same time, adding titanium hydride to sunscreen also enhances sun protection. The SPF value of sunscreen containing 1% titanium hydride and 20% titanium dioxide can reach 31.8, which exceeds the 20% titanium dioxide (15) by more than twofold. Therefore, titanium hydride with anti‐ultraviolet and antioxidant functions can be regarded as a promising and safe ingredient for sunscreen cream.

The impact of a novel digital sun protection campaign on sun‐related attitudes and behaviours of healthcare workers: A prospective observational study

AbstractBackground13 000 cases of skin cancer are diagnosed annually in Ireland, with ultraviolet (UV) radiation exposure the strongest risk factor. Public health primary prevention campaigns focus on encouraging safe sun protective measures and skin cancer awareness. We designed a novel, digitally‐animated hospital‐based campaign targeting all aspects of sun‐protective behaviour.ObjectivesTo explore the sun‐protective attitudes and behaviours of healthcare workers, and the effect of a digital hospital‐based campaign on these findings.MethodsThis was a cross‐sectional prospective observational study involving hospital staff across the six hospitals that form the University of Limerick Hospital Group (ULHG). A two‐phase online survey, the first taking place before campaign launch, and the second upon campaign completion. The digital campaign was displayed across all hospital sites from June to September 2021. Surveys comprised questions on sun‐related attitudes and behaviours, including the internationally validated Sun Exposure Protection Index (SEPI) questionnaire.ResultsEight hundred fifty‐seven staff members completed survey 1 and 704 completed survey 2; 90% in each were female; 79% were aged 25–54; 71% reported skin types I–III. Best sun‐protective habits pre‐campaign included sunscreen use and avoiding sunburn, while wearing hats, protective clothing and seeking shade were least adopted. For 177 matched participants, there were small improvements in SEPI scores. SEPI Part 1 scores, reflecting improved risk behaviour, pre‐campaign had a median of 11 (IQR 7), and 11 (IQR 6) post campaign. SEPI Part 2 scores, reflecting readiness to adopt sun‐protective behaviours, improved from median 7 (IQR 8) to 6 (IQR 6). Post‐campaign, small improvements were seen across some individual sun‐protective behaviours and attitudes, particularly reducing time spent in the midday sun and on sun‐seeking holidays, and improved readiness to seek shade and reduce sunbathing; 79% of all respondents post‐campaign (n = 556) reported raised skin cancer awareness, and 65% (n = 458) said it influenced them to discuss sun protection with others.ConclusionsPositive improvements in attitudes and behaviours related to sun protection were seen following the digital campaign in this population of healthcare workers. These improvements along with increased willingness to discuss sun protection with others, including patients, has the potential to further benefit wider society, and supports future digital health promotion initiatives.

Multimodal Transplant-clinic-based Skin Cancer Prevention Education for Organ Transplant Recipients: Feasibility Study.

Patients enrolled by a transplant-clinic study nurse completed baseline questionnaires and received sun-safety brochures. For the 12-mo intervention, transplant physicians were alerted to provide standard sun-protection advice (use of hat, long sleeves, and sunscreen outdoors) by sun-advice prompt cards attached to participants' medical charts at each clinic visit. Patients indicated receiving advice from their physician and from study personnel via an exit-card postclinic, and at final study clinics, they also reported their sun behaviors by questionnaire. Feasibility of the intervention was measured by patients' and clinic staff's study engagement; effectiveness was assessed by calculating odds ratios (ORs) for improved sun protection, using generalized estimating equations. Of 151 patients invited, 134 consented (89%), and 106 (79 %) (63% male, median age 56 y, 93% of European descent) completed the study. Odds of receiving sun advice from transplant physicians and study nurses rose after the intervention compared with baseline (ORs, 1.67; 95% confidence interval [CI], 0.96-2.96 and 3.56; 95% CI, 1.38-9.14, respectively). After 12 mo of regular transplant-clinic advice, odds of sunburn decreased (OR, 0.59; 95% CI, 0.13-2.60), and odds of applying sunscreen (OR, 1.93; 95% CI, 1.20-3.09) almost doubled. Encouragement of primary prevention of skin cancer among organ transplant recipients by physicians and nurses during routine transplant-clinic visits is feasible and appears to be effective.

