Sunscreen Smarts

burst_is1

With the sun being such an essential part of life and so influential on a person’s psyche, it can be easy to forget that the rays it gives off are the enemy in the battle against skin damage and aging. Many people are beginning to see the effects of youthful days spentBurst Is basking in the sun, dripping with baby oil instead of sunscreen, so now it is more important than ever to get the straight facts on sun care.
       Research proves exposure to UV, or ultraviolet, radiation causes damage to the skin, and studies also prove sunscreens are effective at protecting skin from this damage.1–8 As a skin care professional, getting to know the facts, keeping up-to-date on scientific developments and being a resource to family, friends, clients and colleagues is essential to yourself and your business.
       Studying information on the subjects of solar UV radiation and sunscreens—including the changes that may result from an impending amendment to the FDA sunscreen monograph, which is explained in further detail later in this article—you’ll find a range of important sun care knowledge and resources in the following. Incorporate this learning into your daily life, and use it to be a knowledgeable influence for the people you come in contact with every day.

The ABCs of solar UV radiation
       UV light is described as three wavelengths: UVA, UVB and UVC. UVC is currently absorbed by the ozone layer of the Earth’s atmosphere, so nearly all concern about ultraviolet radiation centers around protection from UVA and UVB rays.
       UVB is only partially absorbed by the ozone layer, and the UVB rays that do penetrate the atmosphere are responsible for causing harmful sunburns, as they enter just below the skin’s surface into the epidermal layers. Transmission of UVB peaks when the sun is high in the sky, traditionally between the hours of 10 AM and 2 PM, making it less dangerous in the early morning and
late evening hours. Also, UVB can be blocked to some extent by very dense clouds, layers of clothing and glass.
       Consequently, an estimated 95% of the UV rays that reach the earth are UVA rays. UVA penetrates deeper into the skin than UVB, causing damage into the dermal layers, which research has linked to premature aging and wrinkle formation.9 UVA can penetrate cloud cover, light clothing and untinted glass, as well.
       Also, both UVB and UVA have been linked to the production of cancer, so protecting the skin from these harmful rays is essential for good health.

How do sunscreens work?
       The primary function of a sunscreen product is to reduce the dose of solar UV the skin receives, protecting it from the damaging effects of UV radiation. In order to provide this protection, sunscreen products contain ingredients that absorb, reflect and scatter UV radiation, thus abating the radiation before it can penetrate into the skin and damage key components, such as DNA, collagen and elastin. Much like an umbrella shields you from the unwanted effects of rain, sunscreen shields you from the unwanted effects of solar UV.
       Be aware that sunscreen ingredients reduce the dose of solar UV to varying degrees. Each sunscreen ingredient absorbs UV across a specific range, so it is important to use a product containing an effective combination of ingredients in order to truly get broad-spectrum protection.

Sun protection factors—what do they mean?
       Austrian scientist Franz Greiter introduced sun protection factor, or SPF, as a standard measure of sun protection more than 40 years ago. An SPF number indicates protection against erythemally induced skin effects, such as redness, inflammation and sunburn, which are weighted for UVB.
       However, SPF is really more complex than most people realize, and this lies mostly in the fact that sun protection factors are not linear. For example, SPF 30 does not block twice as much erythemally weighted UV as SPF 15. In reality, SPF 30 blocks 97% of erythemally weighted UV, while SPF 15 blocks 93%. See Fig. 1 for further explanation and examples.
       The FDA standard dose for SPF testing is 2mg/cm2—approximately enough to fill a shot glass—which is, on average, equal to the amount needed to cover the entire body. Applying two layers of sunscreen assures more even, continuous coverage, and it more than doubles the SPF on the skin. Additionally, applying half of the effective dose of an SPF 30 will not result in an SPF 15, but more likely an SPF 7 or 9.
       At this time, there is no universal test method or standard product label to indicate the level of UVA protection in sunscreens. The Food and Drug Administration (FDA) is, however, currently reviewing a proposed amendment to the sunscreen monograph that will incorporate test methods and labeling for UVA protection.

