Use Of Sun Protection Measures Research Articles

Expert dialogue on topical minocycline gel in acne vulgaris: minologue India

Acne vulgaris is a common skin disorder with a global prevalence of about 9.4%. Oral antibacterials are recommended but they are associated with potential systemic side effects. Topical minocycline 4% has been recently approved by the United States Food and Drug Administration (US-FDA) for the management of moderate to severe acne. Although efficacy and safety are established, little is known of its real word usage. To review and appraise existing literature and make recommendations on the real world usage and positioning of topical minocycline 4% in acne management. The minocycline 4% consensus was developed by nine acne experts and was evidence-based on a review of recent topical minocycline 4% literature. A total of 11 questions were discussed regarding different domains like positioning of topical minocycline in acne management as monotherapy and combination therapy, safety and use in special population. Several recommendations were given regarding topical minocycline use like: no monotherapy use; consider use in combination with other anti-acne treatments like isotretinoin, adapalene and benzoyl peroxide; not recommended to be combined with systemic antibiotics; low chances for hyperpigmentation; use of sun protection measures; consider risk benefit ratio in pregnancy; use in lactation not recommended; and can be used only in children >9 years of age. This consensus has discussed and answered many real world usage questions and place in therapy for topical minocycline in acne management and finds it a useful addition to the existing armamentarium.

Sunburn and sun protection during recreational outdoor sport in summer: Findings from the German general population aged 16-65 years.

Sunburn can increase one's risk of developing skin cancer. We aimed to quantify the prevalence of sunburn during recreational outdoor sport (ROS) in summer, to explore the use of different sun protection measures, and to examine factors associated with sunburn during ROS using a population-based sample from Germany. For this cross-sectional study, 2081 individuals aged 16-65 years who reported being engaged in ROS in summer were surveyed via standardized telephone interviews in 2020 (National Cancer Aid Monitoring, NCAM). Overall, 16.7% reported experiencing at least one sunburn during ROS in the past twelve months. Sunburn occurrence was negatively associated with the age of the participants (e.g. OR = 0.49 in 56-65 year-olds, p < .001), and positively associated with skin type I/II (OR = 1.55, p < .001) and with having a higher number of nevi (OR = 1.42, p = .005). While wearing sleeved shirts was the most frequently-used sun protection measure during ROS (74.9%), wearing headgear was least common in our sample (29.0%). In multivariate analyses, sunburn was positively associated with the use of sun protection measures (e.g. OR = 1.32 for wearing sleeved shirts, p = .02). Our nationwide data show that ROS is one of the settings where sun protection should play a greater role. Especially in organized sports, particular attention should be devoted to organizational (e.g. exercise outside peak hours) or contextual measures (e.g. shade by the natural or built environment) to prevent skin cancer in later life.

Skin cancer in solid organ transplant recipients: still an open problem.

In the last two decades, the optimization of organ preservation and surgical techniques, and the personalized immunosuppression have reduced the rate of acute rejections and early post-transplant complications. However, long-term graft survival rates have not improved over time, and evidence suggest a role of chronic calcineurin inhibitor toxicity in this failure. Solid organ transplant recipients may develop chronic dysfunction/damage and several comorbidities, including post-transplant malignancies. Skin cancers, mostly non-melanoma skin cancers (squamous cell carcinoma and basal cell carcinoma), are the most common malignancies in Caucasian solid organ transplant recipients. Several factors, together with immunosuppression, may contribute to the susceptibility for skin cancers which, although often treatable, could be associated with a much higher mortality rate than in the general population. The rapid identification and treatment (including reduction of immunosuppression and early surgical treatments) have an important role to avoid an aggressive behavior of these malignancies. Organ transplant recipients with a history of skin cancer should be followed closely for developing new and metastatic lesions. Additionally, patient education on the daily use of sun-protective measures and the recognition of the early signs (self-diagnosis) of coetaneous malignancies are useful preventive measures. Finally, clinicians should make themselves aware of the problem and build, in every clinical follow-up center, collaborative network involving transplant clinicians, dermatologists and surgeons who should work together to easily identify and rapidly treat these complications. In this review, we discuss the current literature regarding the epidemiology, risk factors, diagnosis, preventive strategies and treatments of skin cancer in organ transplantation.

