5 mins
Shielding skin
Ms Olivia McCabe-Robinson outlines the nuances of sunscreen types to help you protect your patients’ skin with the product that suits them best
MS OLIVIA MCCABE-ROBINSON
Ms Olivia McCabe-Robinson trained as a surgeon in the NHS before moving to focus full-time on aesthetics while studying for her Biomaterials PhD. She is an aesthetics trainer for SkinViva Academy and is the lead for the North West Aesthetics Research Group which drives her science-based approach. She is also the clinical director of Dr Olivia Medispa, in Glossop, Derbyshire.
The sun’s rays have the potential to be extremely dangerous to the skin, and damage is caused when the skin is exposed to ultraviolet (UV) radiation. Two types of UV rays cause damage to the skin: UVA and UVB.1 These damage the skin in different ways, but the overall effect is that patients present to clinic with:
• Fine lines and wrinkles
• Age spots and pigmentation
• Loss of skin elasticity
• Pre-malignant/malignant skin lesions.2
UVA rays penetrate deep into the skin, reaching the dermis.3 The UVA rays themselves are specifically associated with premature ageing, such as fine lines, wrinkles, and age spots. UVA rays always impact the skin throughout the day and can even penetrate through clouds and glass.4 There is a particularly famed case regarding a man who spent his life driving lorries, where one side of his face was very sun damaged due to sun exposure through the driver-side window (UVA rays), while the other side had aged significantly better.5
UVB rays tend to only affect the outer layer of the skin, the epidermis. They are the main culprit for sunburn, and they play a key role in the development of skin cancers.6 UVB rays differ from UVA rays in that they tend to be more intense during the peak sunshine hours (typically 11am- 3pm).7 Luckily, for us, we have sunscreen!
Ideally, sunscreen should protect against UVA and UVB rays which would then deem it the gold standard ‘broad-spectrum’ sunscreen.8 My advice on how to use sunscreen that I share with my patients is:
• To use a broad-spectrum sunscreen of at least SPF 30, but ideally, SPF 50 every day, even in winter
• Apply as their last layer of skincare, before makeup9
• Apply two lengths of the finger for the face and neck and two tablespoons for the remainder of the body.10
Other key general preventative advice that I give my patience is:
• Avoid the sun between peak hours and wear protective clothing such as hats and sunglasses11
• Regularly check and take photos of the skin and any pigmented lesions or visit their local healthcare professional to have a formal skin map completed.12
DIFFERENT TYPES OF SUNSCREENS
There are different types of sunscreens: chemical and mechanical, and it is important to understand how they work, to ensure your patient is compliant with use daily.
CHEMICAL SUNSCREEN
Chemical sunscreens are also known as organic or synthetic sunscreens. They work by containing chemical compounds (avobenzone octocrylene or oxybenzone) that absorb the UV rays and transform them into heat, which is then released from the skin, without causing damage to the skin itself.13 Chemical sunscreen tends to be easier to apply and offers a more transparent finish, therefore it tends to be preferable for use underneath make-up.14 It is important to note that patients with skin sensitivities and allergies will not tolerate chemical sunscreen well, due to irritation from the chemical components within them.15 With the focus firmly on environmental damage in today’s day and age, it is important to highlight that the chemicals contained within chemical-type sunscreens are associated with coral reef damage. Mechanical sunscreens on the other hand are considered ‘reef safe’.16
MECHANICAL SUNSCREEN
Mechanical sunscreen is also known as physical or mineral sunscreen. It works by creating a physical barrier on top of the skin that reflects and scatters any UV rays that land on it, preventing these rays from penetrating the skin and causing damage. The main two active ingredients contained in mechanical sunscreens are zinc oxide and titanium dioxide.13 Physical sunscreen tends to be gentler on the skin, making it more suited for sensitive skin suffering from rosacea, eczema, psoriasis or allergies.15
Another great feature is that it provides immediate protection on application, which makes it great for small children and babies.17 The downside is that it often has a much thicker and chalky consistency, which makes it much harder to blend underneath everyday makeup.18 Although both sunscreens are safe in pregnancy, some expectant mothers prefer to use products with as few chemicals in as possible and therefore may prefer a physical sunscreen during their carrying months.19
To minimise sun damage and the effect of ageing is imperative all year round. As a clinician, choosing an appropriate product and offering accurate advice is often key to ensuring compliance with daily use by your patient. Ultimately, there will always be a personal preference based on the patient’s enjoyment of the texture, the finish, the application, or skin sensitivities, therefore, taking a medical history including a skin history, and educating your patient on the options available, makes it more likely that you will pick the right product for them.