The FDA sunscreen monograph—what is it?
       In the United States, sunscreen products are regulated as over-the-counter, or OTC, drug products and must comply with rules presented in the sunscreen monograph, created and enforced by the FDA. The legal difference between a cosmetic and a drug is determined by a product’s intended use, and different laws and regulations apply to each type of product. Manufacturers sometimes violate the law by marketing a cosmetic with a drug claim or by marketing a drug as if it were a cosmetic without adhering to requirements for drugs, so the FDA has published monographs, or rules, for a number of OTC drug categories.
       These monographs, which are published in the Federal Register, state requirements for categories of nonprescription drugs, such as what ingredients may be used and for what intended use. Among the many nonprescription drug categories covered by OTC monographs are acne medications; treatments for dandruff, seborrheic dermatitis and psoriasis; and sunscreens.
       The sunscreen monograph rulemaking began in 1978, and the final monograph was issued in 1999, only to be put on hold in 2001 until more reliable testing methods for UVA sunscreen protection could be developed. A proposed amendment of the final monograph was issued in August 2007. “The rule, if finalized, will set long-awaited standards for testing and labeling OTC sunscreen products providing UVA and UVB protection,” says J. F. Nash, PhD, principal scientist with P&G Beauty.
       An international group of beauty professionals has been working to establish technical standards for sunscreens through the International Standards Organization, and Nash and others have estimated the final monograph will be published mid-2009. That would be followed by an 18-month implementation period, making changes in sunscreen product testing and labeling most likely to be effective around late 2010 or early 2011.

Possible monograph changes
       The proposed regulations specify that SPF comes to mean sunburn protection factor rather than simply sun protection factor, which is only a measure of UVB efficacy.* Methods of measurement for SPF will be unchanged for the most part, with SPF numbers likely to be capped at 50+ and the following category descriptions mandatorily accompanying each bottle’s SPF number:

SPF 2–14 = low
SPF 15–29 = medium
SPF 30–50 = high
SPF 50+ = highest

       UVA efficacy will be quantified by a combination of in vitro, or tested on an artificial substrate, and in vivo, or tested on human skin, methods to establish a UVA efficacy rank. The lower result of the two compulsory tests determines the rank, which is then communicated to the consumer via Product Category Descriptors of low, medium, high and highest, along with the appropriate corresponding star symbols, making the UVA ranking semi-independent of the SPF. The star symbols will likely appear as follows:

 No UVA efficacy  (Four empty stars)   
 Low  (One colored star, three empty ones)     
 Medium  (Two colored stars, two empty ones)
 High (Three colored stars, one empty one)
 Highest (Four colored stars) 

       Therefore, if a product scores high in one UVA efficacy test measurement and medium in the other, the product will receive an overall labeling description of UVA medium. However, to achieve the highest rating, a product must have scored the highest ranking using both in vitro and in vivo test methods.
       Other labeling changes would necessitate the inclusion of the following sunscreen statement on product packaging: “UV rays from the sun are made of UVB and UVA. It is important to protect against both UVB and UVA rays.” An OTC Drug Facts box will be required on all packages, as well, and anti-aging and anti-cancer claims attributed to sunscreen products will be prohibited. Additionally, directions will be required that instruct consumers to apply the sunscreen either “liberally” or “generously” and note that the sunscreen should be reapplied at least every two hours.

Emotional attitudes and behaviors toward sunscreen use
       Studies show that while people are aware of the risks of exposure to UV radiation, few regularly use UV protection. Research by P&G Beauty indicates 70% of consumers believe sunlight causes premature aging, yet only 18% use a daily UV moisturizer. And even in the summer, when the risk of burning is most obvious, only 58% of women report using sunscreen daily, and 26% say they never use a sunscreen.10 With statistics such as these, it is important to know it has been shown that skipping sun protection on just one day out of four is enough to lower the skin’s defense mechanisms and increase endpoints related to photo-aging.11
       Additionally, studies have shown the aesthetics of a sunscreen product are extremely important for achieving usage and compliance among both women and men. Many people complain that sunscreens are heavy, greasy and have an unpleasant odor, and P&G Beauty scientists have studied sunscreen usage comparing consumer application habits when using an SPF 30 product versus an SPF 15. The researchers found heavy-feeling products with a higher SPF were applied much more sparingly, whereas cosmetically formulated products with a lower SPF were applied more generously and used more consistently.12 (For more informative sun-related statistics, see More on Sunscreen Advancements.)

