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inSHAPE:

Compiled by Tracy Knox Photos courtesy of CANSA

Hooray, spring's finally back. It's time to head outdoors and work on transforming our now pallid bodies into bronzed sculptures with sunscreen on of course! But with all the hype around sunscreens and their effectiveness just recently, maybe we shouldn't be too quick to shed the layers just yet.

Are Sunscreen Products Safe? www.doitnow.co.za • 1


Research commissioned by the Cancer Association of South Africa (CANSA) showed that some SA sunscreen brands do not offer optimal UVA protection. All of the brands tested by CANSA complied with the local SANS sunscreen standard, but CANSA said that recent research rendered that standard insufficient because it didn’t give protection against 'extreme' (longer) UVA rays. The COLIPA Standard, a testing method involving pre-irradiation (heating the sunscreen before testing it) is now required in Europe and has been incorporated into new ISO standards. CANSA says the Colipa standard is the most stringent test currently in use – while the ISO standard should be incorporated in the local SANS standard by next year.

Some local sunscreens do not comply with the Colipa standard as it is not compulsory by local standards. This means that when we use some sunscreens we are not adequately protected against dangerous UVA rays, which contribute to skin cancer. CANSA came under fire for not releasing the names of the inadequate sunscreens because 1. It signed a confidentiality agreement with the laboratory that ran the tests. 2. The test results were not representative of the whole industry i.e. 35 products tested out of 357 listed locally. 3.  The number of platelets used per test was scaled down to contain costs – was more than sufficient for our probe – but not for product certification. However, CANSA has, as undertaken, published the list of compliant products on its website on 3 September. More certified products will be added to this list as and when submitted to CANSA for publication. A cancer survivor herself, CANSA CEO, Sue Janse van Rensburg, has the interests of cancer survivors and the public at heart. "The public has always been CANSA's number one priority, and as CANSA is a cancer watchdog, we want to ensure that we stay abreast of the latest developments and research in the field of cancer research and control. CANSA feels that the public should not merely have adequate protection in terms of sunscreen, but have the absolute best possible protection. That is the extent of CANSA's commitment to the South African public and that is why CANSA commissioned these tests." 

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So don't be put off by the current publicity and still use sunscreens - preferably 30 to 50 SPF with both UVA and UVB protection and apply generously every 2 to 3 hours. Still apply the other SunSmart principles of avoiding direct sunlight between 10:00 and 15:00 as well as wear protective clothing and hats.

Q&A

CANSA'S RESPONSES TO THE UVA CONCERNS RAISED Q: Can the public trust the CANSA Seal of Recognition? A: Yes. Since 2005 all sunscreens with the CANSA Seal of Recognition (CSOR) had to be broad-spectrum, i.e. give protection against UVA and UVB radiation in a ratio of 0.4/1. Recent research however, has found an increased correlation between UVA exposure and the onset of malignant melanoma, as well as non-optimal UVA protection provided by existing sunscreens in terms of the total UVA radiation spectrum and the photo stability of many critical sunscreen chemicals - leading to a worldwide demand for sunscreen with improved UVA protection properties. In response, an International Standard (ISO) for sunscreen UVA protection was developed and published for comment on 1 June 2012 - this ISO standard should be incorporated in a new South African Standard within the next year and will form part of the CANSA Seal Requirements to become effective from 01 April 2013. Products qualifying for the new harmonised Colipa UVA protection claim will also be required to exhibit the new CANSA SunSmart Choice Seal, replacing the original CANSA Seal of Recognition to differentiate between the former and latter formulations.

New CANSA SunSmart Seal of Recognition

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Q: Waiting for April 2013 for clarity is far too long. The summer is upon us now and we must know what to choose. A:  As per the SunSmart principles mentioned, choose a sunscreen with UVA and UVB protection and SPF of preferably 30 to 50. As part of our responsibility towards the public as cancer watchdog - CANSA will only release objective and comprehensive information enabling the public to make informed Smart choices. CANSA called on all manufacturers within the industry to forward their information to info@CANSA. org.za and work together. Therefore as of Monday 3 September 2012, a list was made available on the CANSA website, indicating the names of all sunscreens currently adhering to the EU Colipa standards and will be regularly updated upon validation of received certification.

