Prepared to make sunscreen recommendations?

Here’s everything pharmacists need to know to help patients with sun care needs this season

With the sheer number of sunscreen products available and the bewildering terms that appear on the bottle, most consumers struggle to know what product to use to protect their skin from the sun. One might choose a sunscreen on the basis of its skin protection factor (SPF), but other terms on sunscreen labels—such as broad-spectrum and water resistant—can add confusion.

As a result of a 2011 FDA ruling, labels on sunscreen products must provide consumers with information about the type of UV protection in the product and what it can do. For pharmacists who interact regularly with patients in the community setting, helping patients decipher this information as well as providing counseling on general sun safety are necessary.

Current recommendations urge consumers to purchase sunscreen products that are broad-spectrum, meaning they can protect against both UVA and UVB rays and help prevent skin cancer and sunburn. Sunscreen should also be water resistant. If the label says “very water resistant,” the product is effective for up to 80 minutes in the water. Otherwise, water resistant means it will work for up to 40 minutes in water before reapplication is needed.

FDA banned sunscreen manufacturers from claiming a sunscreen is “waterproof” or “sweat proof” after it determined those terms were misleading. Consumers also should use a sunscreen product that’s SPF 30 or higher.

“Most patients know they need to get a high SPF, ideally 30, but I don’t think they actually know how to use an SPF in their sun care,” said Cortney Mospan, PharmD, BCACP, BCGP, assistant professor of pharmacy at Wingate University School of Pharmacy in Wingate, NC. The SPF is a measure of how long patients can be in the sun before they start to burn with the sunscreen applied.

For example, with an SPF 30 sunscreen, a person who usually stays in the sun for 10​​ minutes before starting to burn can prolong that time to approximately 300 minutes. However, all recommendations stress that sunscreen—regardless of the SPF calculation—should be applied every 2 hours. And sunscreen should always be reapplied immediately after swimming or sweating.

SPF offers protection from UVB rays (there is currently no standard for measuring UVA protection). The American Academy of Dermatology (AAD) defines UVB rays as the burning rays, which are the primary cause of sunburn. These are different from UVA rays, which can prematurely age skin and cause wrinkles and age spots.

FDA requires sunscreen products that are SPF 15 or lower and are not broad-spectrum to carry a warning that reads: “Skin Cancer/Skin Aging Alert: Spending time in the sun increases your risk of skin cancer and early skin aging. This product has been shown only to help prevent sunburn, not skin cancer or early skin aging.”

Sonali G. Kshatriya, PharmD, manager of clinical program development at a Walgreens in Illinois, along with Walgreens beauty consultant Chris-Anne Ayers, agreed that the needs and preferences of individual patients must be considered with sun protection. Age, skin type, hormones, allergies, and medications that cause photosensitivity (see chart) can all have an impact on how skin will respond to the sun.

Kshatriya and Ayers also said that patients are more likely to adhere to a sunscreen product if the texture, absorbability, and fragrance are cosmetically appealing to them. Walgreens recently partnered with the Skin Cancer Foundation to provide training to its pharmacists and beauty consultants, who work alongside each other.

According to a 2016 study in JAMA Dermatology looking at the number of top-rated sunscreen products (which did not adhere to AAD criteria) sold on Amazon.com, researchers concluded that consumers prefer products that don’t leave a residue and are not greasy or too thick—findings that support previously published literature.

Mospan noted that some new products have entered the market that seem to address these concerns. For instance, mousse and whipped products are now available, which are likely designed with cosmetic appeal in mind.

“There are also more and more stick formulations to improve application ease, and the ever-popular sprays,” said Mospan. “What is key here is to make sure that patients apply enough of these products and still rub them in well enough to avoid streaking.” For individuals with sensitive skin, Mospan said consumers should use sunscreens with zinc oxide and titanium dioxide, which are thicker and may be more difficult to apply.

SPF is also making its way into everyday cosmetic products like makeup, chapstick, and moisturizing lotions—which isn’t a bad thing.

Tara Whetsel, PharmD, BCACP, BC-ADM, a clinical associate professor at West Virginia University School of Pharmacy, said most people don’t realize that everyday sun exposure also puts them at risk of skin cancer and early skin aging. In fact, on cloudy days, up to 80% of the sun’s harmful UV rays can penetrate a person’s skin, according to AAD. UVA rays can also permeate glass, leaving people in cars vulnerable. And snow, sand, and water increase the need for scrupulous sun protection because they reflect the sun’s rays.

For the full article, please visit www.pharmacytoday.org for the June 2018 issue of Pharmacy Today.