Spreading the sunscreen word
       Dermatologists and scientists throughout the world agree that the daily use of at least an SPF 15 broad-spectrum sunscreen product as part of a sun-safe strategy will help to diminish acute and chronic damage to the skin. And although UV radiation is a fundamental concern year-round, it seems to enter people’s minds and conversations much more frequently in the quickly approaching summer months.
       As a skin care professional, you have the perfect opportunity to speak with clients about the damaging effects of UV exposure, as well as what they can do to protect their skin against these effects with appropriate sunscreens. Take the time to make sure they have the facts straight when it comes to sunscreens, UV exposure, cancer risks and skin care. Your clients will thank you for it.

*Comments submitted to the FDA by the Personal Care Products Council object to this, as it is technically incorrect. SPF is a measure of protection against erythemally weighted UV, which includes UVB and UVA.

REFERENCES
1. B Gilchrest, A review of skin aging and its medical therapy. Br J Dermatol 135 867–75 (1996)
2. RP Gallagher, GB Hill, CD Bajdick, S Fincham, AJ Coldman, DI McLean, et al. Sunlight exposure, pigmentary factors, and risk
of nonmelanocytic skin cancer, I: basal cell carcinoma. Arch Dermatol 131 157–63 (1995)
3. RP Gallagher, GB Hill, CD Bajdick, AJ Coldman, S Fincham, DI McLean, et al, Sunlight exposure, pigmentary factors, and risk
of nonmelanocytic skin cancer, II: squamous cell carcinoma. Arch Dermatol 131 164–9 (1996)
4. B Gilchrest, MS Eller, AC Geller, M Yaar, The pathogenesis of melanoma induced by ultraviolet radiation. N Engl J Med 340 1341–8 (1999)
5. DR Bickers, DE DeWitt, RS Gilgor, PE Grimes, KA Holbrook, R Katz, et al, National Institutes of Health summary of the consensus development conference on sunlight, ultraviolet radiation, and the skin: Bethesda, Maryland, May 8–10, 1989. J Am Acad Dermatol 24 608–12 (1991)
6. HW Lim, W Bergfeld, Prevention strategies. J Am Acad Dermatol 41 95–6 (1999)
7. BA Gilchrest, Sunscreens: a public health opportunity. N Engl J Med 329 1193–4 (1993)
8. TJ Philips, J Bhawan, M Yaar, Y Bello, D Piccolo, JF Nash, Effect of daily versus intermittent sunscreen application on solar simulated UV radiation-induced skin response in humans. J Am Acad Dermatol 43(4) 610–18 (2000)
9. P&G Beauty Science, UV & Sunscreen Research Update
10. Procter & Gamble Beauty, Data on file
11. TJ Philips, J Bhawan, M Yaar, Y Bello, D Piccolo, JF Nash, Effect of daily versus intermittent sunscreen application on solar simulated UV radiation-induced skin response in humans. J Am Acad Dermatol 43(4) 610–18 (2000)
12. TL Grosick and PR Tanner, Efficacy as used, not as tested, is true measure of sunscreen performance. Proceedings of the 62nd American Academy of Dermatology Annual Meeting, Washington, DC, Feb 6–11, 2004

Related articles:
Sunscreen Technology, Regulations and Formulations by Ken Klein (April 2007)

Related news items:
L'Oreal Grants to Promote Sun Safety (February 12, 2008)
AAD Addresses New Developments in Skin Cancer Prevention (December 31, 2007)
FDA Extends Comment Period for Proposed Sunscreen Rule (December 5, 2007)

More in Physiology