Sunscreen (also known as sunblock) is a lotion, spray or other topical product that helps protect the skin from the sun’s ultraviolet (UV) radiation, and which reduces sunburn and other skin damage, with the goal of lowering the risk of skin cancer. However in the United States, the term suntan lotion usually means the opposite of sunscreen, and instead refers to lotion designed to moisturize and maximize UV exposure and tanning rather than block it. These are commonly called indoor tanning lotions when designed for use with tanning beds or just suntan lotion if designed for outdoor use and may or may not have SPF protection in them.
The most effective sunscreens protect against both UVB, which can cause sunburn, and UVA, which damages the skin with more long-term effects, such as premature skin aging. Most sunscreens work by containing either an organic chemical compound that absorbs ultraviolet light (such as oxybenzone) or an opaque material that reflects light (such as titanium dioxide, zinc oxide), or a combination of both. Typically, absorptive materials are referred to as chemical blocks, whereas opaque materials are mineral or physical blocks. The sun protection factor (SPF) of a sunscreen is a laboratory measure of the effectiveness of sunscreen — the higher the SPF, the more protection a sunscreen offers against UVB.
Medical organizations such as the American Cancer Society recommend the use of sunscreen because it prevents squamous and basal cell carcinoma. However, the use of sunscreens is controversial for various reasons. Many sunscreens do not block UVA radiation, which does not cause sunburn but can increase the rate of melanoma, another kind of skin cancer.
Contrary to the common advice that sunscreen should be reapplied every 2–3 hours, some research has shown that the best protection is achieved by application 15–30 minutes before exposure, followed by one reapplication 15–30 minutes after the sun exposure begins. Further reapplication is only necessary after activities such as swimming, sweating, or rubbing/wiping.
However, more recent research at the University of California, Riverside, indicates that sunscreen needs to 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 which were absorbed into the skin.
Some studies have shown that people commonly apply only half or a quarter of the amount recommended to achieve the rated sun protection factor (SPF), and in consequence the effective SPF should be downgraded to far below its advertised value.
The first effective sunscreen may have been developed by Swiss chemist Franz Greiter in 1938. The product, called Gletscher Crème (Glacier Cream), subsequently became the basis for the company Piz Buin (named in honor of the place Greiter allegedly obtained the sunburn that inspired his concoction), which is still today a marketer of sunscreen products. It has been estimated that Gletscher Crème had a sun protection factor of 2.
The first widely used sunscreen was produced by Benjamin Green, an American airman and later a pharmacist, in 1944. The product, 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. This product was developed during the height of World War II, when it was likely that the hazards of sun overexposure were becoming apparent to soldiers in the Pacific and to their families at home. Sales of this product boomed when Coppertone acquired the patent and marketed the substance under the Coppertone girl and Bain de Soleil branding in the early 1950s.
Austrian scientist Franz Greiter is credited with introducing the concept of sun protection factor (SPF) in 1962, which has become a worldwide standard for measuring the effectiveness of sunscreen when applied at an even rate of two milligrams per square centimeter. Some controversy exists over the usefulness of SPF measurements, especially whether the 2 mg/cm2 application rate is an accurate reflection of people’s actual use.
The SPF is the amount of UV radiation required to cause sunburn on skin with the sunscreen on, as a multiple of the amount required without the sunscreen. There is a popular oversimplification of how SPF determines how long one can stay in the sun. For example, many users believe that, if they normally get sunburn in one hour, then an SPF 15 sunscreen allows them to stay in the sun fifteen hours (i.e. fifteen times longer) without getting sunburn.
This would be true if the intensity of UV radiation were the same for the whole fifteen hours as in the one hour, but this is not normally the case. Intensity of solar radiation varies considerably with time of day. During early morning and late afternoon, the sun’s radiation intensity is diminished since it must pass through more of the Earth’s atmosphere while it is near the horizon.
Also, often users fail to account for reflective surfaces like snow and water, which can greatly increase the amount of UV radiation to which the skin is exposed.
In practice, the protection from a particular sunscreen depends, besides on SPF, on factors such as: skin type of the user; amount applied and frequency of re-application; activities (e.g. swimming, exercising); and the amount of sunscreen the skin has absorbed.