è Click to view the list of current SEAL – bearing sunscreens Q: Why is CANSA withholding information on the Colipa test results? A:  CANSA has never been inclined to withhold information regarding health risk to the public. On the contrary, CANSA has always followed a policy of transparency and our research findings have always been published on our website and integrated into our health awareness promotional material. However, being less than 10% of all listed products, the test outcome was not designed for publication, consumer reference and/or as a sunscreen purchasing guide. The test results have been used in ongoing discussions between CANSA and the sunscreen industry and form the basis of negotiations motivating for changes and/or product improvements required to provide local consumers with optimal sunscreen protection at affordable prices. It’s also true that we were given no choice and had to agree not to disclose any results or else we would not have been able to get these tests done and thus use results as intended - to put pressure on the industry to meet EU standards which is compulsory by end March 2013. There was no public benefit in disclosing the results of the sample test - whilst the majority of merchandised sunscreens still remain untested in terms of the said EU standard. More so as many manufacturers have already been upping their owns standards before and since the tests were done, some as a result of CANSA’s continued one-on-one negotiations.

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Q: How will CANSA ensure that manufacturers comply with the new standard? A:  Although CANSA has no power to enforce sunscreen manufacturers to increase the UVA absorbing capacity of their products, we will withdraw the Seal from those currently bearing our Seal, if not complying to Colipa standards by March 2013. While the SABS develops standards for sunscreen in South Africa, the industry remains self-regulatory, with no one enforcing the law. Registration with the Cosmetic, Toiletry and Fragrance Association of South Africa (CTFA) is voluntary and infringement of SABS and/ or CTFA regulations until very recent - with the advent of the Consumer Protection Act (CPA) - could only be complained about by brand competitors and lodged with the ASA (Advertising Standards Authority) and corrected voluntarily by the offending party. Q: Will further tests be done on other sunscreens? A: The onus lies with sunscreen manufacturers to provide valid certification documentation of compliance to Colipa standards in order for them to qualify for the CANSA SunSmart Choice Seal by end March 2013. Those certified, will be added to the current list already available on the CANSA website. As a non-profit organisation, CANSA is financially severely restricted. However, we welcome and support any initiative and efforts to encourage the testing of all sunscreens available in South Africa.

IT'S A FACT

Did you know that skin cancer is one of the most common high risk cancers in South Africa? Skin cancer is caused by the sun, in particular by exposure of the skin to UVA and UVB radiation. Southern Africa has one of the highest monitored levels of ultraviolet radiation, only equalled by Australia, New Zealand and some parts of South America.

WHAT YOU SHOULD KNOW ABOUT SUNSCREEN Who needs sunscreen?

In a word: Everyone! Everyone is at risk of getting skin cancer, although people with darker skins are less susceptible because their skin contains more natural melanin that protects against sun damage. People with fair skin, especially those with red hair, moles or skin spots, as well as people with a personal or family history of skin cancer, or who play sport outdoors, work in the sun or spend a lot of time driving, are considered high risk.

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At least 80% of sun-induced skin damage occurs before the age of 18 and only manifests later in life. Therefore it is imperative to take special care of children in the sun, whether it is at the pool, on the beach, at play or at school. Babies younger than one year should never be exposed to direct sunlight. When it comes to protecting the young ones, mothers of babies and toddlers; educators and caregivers play an important role. When it comes to sunbeds and tanning booths, CANSA has recommended that the Department of Health ban sunbeds and sunlamps as it has been proven through recent research findings that there is a relationship between the use of sunbeds and malignant melanoma, as well as other non-melanoma skin cancers. Sunbeds predominantly emit UVA and UVB both which can cause damage in the DNA of skin cells. Sunbeds and tanning booths deliver concentrated UVA radiation to unprotected skin and should be avoided at all costs, as it ages skin more rapidly, while putting you at risk of developing skin cancer.

Spot the Spot

Check your skin carefully every month and ask a family member or friend to examine your back and the top of your head. If you notice any of the warning signs, see a doctor or dermatologist immediately.

Warning signs

A-symmetry - a mole or mark with one half Unlike the other - common moles are round and symmetrical B-order irregularities - scalloped or poorly defined edges - common moles have smooth and even borders Colour variations and inconsistency - tan, brown, black, red, white and blue - common moles are usually a single shade of brown or black Diameter - larger than 6 mm

What are sunscreens?

Sunscreens are products combining several ingredients that help prevent the sun's ultraviolet (UV) radiation from reaching the skin. Two types of ultraviolet radiation, UVA and UVB, damage the skin and increase your risk of skin cancer. Sunscreens vary in their ability to protect against UVA and UVB.

What are UVA and UVB?

Ultraviolet (UV) radiation is part of the electromagnetic (light) spectrum that reaches the earth from the sun. It has wavelengths shorter than visible light, making it invisible to the naked eye. Ultraviolet A (UVA) is the longer wave UV ray that causes lasting skin damage, skin aging, and can cause skin cancer. Ultraviolet B (UVB) is the shorter wave UV ray that causes sunburns, skin damage, and can cause skin cancer.

