All about sunscreens

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SUNSCREEN

Sunscreen on back under normal and UV light

Sunscreen (also commonly known as sun screen, sunblock, suntan lotion, sunburn cream, sun cream or block out) is a lotion, spray, gel or other topical product that absorbs or reflects some of the sun's ultraviolet (UV) radiation on the skin exposed to sunlight and thus helps protect against sunburn. Skin-lightening products have sunscreen to protect lightened skin because light skin is more susceptible to sun damage than darker skin. A number of sunscreens have tanning powder to help the skin to darken or tan; however, tanning powder does not provide protection from UV rays.

Depending on the mode of action, sunscreens can be classified into physical sunscreens (i.e., those that reflect the sunlight) or chemical sunscreens (i.e., those that absorb the UV light).

Medical organizations such as the American Cancer Society recommend the use of sunscreen because it aids in the prevention of squamous cell carcinomas. Many sunscreens do not block UVA radiation, which does not primarily cause sunburn but can increase the rate of melanoma and photodermatitis. The use of broad-spectrum (UVA/UVB) sunscreens can address this concern. Diligent use of sunscreen can also slow or temporarily prevent the development of wrinkles and sagging skin.

HEALTH EFFECTS

Benefits
Sunscreen use can help prevent melanoma and squamous cell carcinoma, two types of skin cancer. There is little evidence that it is effective in preventing basal cell carcinoma.

A 2013 study concluded that the diligent, everyday application of sunscreen can slow or temporarily prevent the development of wrinkles and sagging skin. The study involved 900 white people in Australia and required some of them to apply a broad-spectrum sunscreen every day for four and a half years. It found that people who did so had noticeably more resilient and smoother skin than those assigned to continue their usual practices.

Minimizing UV damage is especially important for children and fair-skinned individuals and those who have sun sensitivity for medical reasons.

Potential risks
In 2008 two studies by the CDC highlighted concerns about the sunscreen chemical oxybenzone (benzophenone-3). The first study detected the chemical in 97% of the 2,500 Americans tested, while the second found that mothers with high levels of oxybenzone in their bodies were more likely to give birth to underweight baby girls. While controversial, oxybenzone does provide broad-spectrum UV coverage, including UVB and short-wave UVA rays.

In 2006 the Therapeutic Goods Administration of Australia carried out a review of sunscreen safety studies and concluded: "There is evidence from isolated cell experiments that zinc oxide and titanium dioxide can induce free radical formation in the presence of light and that this may damage these cells (photo-mutagenicity with zinc oxide). However, this would only be of concern in people using sunscreens if the zinc oxide and titanium dioxide penetrated into viable skin cells. The weight of current evidence is that they remain on the surface of the skin and in the outer dead layer (stratum corneum) of the skin."

Concerns have also been raised about potential vitamin D deficiency arising from prolonged use of sunscreen. Typical use of sunscreen does not usually result in vitamin D deficiency; however, extensive usage may. Sunscreen prevents ultraviolet light from reaching the skin, and even moderate protection can substantially reduce vitamin D synthesis. However, adequate amounts of vitamin D can be produced with moderate sun exposure to the face, arms and legs, averaging 5–30 minutes twice per week without sunscreen. (The darker the complexion, the more minutes of exposure, approximating 25% of the time for minimal sunburn. Vitamin D overdose is impossible from UV exposure; the skin reaches an equilibrium where the vitamin degrades as fast as it is created.)

HISTORY

Early civilizations used a variety of plant products to help protect the skin from sun damage. For example, ancient Greeks used olive oil for this purpose, and ancient Egyptians used extracts of rice, jasmine, and lupine plants whose products are still used in skin care today. Zinc oxide paste has also been popular for skin protection for thousands of years.

Early synthetic sunscreens were first used in 1928, and the first major commercial product was brought to market in 1936, introduced by the founder of L'Oreal, French chemist Eugène Schueller. During the same period, Hamilton Sunscreen came to the Australian market in 1932, developed by chemist H. A. Milton Blake.

Among widely used modern sunscreens, one of the earliest was produced in 1944 for the US military by Benjamin Green, an airman and later a pharmacist, as the hazards of sun overexposure became apparent to soldiers in the Pacific tropics at the height of World War II. The product, named Red Vet Pet (for red veterinary petrolatum), had limited effectiveness, working as a physical blocker of ultraviolet radiation. It was a disagreeable red, sticky substance similar to petroleum jelly. Sales boomed when Coppertone improved and commercialized the substance under the Coppertone girl and Bain de Soleil branding in the early 1950s.