Common Benign Melanocytic and Non-Melanocytic Skin Tumors among the Elderly: Results of the Graz Study on Health and Aging

Background and Objectives: Benign skin tumors are the most common skin findings and contribute to the major reasons for consulting a dermatologist. However, the frequency of benign skin tumors concerning different body areas and their relationship with sun-related behavior have not been sufficiently characterized. We aimed to improve knowledge about the anatomic distribution of the most frequently occurring benign skin tumors among a healthy predominant elderly population. Furthermore, we investigated associations with sun-related habits. Methods: In total, 100 participants, 37 men, and 63 women (mean age: 67.2 years; range: 46–86 years) were enrolled in the Graz Study on Health and Aging (GSHA) cohort. Full body images were investigated for melanocytic nevi, seborrheic keratoses, hemangiomas, dermatofibromas, and lentigines. Information on the phenotypic trait, sun exposure, use of sun-protective measures, and history of sunburns was collected in a questionnaire. Results: Common melanocytic nevi were the most frequently encountered skin lesions. Male sex was associated with multiple common nevi on the abdomen and the presence of atypical nevi. High sun exposure in central European latitudes during adolescence was positively associated with multiple common nevi on the total body. Multiple common nevi and atypical nevi on the back correlated with frequent use of sunscreens with SPF during young adulthood and adolescence, respectively. Conclusion: Our study adds new knowledge about the most frequently occurring benign skin tumors, considering all visible body areas. This research may serve as a reference basis for following epidemiological studies.

Community Educational Interventions: An Effective Means to Improve Photoprotection and Skin Cancer Awareness in Outdoor Occupational Workers

Introduction: Outdoor workers are at increased risk for developing skin cancer compared to the general population due to environmental conditions at work sites and riskier behavior regarding skin cancer risk factors. In many populations, sun protection education is associated with increased use of sun protective measures. This study aimed to assess outdoor workers’ knowledge of sun safety and evaluate the impact of educational measures on the awareness of photoprotection practices.&#x0D; Methods: A group of medical students visited construction sites in Birmingham, AL, to deliver 15-minute presentations on the risks of prolonged UV exposure and the prevention of photodamage. Identical 10-question surveys were given to each participant before and after the presentation. Participants rated their level of agreement with statements on photoprotection and skin cancer.&#x0D; Results: The survey response rate was 79%. Analysis revealed an average pre-presentation score of 3.01 and a post-presentation score of 3.73. Two-sample paired t-tests for each question yielded statistically significant results (p &lt;0.05). &#x0D; Conclusion: Outdoor occupational workers reported a better understanding of the risks of UV exposure and a greater willingness to engage in sun-protective practices following a brief educational intervention. These findings suggest that community-based education may improve awareness regarding photoprotection and skin cancer risk.

33632 Educational interventions may improve sun protection and skin cancer awareness in outdoor occupational workers

Introduction: Skin cancer is a preventable, yet leading, cause of cancer in the United States. Outdoor workers experience more UV exposure and report lower rates of sunscreen use. As such, they are at increased risk of developing skin cancer without intervention. Sun protection education, a means of preventative intervention, is associated with increased use of sun protective measures in several populations.

Sun Protection and Sunburn in Children Aged 1-10 Years in Germany: Prevalence and Determinants.

Seeking shade, the use of textile sun protection and sunscreen, and protecting one’s eyes by wearing sunglasses are recommended sun protection measures in children. We aimed to quantify the use of these measures as well as the prevalence of sunburn in children aged 1 to 10 years in Germany and to identify their determinants. Data collected via telephone interviews in a nationwide sample of 554 parents or caregivers in family were analyzed. Use of sunscreen was the most common measure applied (77.8%), while sunglasses were least frequently used (12.5%). The prevalence of sunburn during the past year was 21.8%, and it was positively associated with children’s age. The use of sun protection measures was significantly associated with the age and skin color of the child, while characteristics and tanning behaviors of the caregivers only played a minor role. The use of sun protection measures was higher when caregivers perceived themselves as a role model (Odds Ratio (OR) = 4.33, p < 0.001). Our nationwide data show that there remains a need for the improved use of sun protection measures, especially in children aged 7 to 10 years. In educational material, parents should be encouraged to become positive role models for their children regarding sun protection.