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What is SPF?

SPF – or Sun Protection Factor - is a measure of a sunscreen's ability to prevent UVB from damaging the skin. Here's how it works: If it takes 5 to 10 minutes for your unprotected skin to start turning red, using an SPF 20 sunscreen theoretically prevents reddening 20 times longer - about 1 hour 40 minutes to 3 hours 20 minutes (on average 2 hours). Most sunscreens with an SPF of 20 or higher do an excellent job of protecting against UVB.

What does broad- spectrum mean?

Broad-spectrum sunscreens protect the skin from both UVA and UVB rays. The current South African standard makes provision for protection against UVA and UVB radiation in a ratio of 0.4/1. Recent research however, has found an increased correlation between UVA exposure and the onset of malignant melanoma, as well as nonoptimal UVA protection provided by existing sunscreens in terms of the total UVA radiation spectrum and the photo stability of many critical sunscreen chemicals - leading to a worldwide demand for sunscreen with improved UVA protection properties. To qualify for the CANSA Seal in future, all products manufactured after 31 March 2013 will have to comply (in addition to the existing CSOR Requirements) with the new Harmonized Colipa UVA Protection Claim - and ultimately with a new ‘SANS 1557: 2012/13 Standard’ which makes provision for a UVA and UVB radiation protection in a ratio of at least 0.33/1.

Does sunscreen expire?

Unless indicated by an expiration date, the EU standard requires that all sunscreens be stable and at their original strength for three years. CANSA advises that no sunscreen should be used for more than one year after being opened for use.

TO PREVENT SKIN CANCER, CANSA ADVOCATES THE FOLLOWING:

• Avoid direct sunlight between 10 a.m. and 3 p.m.; when the sun's rays are most dangerous. • UV rays reflect off cement, water, sand, glass and grass and can cause sunburn in the shade. You can also get overexposed in cool weather - so take care on windy or overcast days. • Cover up by wearing hats with wide brims and loose fitting clothes, made of tightly-woven, fabric that is cool, but will block out harmful UV rays. Look out for UV protective swimsuits and beach wear as UV radiation can penetrate fabric. Swimwear and umbrellas should also be part of your protection kit. • Always apply sunscreen with a Sun Protection Factor (SPF) of a minimum of 20 and not higher than 50, to all exposed skin areas, preferably one bearing the CANSA Seal. Re-apply regularly (at least every two hours), after towel-drying, perspiring or swimming. Apply it liberally to all exposed skin; including the back of the neck, tips of ears, arms, feet and hands. The use of sunscreen lotion is not a license to 'bare all' in the sun. Go under cover whenever possible, to ensure that you are sun smart while out in the sun. • Protect your eyes by wearing sunglasses with a UV protection rating of UV400. • Use lip balm with a minimum of SPF 20 and apply regularly. • Avoid sunlamps and tanning parlours, especially if under 18 years old. • Take special care to protect children - babies younger than one year should never be exposed to direct sunlight. • Check your skin regularly for changes, unusual marks or moles. Source: The Cancer Association of South Africa (CANSA) – link to http://goo.gl/zrdTV with all latest info and sunscreens.

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Most Recent SA Skin Cancer Statistics as per National Cancer Registry (2004): Group

Type of Skin Cancer

Number of Cases

Lifetime Risk

All Males

Basal Cell Carcinoma

6 370

1 : 18

Asian Males

25

1 : 272

Black Males

269

1 : 303

Coloured Males

652

1 : 15

White Males

5 425

1:5

All Females

4 484

1 : 37

Asian Females

34

1 : 159

Black Females

216

1 : 584

Coloured Females

457

1 : 30

White Females

3 777

1:9

2 742

1 : 42

Asian Males

12

1 : 231

Black Males

264

1 : 312

Coloured Males

277

1 : 32

White Males

2 190

1 : 12

All Females

1 791

1 : 94

Asian Females

13

1 : 307

Black Females

214

1 : 554

Coloured Females

175

1 : 83

White Females

1 389

1 : 25

745

1 : 164

Asian Males

2

1 : 1 971

Black Males

98

1 : 872

Coloured Males

58

1 : 164

White Males

588

1 : 43

All Females

760

1 : 229

Asian Females

6

1 : 928

Black Females

159

1 : 660

Coloured Females

81

1 : 209

White Females

513

1 : 60

All Males

All Males

Squamous Cell Carcinoma

Melanoma

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