In 1946, Swiss chemist Franz Greiter introduced what may have been the first effective modern sunscreen. The product, called Gletscher Crème (Glacier Cream), subsequently became the basis for the company Piz Buin, which is still today a marketer of sunscreen products, named in honor of the mountain where Greiter allegedly obtained the sunburn that inspired his concoction. In 1974, Greiter adapted earlier calculations from Friedrich Ellinger and Rudolf Schulze and introduced the "sun protection factor" (SPF), which has become a worldwide standard for measuring the effectiveness of sunscreen. It has been estimated that Gletscher Crème had an SPF of 2.

Water-resistant sunscreens were introduced in 1977, and recent development efforts have focused on making sunscreen protection both longer-lasting and broader-spectrum, as well as more appealing to use.

Sunscreen helps prevent sunburn, such as this, which has blistered

Two photographs showing the effect of applying sunscreens in visible light and in UVA. The photograph on the right was taken using ultraviolet photography shortly after application of sunscreen to half of the face.

MEASUREMENTS OF PROTECTION

Sun protection factor and labelling
The SPF rating is a measure of the fraction of sunburn-producing UV rays blocked. For example, "SPF 15" means that 1/15th of the burning radiation will reach the skin, assuming sunscreen is applied evenly at a thick dosage of 2 milligrams per square centimetre (mg/cm2). A user can determine the effectiveness of a sunscreen "by multiplying the SPF factor by the length of time it takes for him or her to suffer a burn without sunscreen." Thus, if a person develops a sunburn in 10 minutes when not wearing a sunscreen, the same person in the same intensity of sunlight will avoid sunburn for 150 minutes if wearing a sunscreen with an SPF of 15. It is important to note that sunscreens with higher SPF do not last or remain effective on the skin any longer than lower SPF and must be continually reapplied as directed, usually every two hours.

The SPF is an imperfect measure of skin damage because invisible damage and skin aging are also caused by ultraviolet type A (UVA, wavelengths 315–400 or 320–400 nm), which does not primarily cause reddening or pain. Conventional sunscreen blocks very little UVA radiation relative to the nominal SPF; broad-spectrum sunscreens are designed to protect against both UVB and UVA. According to a 2004 study, UVA also causes DNA damage to cells deep within the skin, increasing the risk of malignant melanomas. Even some products labelled "broad-spectrum UVA/UVB protection" have not always provided good protection against UVA rays. Titanium dioxide probably gives good protection, but does not completely cover the UVA spectrum, as early 2000s research suggests that zinc oxide is superior to titanium dioxide at wavelengths 340–380 nm.

Owing to consumer confusion over the real degree and duration of protection offered, labelling restrictions are in force in several countries. In the EU, sunscreen labels can only go up to SPF 50+ (initially listed as 30 but soon revised to 50). Australia's Therapeutic Goods Administration increased the upper limit to 50+ in 2012. In its 2007 and 2011 draft rules, the US Food and Drug Administration (FDA) proposed a maximum SPF label of 50, to limit unrealistic claims. Others have proposed restricting the active ingredients to an SPF of no more than 50, due to lack of evidence that higher dosages provide more meaningful protection.

UV sunlight spectrum (on a summer day in the Netherlands), along with the CIE Erythemal action spectrum. The effective spectrum is the product of the former two.

The SPF can be measured by applying sunscreen to the skin of a volunteer and measuring how long it takes before sunburn occurs when exposed to an artificial sunlight source. In the US, such an in vivo test is required by the FDA. It can also be measured in vitro with the help of a specially designed spectrometer. In this case, the actual transmittance of the sunscreen is measured, along with the degradation of the product due to being exposed to sunlight. In this case, the transmittance of the sunscreen must be measured over all wavelengths in sunlight's UVB–UVA range (290–400 nm), along with a table of how effective various wavelengths are in causing sunburn (the erythemal action spectrum) and the standard intensity spectrum of sunlight (see the figure). Such in vitro measurements agree very well with in vivo measurements.