Behaviors, Attitudes, and Knowledge Related to Sun Exposure Among Medical Students at the Universidad de Las Palmas de Gran Canaria

IntroductionThe incidence of skin cancer, for which the main risk factor is exposure to ultraviolet radiation, has risen worldwide. Sunburn is one of the simplest ways to assess sun exposure habits. To date, few studies have evaluated sun exposure in university students. ObjectivesTo determine behaviors, attitudes, and knowledge related to sun exposure and sun protection measures among medical students at the Universidad de Las Palmas de Gran Canaria; and to assess their relation to sunburn frequency. Material and MethodsThe voluntary participants in this cross-sectional survey were first-, third- and sixth-year university students enrolled during the 2016–2017 academic year. The students responded to a validated questionnaire about their habits, attitudes, and knowledge in relation to sun exposure. Respondents were grouped according to the number of sunburns they had experienced during the previous summer. ResultsA total of 286 students responded. The students demonstrated a high level of knowledge, but the percentage who experienced a sunburn was high. Multivariate analysis showed independent correlations between experiencing a sunburn and age, male sex, academic year of enrollment at the time of the survey, phototype, and negative attitudes toward the use of sun protection measures. ConclusionsOur medical students’ level of knowledge about sun exposure and sun protection is high and scarcely varies with time spent at the university. However, their knowledge is not reflected in their behavior and attitudes or in the frequency of sunburns.

Sunburn and sun protection in black skin

People with black skin are much less susceptible to sunburn than white-skinned individuals, yet there are scarce data on self-reported incidence of sunburn and sun protection measures in people with deeply-pigmented skin. An on-line survey tool was used to collect self-assessed data about demographic variables, sunburn incidence, and use of sun protection modalities. Two-thirds of respondents with black skin living in the UK claimed never to have been sunburnt; a much higher proportion than those living in South Africa and Nigeria where 34 and 46%, respectively, reported never experiencing sunburn. Similar results were seen in the reported use of sun protection measures between the countries with two-thirds of black people living in the UK claiming they never used any form of sun protection compared with about one-third of Black Africans. Black people living in the UK were more likely to use sunscreen as a form of sun protection, whereas sunscreen was the least popular modality in the two African countries with shade being the most common form of limiting sun exposure. The findings provide some insight into the complexities of skin color perception, incidence of sunburn, and sun protection use among people with deeply-pigmented skin living in three countries with large differences in the solar UV environment.

Comportamientos, actitudes y conocimientos relacionados con la exposición solar en estudiantes de medicina de la Universidad de Las Palmas de Gran Canaria

IntroductionThe incidence of skin cancer, for which the main risk factor is exposure to ultraviolet radiation, has risen worldwide. Sunburn is one of the simplest ways to assess sun exposure habits. To date, few studies have evaluated sun exposure in university students. ObjectivesTo determine behaviors, attitudes, and knowledge related to sun exposure and sun protection measures among medical students at the Universidad de Las Palmas de Gran Canaria; and to assess their relation to sunburn frequency. Material and methodsThe voluntary participants in this cross-sectional survey were first-, second- and sixth-year university students enrolled during the 2016–2017 academic year. The students responded to a validated questionnaire about their habits, attitudes, and knowledge in relation to sun exposure. Respondents were grouped according to the number of sunburns they had experienced during the previous summer. ResultsA total of 286 students responded. The students demonstrated a high level of knowledge, but the percentage who experienced a sunburn was high. Multivariate analysis showed independent correlations between experiencing a sunburn and age, male sex, academic year of enrollment at the time of the survey, phototype, and negative attitudes toward the use of sun protection measures. ConclusionsOur medical students’ level of knowledge about sun exposure and sun protection is high and scarcely varies with time spent at the university. However, their knowledge is not reflected in their behavior and attitudes or in the frequency of sunburns.

