Prevention of sun induced disorders
As we have seen, it is best to be particularly careful when the UV radiation in sunlight is at its most intense. The sensible approach would be to adopt a Mediterranean or Mexican lifestyle, tending to stay inside around the middle of the day; otherwise you should seek the shade if outside at these times, as well as covering up with suitable clothing and using a highly protective sunscreen. You may, however, enjoy the outdoors relatively harmlessly at other times.
If you’re reluctant to take such precautions because you think they stop you from enjoying the sun, you need to realise that, if you don’t, you will almost certainly develop the signs of photoageing in due course – namely, a dry, itchy, blotchy, coarse, yellowish and wrinkled skin. In addition, you will also be putting yourself at an increased risk of potentially lethal skin cancer, and both this and photoageing are more likely if you are fair-skinned. All white skins, in fact, although not black or, to a lesser extent, brown, are poorly designed to cope with strong UV exposure, and it is most sensible to enjoy being outdoors when the sun is lowish in the sky. Even dark skins photoage, however. Even if the weather is bright and hot, the damaging UVB will be much less intense at these times, although UVA will still be around, but is many times less harmful.
So, during the middle of a summer day, stay inside or else cover up with suitable clothing and routinely use a sun-screen, even if there is a cool breeze or a cloudy sky, but be more relaxed in your precautions for the rest of the time.
Furthermore, most people in the UK with indoor jobs get almost half their total sun exposure each year during a single two-week holiday abroad, so you definitely need to be careful then. However, this does not mean that you cannot enjoy your holiday – you just need to take a few extra precautions!
DRESS, FASHION AND SUN PROTECTION
Until the 1950s, it was relatively common for people to wear hats – and relatively uncommon for them to sunbathe on a beach. However, changes in fashion and behaviour over the last few decades have now meant that we are increasingly exposed to the summer or tropical sun and so at much greater risk from its harmful effects.
If you are out around midday in the summer, particularly if you have a thinning head of hair, consider wearing a hat, preferably with a broad brim; this will protect both your scalp and your face from many of the sun’s harmful rays. Also try to wear close-weave, loose-fitting cotton or similar clothing to protect your shoulders, back and arms, and something of a similar nature to protect your legs. If you are swimming, wind-surfing or sailing, aim to wear at least a T-shirt, which will provide some protection although such shirts are less effective when wet against the skin. Perhaps a better choice in such situations would be to wear clothing made from specially designed protective fabrics offering a high ultraviolet protection factor (UPF); the exact number is generally indicated on them. These are now available in many department stores for children and young adults, and provide the same UPF whether wet or dry.
SUNSCREENS AND SUN PROTECTION
Sunscreens are creams, lotions, mousses and sprays for application to the skin to diminish the risk of sunburn. They also appear significantly to reduce the risk of skin photoageing and cancer if used properly. Sunblock is also a term used in this regard, but just refers to a more powerful sunscreening effect – sunblocks are generally thick white creams containing zinc or titanium oxides to reflect back the sunlight, although they do still let some UV radiation through!
However, these products are effective only if applied liberally before sun exposure and then reapplied every hour or so; if put on scantily and infrequently they do not work.
There are essentially three types of sunscreening product: those containing organic chemical substances that absorb UV radiation, those containing the fine inert powders mentioned above that largely reflect it, and combinations of the two. In the UK, until recently many have been combinations providing protection against both UVB and UVA, although relatively less against UVA, but chemical sunscreens are now much more effective, and so are tending to support the other forms, and are cosmetically more acceptable. UVB efficacy in a sunscreen is most important, but good UVA protection also helps significantly against photoageing and many skin rashes (see later).
The SPF (sun protection factor) number on the packaging of sunscreens indicates the level of protection against sunburn from UVB and UVA combined, compared with that of unprotected skin, the value in fact indicating the number of times that your skin damage is reduced while wearing the preparation; thus, the higher the number, the better the protection. The degree of UVA protection alone is sometimes indicated, often as a star-rating (* to ****) – again, the more stars there are, the better the protection. However, exact UVA protection is in fact not easy to measure and star ratings are therefore only a guide.
Products combining a high SPF with good UVA protection and satisfactory cosmetic qualities are best overall and are now readily available at reasonable prices, so preferably go for them, particularly as good UVA protection helps significantly against photoageing and sun rashes, as already stated.
In addition to pure sunscreens there is now a variety of all-yearround moisturising sunscreen products available on the market.
These appear worthwhile because the skin changes, predisposing to photo-ageing and cancer, which may also occur with levels of UV radiation exposure that are often insufficient to cause sunburn. They do still need to be applied regularly, however, or their protection lessens.
Other less usual protective options range from tinted products, which blend in with your skin colour, to brightly coloured preparations designed to look interesting, to water-resistant and hypoallergenic preparations for those with sensitive skins. Ask your pharmacist’s advice about the best type for you.
Sunscreens can have occasional side effects, but these are generally not serious. These include not infrequent mild irritation after application, particularly around the eyes, and much rarer allergic itchy rashes; if either of these happens, change the sunscreen. Most itchy rashes occurring during sunscreen use are not, however, caused by the product, but are a form of sun-induced rash, usually polymorphic light eruption.
Finally, some people use sunscreens to increase their ability to stay uncovered outdoors for longer periods without burning, perhaps to achieve a tan, perhaps just to enable some activity. However, although burning may often be avoided in this way, such sunscreen use may not necessarily provide full protection against future skin photoageing and skin cancer in very fair people.
PROTECTION FOR CHILDREN
Children are especially vulnerable to the damaging effects of sunlight for several reasons. First, their skin has initially not built up even a mild tan or protective thickening, and is thus more susceptible to UV damage. In addition, children don’t know that they should protect their skins from sunlight, so you need to be vigilant on their behalf. Furthermore, they tend to be outside more than adults, because they have time to enjoy the outdoors, as, for example, during school lunch breaks.
As a result, it is estimated that we receive around 50 per cent of our total lifetime sun exposure by the age of 18 years – and it is overall exposure that predisposes to skin photoageing and cancer. It follows therefore that the effort involved in minimising your child’s exposure while young is very worthwhile, particularly as careful habits taught early are likely to persist.
By setting an example, and making sure our children understand the dangers of sun exposure, we can lay the foundations for sensible behaviour in the future and help to ensure that their skins remain healthy throughout their lives.