Numerous methods have been devised for evaluation of UVA and UVB protection. The most-reliable spectrophotochemical methods eliminate the subjective nature of grading erythema.

The ultraviolet protection factor (UPF) is a similar scale developed for rating fabrics for sun protective clothing. According to recent testing by Consumer Reports, UPF ~30 is typical for protective fabrics, while UPF ~6 is typical for standard summer fabrics.

UVA protection
Persistent pigment darkening (PPD)
The persistent pigment darkening (PPD) method is a method of measuring UVA protection, similar to the SPF method of measuring sunburn protection. Originally developed in Japan, it is the preferred method used by manufacturers such as L'Oréal.

Instead of measuring erythema or reddening of the skin, the PPD method uses UVA radiation to cause a persistent darkening or tanning of the skin. Theoretically, a sunscreen with a PPD rating of 10 should allow a person 10 times as much UVA exposure as would be without protection. The PPD method is an in vivo test like SPF. In addition, Colipa has introduced a method that, it is claimed, can measure this in vitro and provide parity with the PPD method.

SPF equivalence

The UVA seal used in the EU

A tube of SPF 15 sun lotion

As part of revised guidelines for sunscreens in the EU, there is a requirement to provide the consumer with a minimum level of UVA protection in relation to the SPF. This should be a "UVA PF" of at least 1/3 of the SPF to carry the UVA seal.

A set of final US FDA rules effective from summer 2012 defines the phrase "broad spectrum" as providing UVA protection proportional to the UVB protection, using a standardized testing method.

Star rating system
In the UK and Ireland, the Boots star rating system is a proprietary in vitro method used to describe the ratio of UVA to UVB protection offered by sunscreen creams and sprays. Based on original work by Prof. Brian Diffey at Newcastle University, the Boots Company in Nottingham, UK, developed a standard method that has been adopted by most companies marketing these products in the UK. The logo and methodology of the test are licensed for a token fee to any manufacturer or brand of sunscreens that are sold in the Boots retail chain, provided the products to which the logo is applied perform to the standard claimed. Own Label products exclusively sold in other retailers are now excluded from the terms of the license.

One-star products provide the least ratio of UVA protection; five-star products are best. The method was recently revised in light of the Colipa UVA PF test and the revised EU recommendations regarding UVA PF. The method still uses a spectrophotometer to measure absorption of UVA versus UVB; the difference stems from a requirement to pre-irradiate samples (where this was not previously required) to give a better indication of UVA protection and photostability when the product is used. With the current methodology, the lowest rating is three stars, the highest being five stars.

In August 2007, the FDA put out for consultation the proposal that a version of this protocol be used to inform users of American product of the protection that it gives against UVA; but this was not adopted, for fear it would be too confusing.

PA system
Asian brands, particularly Japanese ones, tend to use The Protection Grade of UVA (PA) system to measure the UVA protection that a sunscreen provides. The PA system is based on the PPD reaction and is now widely adopted on the labels of sunscreens. According to the Japan Cosmetic Industry Association, PA+ corresponds to a UVA protection factor between two and four, PA++ between four and eight, and PA+++ more than eight.

SUNBLOCK

Sunblock typically refers to opaque sunscreen that is effective at blocking both UVA and UVB rays and uses a heavy carrier oil to resist being washed off. Titanium dioxide and zinc oxide are two of the important ingredients in sunblock. Unlike the organic sun-blocking agents used in many sunscreens, these metal oxides do not degrade with exposure to sunlight.

The use of the word "sunblock" in the marketing of sunscreens is controversial. Since 2013, the FDA has banned such use because it can lead consumers to overestimate the effectiveness of products so labelled. Nonetheless, many consumers use the words sunblock and sunscreen synonymously.

For total protection against damage from the sun, the skin needs to be protected from UVA, UVB and IRA (infrared light). Roughly 35% of solar energy is IRA.

ACTIVE INGREDIENTS

Sunscreens contain one or more of the following ingredients:

• Organic chemical compounds that absorb ultraviolet light.
• Inorganic particulates that reflect, scatter, and absorb UV light (such as titanium dioxide, zinc oxide, or a combination of both).
• Organic particulates that mostly absorb light like organic chemical compounds, but contain multiple chromophores that may reflect and scatter a fraction of light like inorganic particulates, and behave differently in formulations than organic chemical compounds. An example is Tinosorb M. Since the UV-attenuating efficacy depends strongly on particle size, the material is micronised to particle sizes below 200 nm. The mode of action of this photostable filter system is governed to about 90% by absorption and 10% by scattering of UV light.

