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WELL Duquesne University Mylan School of Pharmacy



from the Pharmacy Care Awareness Program

May-August 2003

Staying Safe Under the Sun


s flowers begin to bloom and temperatures rise, more people will turn to fun in the sun for relaxation and recreation. Despite the abundance of warnings about the hazards of over-exposure to the sun, large numbers of people continue to subject themselves to short and long-term negative health consequences. Excessive exposure to ultraviolet radiation emanating from the sun may lead to minor problems like sunburn and premature aging or to more serious consequences such as skin cancer. It is not realistic to recommend that one completely avoid the sun, but it is important to use proper protection. Protective clothing is best, such as long pants, long-sleeved shirt, a brimmed hat and proper sunglasses. One of the most popular and effective methods of protecting oneself from sun damage is the application of sunscreen.

Ultraviolet Radiation Sun damage, most notably sunburn, is caused by ultraviolet radiation (UVR). The ultraviolet spectrum can be broken into two bands: UVB and UVA. Ultraviolet B (UVB) radiation is the most active wavelength for producing redness, which is why it is called sunburn radiation. UVB is also considered primarily responsible for wrinkling, collagen damage and inducing skin cancer. The most intense concentration of UVB may be experienced from 10 a.m. to 3 p.m. Ultraviolet A (UVA) radiation penetrates deeper into the skin than UVB, thus causing more serious damage to the underlying tissue, including sagging of the skin, premature aging and thickening of the epidermis. In addition, UVA radiation may trigger herpes simplex labialis (cold sores) as well as produce a reaction in those who have taken photosensitiz-

ing agents (such as some antibiotics, diuretics, blood pressure medications, oral contraceptives, etc.). Contrary to popular belief, cloud cover filters very little UVR. In fact, 70 to 80 percent of ultraviolet radiation will penetrate the clouds. Fresh snow reflects 85 to 100 percent of UVR,

Upcoming Events Mark Your Calendar MAY – Skin Cancer Awareness Month • May 14, 2003, 11:30 a.m. - 12:30 p.m. Blood Pressure Check-Up • May 28, 2003, 11:30 a.m. - 12:30 p.m. Blood Pressure Check-Up

All events take place in the Center for Pharmacy Practice, Room 432 Mellon Hall, unless otherwise stated.

JUNE • June 4, 2003, 12 p.m. - 12:50 p.m. “Here Comes the Sun! Enjoy it Safely!” Frequently asked questions about sunscreens and medication-induced sun sensitivity Christine O’Neil, Pharm.D., BCPS • June 11, 2003, 11:30 a.m. - 12:30 p.m. Blood Pressure Check-Up • June 25, 2003, 11:30 a.m. - 12:30 p.m. Blood Pressure Check-Up

JULY • July 2, 2003, 12 p.m. - 12:50 p.m. “Deciphering the Unknowns of Your Prescription Drug Benefit” Shane Desselle, Ph.D. • July 9, 2003, 9 a.m. – 12 p.m. Derma-View Screening Blood Pressure Check-Up • July 23, 2003, 11:30 a.m. - 12:30 p.m. Blood Pressure Check-Up AUGUST • August 13, 2003, 11:30 a.m. - 12:30 p.m. Blood Pressure Check-Up • August 27, 2003, 11:30 a.m. - 12:30 p.m. Blood Pressure Check-Up

Call x1093 to RSVP for screenings and lunchtime lectures.

explaining why a skier can receive a significant sunburn even on a cloudy day, and thus should use a sunscreen. Water reflects no more than 5 percent of UVR, causing the remaining 95 percent to penetrate and burn the swimmer. Wet clothes themselves allow transmission of approximately 50 percent of ultraviolet radiation. Although UVB does not penetrate window glass, UVA does. People sensitive to UVA, such as those taking some photosensitizing drugs, should use appropriate sunscreens even when driving with the window closed.