Sun Protection Among Organ Transplant Recipients After Participation in a Skin Cancer Research Study

Because of long-term immunosuppressive therapy, organ transplant recipients experience significantly elevated skin cancer risk1 and mortality.2 Because of increasing rates of transplantation and improved survival among organ transplant recipients, primary skin cancer prevention is essential for organ transplant recipients to reduce their skin cancer burden. Elsewhere we reported the sun protection behaviors among a subset of organ transplant recipients who were at especially high risk of skin cancer because of a history of actinic skin lesions. We found that approximately 50% of the study participants regularly practiced multiple sun protection measures.3 It has been shown elsewhere that specific educational interventions can improve the use of sun protection measures among organ transplant recipients.4 Here we report a significant increase in the number of organ transplant recipients who practiced multiple sun protection behaviors after participation in a skin cancer research study for at least 1 year without any specific educational intervention.

Australian primary school communities' understandings of SunSmart: a qualitative study

Objectives:Skin cancer represents a major health issue for Australia. Childhood sun exposure is an important risk factor and evidence suggests the use of sun protection measures by Australian school children could be improved. This study examines how the SunSmart Program, a school‐based skin cancer prevention resource, can be supported to further increase sun protection behaviours to assist in lowering skin cancer incidence. Methods:The Health Promoting Schools (HPS) framework was adopted to select key stakeholders from a convenience sample of five school communities. Students, teaching staff and parents participated in semi‐structured focus group and individual interviews. A thematic analysis was used to extract key themes from the data. Results:Although these school communities were aware of sun protection practices and the risks associated with sun exposure, their understandings of the SunSmart Program were limited. Sun protection policy implementation was inconsistent and students were unlikely to engage in sun protection practices beyond the school setting. Conclusion and implications:School communities require additional support and engagement to holistically enforce the principles of the SunSmart Program.

An objective and cross-sectional examination of sun-safe behaviours in New South Wales primary schools

BackgroundPrevious evaluations have supported the link between sun protection policies and improved sun protection behaviours. However these evaluations have relied on self-reported data.MethodsA cross-sectional design as part of an ongoing 18-month cluster-controlled trial in primary schools (n = 20) was used. Researchers conducted direct observations to record students’ hat use and teachers’ use of sun protective measures during recess and lunch. Researchers also recorded the volume of sunscreen consumed in each school.ResultsOnly 60% of primary school children wear a sun-safe hat during their breaks when observed using objective measures. Weak correlations were observed between the wearing of a sun-safe hat and a school’s socio-economic status (r = 0.26). All other independent variables measured had only very weak correlations (r < 0.19) with sun-safe hat wearing behaviour of students. Sunscreen consumption by school students during the school day is negligible.ConclusionsA large percentage of NSW primary schools in this study wear sun-safe hats during the school day but this is well below what has been reported in previous national surveys. Given the finite resources of schools and the correlation, though small, with SES status for these behaviours, it behoves researchers to investigate low-cost solutions to these problems. Further qualitative data will also be needed to inform the enablers and barriers for sun-safe behaviour interventions to be adopted in NSW primary schools.

Conocimiento y actitud frente a exposición solar del personal de salud en Atención Primaria, comuna Recoleta, Santiago, Chile