REFERENCES
1. UV Radiation: skincancer.org/risk-factors/uv-radiation/ (accessed 10/3/24)
2. L. Rittie, G. Fisher, Natural and Sun Induced Aging of Human Skin, 2015 Jan; 5(1) accessed 10/3/24)
3. J. D’Orazio, S. Jarrett, UV Radiation and the Skin (accessed 10/3/24)
4. What’s the difference between UVA and UVB Rays: mdanderson.org/publications/focused-on-health/what-s-the-difference-between-uva-and-uvb-rays-.h15-1592991. html, (accessed 10/3/24)
5. Trucker accumulates skin damage on left side of his face after 28 years on the road: cbsnews.com/news/trucker-accumulates-skin-damage-on-left-side-of-his-faceafter-28-years-on-the-road/ (accessed 10/3/24)
6. How does the sun and UV cause cancer: cancerresearchuk.org/about-cancer/causes-of-cancer/sun-uv-and-cancer/how-does-the-sun-and-uv-causecancer#:~:text=UVB%20reaches%20the%20outer%20layer,but%20contributes%20 less%20towards%20sunburn. (accessed 10/3/24)
7. Sunburn: nhsinform.scot/illnesses-and-conditions/injuries/skin-injuries/sunburn/ (accessed 10/3/24)
8. What is broad spectrum sunscreen: colorescience.com/blogs/blog/what-is-broadspectrum-sunscreen#:~:text=By%20definition%2C%20broad%2Dspectrum%20 sunscreen,(ultraviolet%20B%20radiation)%20rays. (accessed 10/3/24)
9. Does sunscreen or makeup go on first: drbaileyskincare.com/blogs/blog/doessunscreen-or-makeup-go-on-first, (accessed 10/3/24)
10. S. Taylor, B. Diffey: ncbi.nlm.nih.gov/pmc/articles/PMC1123459/, (accessed 10/3/24)
11. Sunscreen and sun safety: nhs.uk/live-well/seasonal-health/sunscreen-and-sunsafety/, (accessed 10/3/24)
12. Everything you need to know about mole mapping: kingedwardvii.co.uk/health-hub/everything-you-need-to-know-about-mole-mapping, (accessed 10/3/24)
13. The difference between physical and chemical sunscreen: piedmont. org/living-real-change/the-difference-between-physical-and-chemicalsunscreen#:~:text=Chemical%20sunscreen%20absorbs%20into%20the,and%20 reflects%20the%20sun%27s%20rays. (accessed 10/3/24)
14. Mineral vs Chemical Sunscreen: Which One You Should Use, According to Derms: byrdie.com/natural-sunscreen-chemical-sunscreen#:~:text=Clear%3A%20 Chemical%20sunscreens%20are%20typically,sunscreens%20than%20with%20 physical%20sunscreens. (accessed 10/3/24)
15. Chemical vs Physical Sunscreens: wilmingtonskinsurgerycenter.com/blog/chemicalvs-physical-sunscreens/#:~:text=Physical%20Sunscreens%20are%20Less%20 Irritating,or%20those%20with%20sensitive%20skin. (accessed 10/3/24)
16. About reef-safe sunscreen: savethereef.org/about-reef-save-sunscreen.html (accessed 10/3/24)
17. The 411 on sunscreen: charlestondermatology.com/the-411-on-spf-chemicalsunscreen-vs-physical-sunscreen/#:~:text=Physical%20sunscreens%20 provide%20immediate%20protection,who%20need%20immediate%20sun%20 protection. (accessed 10/3/24)
18. Chemical vs Physical Sunscreen: lifejacketskin.com/blogs/lifejournal/chemicalvs-physical-sunscreen#:~:text=Physical%20sunscreens%20also%20absorb%20 UV,heavy%20although%20this%20is%20improving. (accessed 10/3/24)
19. Sunscreen pregnancy: healthline.com/health/pregnancy/sunscreenpregnancy#:~:text=It%27s%20best%20to%20avoid%20chemical,mineral%20 sunscreens%20while%20breastfeeding%20too. (accessed 10/3/24)