Sunscreen Basics When the amount of exposure to the sun exceeds the ability of the body’s pigment to protect the skin, a sunscreen is needed. Sunscreens come in a variety of forms such as lotions, gels and sprays. They work by both absorbing and blocking the transmission of UVR to the skin or by reflecting and scattering UVR. The degree of protection that sunscreen offers is related to a term called sun protection factor (SPF). The higher the SPF, the more effective the sunscreen is in preventing sunburn. If it normally takes a person 60 minutes to experience a bright red sunburn, a sunscreen with an SPF of 6 will allow that person to stay in the sun six times longer (or 6 hours) before receiving the same sunburn (assuming the sunscreen is reapplied at recommended intervals).

How Much is Enough? Major causes of poor sun protection are inadequate and infrequent application of sunscreen. Sunscreen should be applied liberally to face and body 15 to 30 minutes before sun exposure. Water-resistant products should be reapplied every 40 minutes and every 90 minutes for waterproof formulations. Experts generally recommend selecting a product with an SPF of 15 or greater with application every two hours. However, the most controversial issue dealing with SPF is the debate about whether products with an SPF greater than 30 offer any advantage to users. The FDA has responded by stating that an SPF of 30 provides adequate protection for all skin types, including those with systemic lupus (a UVR induced disorder). Products with an SPF greater than 30 may be marketed, but will appear with the labeling of “30+” only. Another important factor when selecting a sunscreen is its ability to remain effective during prolonged exercising, sweating and swimming. In general, the products that are cream-based appear more resistant to removal by water. Oil based products are the easiest to

apply but they tend to have lower SPF values. If a product is said to be water resistant it will retain its SPF for at least 40 minutes. A product labeled very water resistant will retain sun protection for at least 80 minutes.

Risk Factors and Product Choices Although over-exposure is dangerous to all people, some people are more susceptible to UVR and should avoid sun exposure as much as possible. People with the following characteristics need to be especially careful: fair skin that always burns and never tans; blonde or red hair; blue, green, or gray eyes; a history of freckling; patients taking immunosuppressive drugs; and current use of a photosensitizing drug. Always check with your pharmacist to see if any of the medication that you take can be a photosensitizing agent. There are different sunscreen recommendations for different types of people. Babies and infants six months of age and older should be covered with sunscreen on all exposed areas, including lips, ears, the top of the head where there is no hair or very thin hair, nose and bony surfaces. Children tend to spend a lot of time outside which increases their need for a good sunscreen. Creams and lotions are best for young skin; this also applies to people with dry skin. Teens that have acne-prone skin would benefit from using a gel or alcohol based sunscreen product. Adults and the elderly need to be especially careful in the sun because aging skin loses the ability to repair damage done by sun exposure.

Newsletter Contributors

The consistent use of sunscreen, especially in childhood, could help prevent 80 percent of all skin cancers. The sunscreen must be applied properly as outlined above and used in conjunction with other sun protection measures such as protective clothing. It is important to remember that sunscreen should be used to protect against normal sun exposure, not to prolong it. For more information on sunscreens, visit the following Web sites:

Tanning and Burning A tan is produced when ultraviolet radiation stimulates melanocytes (pigment producing cells) in the skin layer to produce more melanin. The melanin eventually moves towards the outer layers of the skin and becomes visible as a tan. Tanning is the body’s natural defense mechanism to protect the skin against burn. Sunburn is most often seen as a first-degree (superficial) burn. It causes reactions such as mild redness or tenderness, pain and swelling. Severe reactions to excessive UVR exposure may produce a second-degree burn characterized by the development of blisters as well as symptoms of fever, chills, weakness or shock.

A publication of the Duquesne University Mylan School of Pharmacy

John G. Lech, Pharm.D. Danielle M. Nath, Pharm.D. Candidate Mandi N. Palumbo, Pharm.D. Candidate

Pharmacy Care Awareness Program (PCAP) & Pharmaceutical Information Center (PIC) Additional information on any of the topics discussed may be obtained from the Pharmaceutical Information Center by calling 412-396-4600 or sending an e-mail to Questions about screenings or programs: Christine O’Neil, Pharm.D, B.C.P.S. 412-396-6417 05/03 1.5M DIH