Introduction: Skin cancer rates have increased worldwide despite the current prevention&#x0D; measures. It’s crucial to evaluate people’s knowledge, attitudes, and behaviour regarding&#x0D; sun exposure. Objective: To assess the knowledge and attitudes regarding sun exposure&#x0D; in the workers from primary health care. Method: 223 workers from three Family Care&#x0D; Centres(CESFAM) and from one Primary Emergency Service (SAPU) in the district of Recoleta&#x0D; were surveyed between the months of October and November 2015. Fisher’s exact test&#x0D; and Chi square test were used for statistic analysis. The survey included questions about&#x0D; demographic variables, knowledge of the association between sun radiation/skin cancer and&#x0D; attitudes towards sun protection. Results: the sample consists of 74 men and 149 women,&#x0D; with a mean age of 37 years ±SD 7.9. Phototype III was the most common (41.3%). The&#x0D; majority of the surveyed declared to be aware of the association between sun exposure and&#x0D; skin cancer (93.3%). As photoprotecting measures, sunscreens (87.4%) and seeking shade&#x0D; (71.3%) were the most frequently measures used. Regarding sunburns, 91.9% declared to&#x0D; have at least one during their lifetime, 21.5% occurring during the previous summer. As to the&#x0D; use of sunscreen, 42.1% referred only using while at the pool / beach and 12.6% declared&#x0D; not to use it at all. As for health promotion, 29.1% declared they never recommend the use&#x0D; of sun protection measures in their working practice. Discussion: Although there is adequate&#x0D; knowledge regarding the effects of sun exposure, it doesn’t always reflect on favourable&#x0D; attitudes and photoprotecting measures. There was a significantly greater amount of females&#x0D; with adequate knowledge and use of sun protection measures. This study is one of the first to&#x0D; assess photoprotection behaviour in health care workers.

Sun Exposure Habits and Sun Protection Practices of Skaters.

Beach activities and outdoor sports are risk factors for developing skin cancer. Skateboarding is among the most popular sports among adolescents. The aim was to analyse the sun exposure habits and sun protection practices of skaters, in comparison with corresponding sun exposure and protection practices on the beach. This cross-sectional study is based on health surveys carried out into sun exposure and protection practices among young skateboarders. The study population was composed of 102 skaters, of whom 84 (82.4%) were male. Fifty-eight (56.8%) of the participants reported having suffered at least one sunburn event the previous summer. Eighty-seven (91.6%) said they practiced outdoor sports more than 90days per year, while only six (6.1%) spent this long at the beach. Forty-nine (52.1%) practiced outdoor sports for 5 or more hours a day compared to 42 (43.3%) who spent comparable periods at the beach. A long-sleeved shirt was worn more frequently during sports than at the beach. Keen skaters are a risk group for the development of skin cancer due to excessive sun exposure, high rates of sunburn and scant use of sun protection measures. Specific educational and behavioural interventions should be aimed at this risk group.

Skin Protection Behaviors among Young Male Latino Day Laborers: An Exploratory Study Using a Social Cognitive Approach

Latino Day Laborers (LDLs) are employed in occupations where multiple work hazards exist. One such hazard is the overexposure to solar ultraviolet radiation for continuous periods of time. Regular sun exposure can put individuals at increased risk of developing skin cancers, especially without adequate protection. The purpose of this cross-sectional exploratory study was to use a social cognitive framework to assess skin protective behaviors among LDLs. A community-based nonrandom and purposive sample of LDLs was recruited in two states: Mississippi and Illinois. The study sample consisted of 137 male participants, of which the majority were of Mexican ancestry (72%). The average age was 35.40 (SD = 9.89) years. Results demonstrated that a substantial number of LDLs do not adequately practice sun protection behaviors on a regular basis. The skin cancer knowledge scores were very modest. The most frequently indicated barriers towards sun protection were “inconvenient,” “forget to use,” and “not being able to reapply sunscreen.” Overall, LDLs had moderate confidence in their abilities to adopt successful sun protection strategies. This study underscores the need for intervention programs aimed at LDLs to reduce extended time in the sun and increase use of sun protective measures when working outdoors.

Rationale and study protocol to evaluate the SunSmart policy intervention: a cluster randomised controlled trial of a primary school-based health promotion program.