Impact of ultraviolet radiation on the skin and the role of photoprotection – the review of the literature

Introduction and objective: 
 The sun emits ultraviolet radiation in the UV-A, UV-B and UV-C ranges. Photoprotection is used to prevent the impact of this radiation on the skin. It effectively counteracts photoaging, photodermatoses and photocarcinogenesis.
 The aim of the study is to discuss the impact of UV radiation on the skin and the role of sun protection, also in special groups of patients - children and non-immunocompetent people. The article also presents a summary of data on the effect of sunscreens on vitamin D synthesis.
 Materials and methods: 
 The literature was reviewed in the Pubmed, Google Scholar database and in the recommendations of the Polish Dermatological Society with the use of keywords.
 State of knowledge: 
 Erythema is the most visible effect of sunburn, but exposure to UV radiation is primarily photocarcinogenesis or photoimmunosuppression. The SPF factor is the main determinant of the effectiveness of sunscreens, but effective protection against both UVB and UVA radiation is essential. Daily use of sunscreen reduces skin damage associated with exposure to light and does not negatively affect vitamin D synthesis.
 Conclusions:
 The basis of skin protection is using sunscreens, avoiding excessive exposure to solar radiation and using protective clothing, hats and sunglasses. Thanks to these activities, we can significantly reduce the number of cases of certain skin cancers. It is also important to remember that sun protection applies to everyone, especially children and non-immunocompetent people.

UJI AKTIVITAS GEL TABIR SURYA EKSTRAK ETANOL KULIT BUAH MANGGIS (Garcinia mangostana L.) DENGAN VARIASI GELLING AGENT CARBOPOL 940 SECARA IN VITRO

Excessive sun exposure is dangerous for humans because it has many detrimental effects on the eyes, immune system as well as on the skin. Sunscreen can prevent the harmful effects of UV radiation and free radicals. Flavonoid compounds in mangosteen rind have natural sunscreen activity. The purpose of this study was to determine the physical quality and stability and activity of the ethanol extract gel of mangosteen peel in vitro with variations of carbopol 940. The extract was obtained from the maceration process using 70% ethanol. The gel was formulated using 0.1% extract and 0.5% gelling agent variations; 1%; and 1.5%. Gel test parameters including organoleptic test, homogeneity, viscosity, pH, spreadability, adhesion stability test cycling test, and sunscreen gel activity test were carried out in vitro by measuring the value of Sun Protection Factor (SPF) using UV spectrophotometry. The results showed that the 0.1% mangosteen rind ethanol extract gel formulation with variations of the gelling agent carbopol 940 0.5;1 and 1.5% had good physical quality and stability as well as sunscreen activity with an SPF value of 41,099; 39,898; 39,270 with the ultra category.

Sun exposure and associated risks: Insight from an international survey with a focus on the population with past medical history of skin cancers.

e21575 Background: This survey investigates knowledge and behaviors regarding sun exposure among population who have been treated for skin cancer (melanoma/non melanoma) or pre-cancerous lesions in 17 countries. Methods: The survey (N = 17,001) was conducted online in 17 countries (5 continents) from 28 September-18 October 2021. Automated selection from the Ipsos online Panel ensured samples of 1,000 individuals in each country fit the quotas method based on gender, age, employment status, and country regions. Data covered demographics, phototype, exposure habits and practices, knowledge and understanding of risks. The current focus in this abstract was defined as individuals with a history of melanoma/non melanoma skin cancer, pre-cancerous lesions. Results: This sub population represents 8% of the general population (n = 1372), it comprised 54% men, average age was 49.9 years (SD:17.6) and 58% were of phototype 1-2. 90% were aware of sun-related skin-health issues (vs 88% in the general population). 79% did know that sun protection is useful when the weather is overcast, a better knowledge compared to the general population (61%). However, 34% indicated it was safe to expose themselves without protection when already tanned, a larger misconception compared to the general population (23%). 54% did not understand the difference between UVA and UVB vs 70% in the general population. Only 28% systematically/often use all protections measures during exposure; still a higher practice compared to the general population (12%). However, 42% said they protected from the sun all year round, a better habit compared to the general population (23%). During sun exposure, among the 91% who declared using sunscreen, 74% applied sunscreen only once or twice a day, a similar practice among general population (74%). And when already tanned 38% decreased frequency of application and/or used lower protection (44% among general population). 82% regretted not having previously used better protection, a much stronger regret compared to the general population (57%). Conclusions: Although individuals who have been treated for skin cancer or pre-cancerous lesions had better knowledge and behavioral attitudes compared to the general population, this survey shows that even a population at high risk of melanoma and having a regular medical follow-up does not sufficiently perceive the importance of photoprotection in a prevention objective. This leads to discuss the implementation of new information tools with more impact.

