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 “There is an understandably long list of reasons most people do not
use or apply enough sunscreen: the lotion is uncomfortable,
inconvenient to apply, not always readily available, expensive and
the list goes on,” said lead study author Dr. Aaron Farberg of the
Icahn School of Medicine at Mount Sinai in New York.
“However, we know that solar UV causes skin cancer, so as
dermatologists we want to encourage our patients to continually
improve their sun protection,” Farberg added by email. “This
includes using sunscreen, seeking shade, and wearing sun protective
clothing with sunglasses.”
In a survey of 156 U.S. dermatologists, every single one of them
agreed that sunscreen reduces premature aging of the skin, or
photoaging, and 97 percent agreed that it also lowers the risk of
cancer.
But 99 percent of them also think their patients don’t apply enough
sunscreen.
Most people need at least an ounce of sunscreen, or enough to fill a
shot glass, to cover all the exposed parts of their body, according
to the American Academy of Dermatology.
It should offer broad spectrum (UVA and UVB) protection and have a
Sun Protection Factor (SPF) of 30 or higher, the AAD recommends.
Sunscreen should be applied at least 15 minutes before going
outdoors, and reapplied every two hours or after swimming or
sweating even if it’s labeled as water resistant.
Nearly all of the dermatologists surveyed were comfortable
recommending sunscreens with an SPF of 50 or higher, and 83 percent
of them believed that high-SPF sunscreens provide an additional
margin of safety.
When advising patients on how to choose sunscreen, 99 percent of
dermatologists recommend looking at the SPF level and checking for
broad spectrum protection, while 71 percent also counsel patients to
consider how it looks or feels.
One topic the majority of dermatologists don’t broach with patients
is what’s known as photostability, or UV filters that work in
sunlight. Certain sunscreen ingredients, including avobenzone and
octinoxate, can be unstable and become ineffective in sunlight,
previous research has shown.
This is tricky to discuss with patients, though, because there’s no
meaningful way for consumers to assess photostability when they’re
choosing sunscreens, said Dr. David Leffell, a dermatology
researcher at Yale School of Medicine in New Haven, Connecticut, who
wasn’t involved in the study.
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“Photostability is always somewhat of an issue but the technology
has improved especially for broad spectrum sunscreens,” Leffell said
by email. “I recommend they go with a recognized brand.”
Beyond its small size, limitations of the study include the
possibility that some participants may have provided survey
responses they thought were desirable instead of reflecting their
actual beliefs, the authors note in JAMA Dermatology.
It’s possible, too, that the minority of dermatologists who said
they didn’t believe regular sunscreen use lowers the risk of skin
cancer did so not because they think it’s a bad idea, but because
they think patients need to take additional steps to protect
themselves, said Dr. Elizabeth Martin, who wasn’t involved in the
study.
“The data are clear that daily sunscreen use can cut the incidence
of melanoma, the deadliest form of skin cancer, in half,” Martin, a
researcher at the University of Alabama at Birmingham School of
Medicine and president of Pure Dermatology and Aesthetics in Hoover,
Alabama, said by email.
“Perhaps when considering their response, this small number of
dermatologists recognized that applying sunscreen is only one part
of an overall comprehensive sun protection plan, which also includes
seeking shade and wearing protective clothing,” she said.
SOURCE: http://bit.ly/2dDamUq JAMA Dermatology, online October 19,
2016.
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