The principal ingredients in sunscreens are usually aromatic molecules conjugated with carbonyl groups. This general structure allows the molecule to absorb high-energy ultraviolet rays and release the energy as lower-energy rays, thereby preventing the skin-damaging ultraviolet rays from reaching the skin. So, upon exposure to UV light, most of the ingredients (with the notable exception of avobenzone) do not undergo significant chemical change, allowing these ingredients to retain the UV-absorbing potency without significant photodegradation. A chemical stabilizer is included in some sunscreens containing avobenzone to slow its breakdown; examples include formulations containing Helioplex and AvoTriplex. The stability of avobenzone can also be improved by bemotrizinol, octocrylene and various other photostabilisers. Most organic compounds in sunscreens slowly degrade and become less effective over the course of several years if stored properly, resulting in the expiration dates calculated for the product.

Sunscreening agents are used in some hair care products such as shampoos, conditioners and styling agents to protect against protein degradation and color loss. Currently, benzophenone-4 and ethylhexyl methoxycinnamate are the two sunscreens most commonly used in hair products. The common sunscreens used on skin are rarely used for hair products due to their texture and weight effects.

APPLICATION

A sunscreen study from 2001 suggests that the best protection is achieved by dividing the SPF number in half and reapplying that many minutes after sun exposure begins. For example, if the SPF is 30, sunscreen should be reapplied once after 15 minutes of exposure. Further reapplication is only necessary after activities such as swimming, sweating, or rubbing/wiping.

More-recent research at the University of California, Riverside, indicates that sunscreen must be reapplied within 2 hours in order to remain effective. Not reapplying could even cause more cell damage than not using sunscreen at all, due to the release of extra free radicals from those sunscreen chemicals that were absorbed into the skin.

DOSAGE

The dose used in FDA sunscreen testing is 2 mg/cm2 of exposed skin. If one assumes an "average" adult build of height 5 ft 4 in (163 cm) and weight 150 lb (68 kg) with a 32-inch (82-cm) waist, that adult wearing a bathing suit covering the groin area should apply 29 g (approximately 1 oz) evenly to the uncovered body area. Considering only the face, this translates to about 1/4 to 1/3 of a teaspoon for the average adult face. Larger or smaller individuals should scale these quantities accordingly.

Some studies have shown that people commonly apply only 1/2 to 1/4 of the amount recommended for achieving the rated sun protection factor (SPF), and in consequence the effective SPF should be downgraded to a square root or 4th root of the advertised value. A later study found a significant exponential relation between SPF and the amount of sunscreen applied, and the results are closer to linearity than expected by theory.

OTHER FDA LABELING REGULATIONS

Sunscreen labelling standards have been evolving in the United States since the FDA first adopted the SPF calculation in 1978. The FDA issued a comprehensive set of rules in June 2011, taking effect in 2012–2013, designed to help consumers identify and select suitable sunscreen products offering protection from sunburn, early skin aging, and skin cancer.

To be classified as "broad spectrum", sunscreen products must provide protection against both UVA and UVB, with specific tests required for both.

Claims of products being "waterproof" or "sweatproof" are prohibited, while "sunblock" and "instant protection" and "protection for more than 2 hours" are all prohibited without specific FDA approval.

"Water resistance" claims on the front label must indicate how long the sunscreen remains effective and specify whether this applies to swimming or sweating, based on standard testing.

Sunscreens must include standardized "Drug Facts" information on the container. However, there is no regulation that deems it necessary to mention whether the contents contain nanoparticles of mineral ingredients. (The EU has stricter regulation against the use of nanoparticles, and in 2009 introduced labelling requirements for nanoparticle ingredients in certain sunscreens and cosmetics.)

The maximum SPF value on sunscreen labels is "50+".

ENVIRONMENTAL EFFECTS

Certain sunscreens in water under ultraviolet light can increase the production of hydrogen peroxide, which damages phytoplankton. Nanoparticles of titanium dioxide, a common ingredient of sunscreens, can accumulate in coastal waters and be ingested by marine animals.

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