Sun exposure and associated risks: Insight from an international survey with a focus on the organ transplant recipient population.

e21578 Background: This survey investigates knowledge and behaviors regarding sun exposure among population who have been treated with immunosuppressive anti-graft rejection drugs because of an organ transplantation. Methods: The survey (N = 17,001) was conducted online in 17 countries (5 continents) from 28 September-18 October 2021. Automated selection from the Ipsos online Panel ensured samples of 1,000 individuals in each country fit the quotas method based on gender, age, employment status, and country regions. Data covered demographics, phototype, exposure habits and practices, knowledge and understanding of risks. The current focus in this abstract was defined as individuals who have been treated with immunosuppressive anti-graft rejection drugs because of an organ transplantation. Results: This sub population represents 3% of the general population (n = 434), it comprised 65% men, average age was 39.7 years (SD:14.6) and 57% were of phototype 1-2. 85% were aware of sun-related skin-health issues, a similar awareness among general population (88%). 79% did know that sun protection is useful when the weather is overcast, a better knowledge compared to the general population (61%). Furthermore, 75% did understand the difference between UVA and UVB vs 30% in the general population. But, 69% indicated it was safe to expose themselves without protection when already tanned, a much larger misconception compared to the general population (23%). Only 46% systematically/often use all protections measures during exposure; still a higher practice compared to the general population (12%). And, 63% said they protected from the sun all year round, a better habit compared to the general population (23%). However, during sun exposure, among the 93% who declared using sunscreen, 85% applied sunscreen only once or twice a day, a worse practice compared to the general population (74%). And when already tanned 37% decreased frequency of application and/or used lower protection (44% among general population). 89% regretted not having previously used better protection, a much stronger regret compared to the general population (57%). Conclusions: Although individuals who have been treated with immunosuppressive anti-graft rejection drugs because of an organ transplantation had better knowledge and behavioral attitudes compared to the general population, this survey shows that even a population at high risk of skin cancers and having a regular medical follow-up does not sufficiently perceive the importance of photoprotection in a prevention objective. This leads to discuss the implementation of new information tools with more impact.

The effect of an ultraviolet photography educational exercise on sunscreen application.

e22506 Background: Sun exposure is a known risk factor for skin cancer development. Sun protection factor (SPF) is based on an application of 2 mg/cm2 of facial surface area (FSA). Studies demonstrate that most people do not apply a sufficient volume to achieve the intended SPF, thus overestimating their sun protection. Ultraviolet photography (UVP) is easily performed by placing an inexpensive UV filter over a digital camera lens. Chemical and physical sunscreen appear metallic black and blue, respectively, under UV light, thus helping to visualize sunscreen application. We sought to determine if visualizing application with UVP increases the volume of sunscreen applied and to investigate the effect of demographic factors and sunscreen type (physical and chemical) on the results of the intervention. Methods: Participants were recruited from June to August 2022. Subjects were randomized to either physical or chemical sunscreen for the first round of sunscreen application. Using a mirror, subjects applied sunscreen as they normally would. Subjects were then shown a UV photo that helped visualize the extent of sunscreen application. With a clean face, the process was repeated with the other sunscreen type (physical or chemical), such that each subject applied both types by the end of the study (round 2). Sunscreen bottles were weighed before and after applications to calculate the volume of sunscreen applied. Statistics were performed in RStudio version 1.4.1717, a language and environment for statistical computing. Results: 30 subjects (ages 18 to 88, Fitzpatrick skin type I-V) were enrolled. A greater percentage of participants applied > 2mg/cm2 from round 1 to round 2 (23% vs 36%). Mean application volume significantly increased from round 1 to round 2 (1.46 SD = 0.936 to 2.15 SD = 1.91, p = 0.0256). Subjects in the “chemical first” group applied a greater amount in round 2 (p< 0.001), however the same was not true in the “physical first” group. Mean sunscreen applied did not significantly differ between chemical and physical in round 1 (p = 0.187). There were no significant differences observed in sunscreen application across race, gender, skin type, and age. Conclusions: The volume of application increased during round 2, indicating that UVP may be an effective intervention to increase the volume of sunscreen application. Differences between the chemical first and physical first groups indicate the intervention may be more suited to teach the application of chemical sunscreen, which appears darker on UVP. Lack of difference between sunscreen types in round 1 suggests there was negligible pre-intervention bias in application behaviors. Overall, most subjects applied less than the recommended amount of sunscreen in both rounds, suggesting that additional counseling is paramount to ensuring proper sunscreen utilization among the public to prevent skin malignancy.