The SPF is an imperfect measure of skin damage because invisible damage and skin aging are also caused by ultraviolet type A, which does not cause reddening or pain. Even some products labeled ‘broad-spectrum UVA/UVB protection’ do not provide good protection against UVA rays. The best UVA protection is provided by products that contain zinc oxide, avobenzone, and ecamsule. Titanium dioxide probably gives good protection, but does not completely cover the entire UV-A spectrum.
Owing to consumer confusion over the real degree and duration of protection offered, labeling restrictions are in force in several countries. In the EU sunscreen labels can only go up to SPF 50+, while Australia’s upper limit is 30+. The United States does not have mandatory, comprehensive sunscreen standards, although a draft rule has been under development since 1978. In the 2007 draft rule, the FDA proposed to institute the labelling of SPF 50+, and other measures were proposed to limit unrealistic claims about the level of protection offered (such as ‘all day protection’ or ‘waterproof’).
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.
The persistent pigment darkening (PPD) method is a method of measuring UVA protection, similar to the SPF method of measuring UVB light 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.
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. There must be a UVA PF of at least 1/3 of the SPF to carry the UVA seal. The implementation of this seal is in its phase-in period, so a sunscreen without it may already offer this protection.
In the UK and Ireland, the Boots star rating system is a proprietary laboratory 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 which has been adopted by most companies marketing these products in the UK. One-star products provide the least ratio of UVA protection; five-star products are best.
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. The FDA has considered banning such use because it can lead consumers to overestimate the effectiveness of products so labeled.
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.
Sunscreen should also be hypoallergenic and noncomedogenic so it doesn’t cause a rash or clog the pores, which can cause acne.
As a defense against UV radiation, the amount of the brown pigment melanin in the skin increases when exposed to moderate (depending on skin type) levels of radiation; this is commonly known as a sun tan. The purpose of melanin is to absorb UV radiation and dissipate the energy as harmless heat, blocking the UV from damaging skin tissue. UVA gives a quick tan that lasts for days by oxidizing melanin that was already present and triggers the release of the melanin from melanocytes (melanin producing cells). UVB on the other hand yields a tan that takes roughly two days to develop because it stimulates the body to produce more melanin. The photochemical properties of melanin make it an excellent photoprotectant.
Sunscreen chemicals on the other hand cannot dissipate the energy of the excited state as efficiently as melanin and therefore the penetration of sunscreen ingredients into the lower layers of the skin increases the amount of free radicals. Some sunscreen lotions now include compounds such as titanium dioxide which helps protect against UVB rays. Other UVA blocking compounds found in sunscreen include zinc oxide and avobenzone. There are also naturally occurring compounds found in rainforest plants that have been known to protect the skin from UV radiation damage, such as the golden polypody fern (Phlebodium aureum).
Some sunscreen chemicals produce potentially harmful substances if they are illuminated while in contact with living cells. ‘The question whether UV filters acts on or in the skin has so far not been fully answered. Despite the fact that an answer would be a key to improve formulations of sun protection products, many publications carefully avoid addressing this question.’
Some epidemiological studies indicate an increased risk of malignant melanoma for the sunscreen user. Despite these studies, no medical association has published recommendations to not use sunblock. Different meta-analysis publications have concluded that the evidence is not yet sufficient to claim a positive correlation between sunscreen use and malignant melanoma.
Adverse health effects may be associated with some synthetic compounds in sunscreens. In 2007 two studies by the CDC highlighted concerns about the sunscreen chemical oxybenzone (benzophenone-3). The first detected the chemicals in greater than 95% of 2000 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.
The use of sunscreen also interferes with vitamin D production, leading to deficiency in Australia after a government campaign to increase sunscreen use. Doctors recommend spending small amounts of time in the sun without sun protection to ensure adequate production of vitamin D. When the UV index is greater than 3 (which occurs daily within the tropics and daily during the spring and summer seasons in temperate regions) adequate amounts of vitamin D3 can be made in the skin after only ten to fifteen minutes of sun exposure at least two times per week to the face, arms, hands, or back without sunscreen. With longer exposure to UVB rays, an equilibrium is achieved in the skin, and the vitamin simply degrades as fast as it is generated.
Concerns have been raised regarding the use of nanoparticles in sunscreen. Theoretically, sunscreen nanoparticles could increase rates of certain cancers, or diseases similar to those caused by asbestos. ‘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. 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.’
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