BackgroundPrevious evaluations of the SunSmart Program have supported the link between a written sun protection policy and improved sun protection behaviours in New South Wales (NSW) primary schools. However these evaluations have relied on self-reported data and research suggests that direct observations are required to better represent schools’ usual sun protective practices.Methods/DesignData will be collected in the summer months of 2014, 2015, and 2016 as part of an 18-month cluster-controlled trial in NSW primary schools (n = 20). Researchers will conduct three direct observations to record students’ hat use and teachers’ use of sun protective measures during recess and lunch periods in each school. Researchers will also record the volume of sunscreen that the Year 6 classes in each school utilise over the term. At the conclusion of baseline data collection, five schools will be randomised into an intervention group that will work with researchers to develop a policy-driven intervention to improve sun safety behaviour in NSW primary schools.DiscussionAn initial review of relevant Australian and New Zealand literature suggests that provision of policy support is likely to improve school sun protection practices; however there is no suggested model for this support. This will be the first objective analysis of sun safe behaviours leading to a policy-driven intervention conducted in Australian primary schools since the 1990s, and will inform the future direction of sun safety in our schools.Trial registrationAustralian and New Zealand Clinical Trials Register ACTRN12614000926639 Registered 28th August 2014.

Occupational exposure to solar radiation in Australia: who is exposed and what protection do they use?

Objective:Solar ultraviolet radiation (UVR) exposure is widely recognised as a leading cause of skin cancer, with outdoor workers being particularly at risk. Little is known on a national level about how many workers are exposed to solar radiation, the circumstances in which they are exposed, or their use of protective measures. Methods:The Australian Work Exposures Study (AWES) was a cross‐sectional telephone survey of 5,023 Australian workers aged 18 to 65. A subset of 1,113 respondents who indicated they worked outdoors was asked about their exposure to solar radiation in terms of the amount of time they spent working outdoors, their working location and their use of sun protective measures. Results:A total of 1,100 respondents (22% overall) were assessed as being exposed to solar radiation at work. Exposure was more likely among males and those residing in lower socioeconomic and regional areas. Sun protection was used by 95% of the respondents, although the level of protection varied among workers, with only 8.7% classified as fully protected. Conclusions:This study provides valuable information regarding solar exposure that has not previously been available. Implications:The results of this study will inform strategies for risk reduction.

Determinants of inadequate parental sun protection behaviour in their children – Results of a cross-sectional study in Germany

Unprotected sun exposure especially during childhood is a risk factor for skin cancer. A combined use of sun protection measures is recommended to protect children. However, the prevalence and determinants for combined use have been scarcely studied in children. The objective of this study was to identify determinants of parental sun protection behaviour. A cross-sectional survey was performed in five regions in Bavaria (Germany) during school entrance health examination (2010/2011). Parents of 4579 children (47% female, aged 5-6 years) completed a self-administered questionnaire (response 61%). Most children were regularly protected with single measures (shade (69%), clothes (80%), hat (83%), sunscreen (89%), sunglasses (20%)). However, regarding regular and combined use, >50% of children were inadequately protected. Larger family size, lower household equivalent income, darker skin and sunburn history were associated with inadequate use of different sun protection measures. The less frequent use of one sun protection measure was associated with less frequent use of the others. Child's sex, migration background, parental education and sun exposure showed inconsistent results regarding the different sun protection outcomes. Based on our results a regular, combined and correct use of multiple sun protection for children should be promoted independent of sociodemographic characteristics. Priority of shade, clothes and hat before sunscreen should be clarified.

Informed reasoning: repositioning of nitisinone to treat oculocutaneous albinism

Oculocutaneous albinism (OCA) is a group of genetic disorders characterized by hypopigmentation of the skin, hair, and eyes. Affected individuals experience reduced visual acuity and substantially increased skin cancer risk. There are four major types of OCA (OCA1-OCA4) that result from disruption in production of melanin from tyrosine. Current treatment options for individuals with OCA are limited to attempts to correct visual problems and counseling to promote use of sun protective measures. However, Onojafe et al., reporting in this issue of the JCI, provide hope for a new treatment approach for OCA, as they demonstrate that treating mice that model OCA-1b with nitisinone, which is FDA approved for treating hereditary tyrosinemia type 1, elevates plasma tyrosine levels, and increases eye and hair pigmentation.