The UV protective qualities of clothing are measured through a UPF (ultraviolet protection factor) scale.
Most authorities recommend clothing and headwear which offers UPF 50+ to be worn during hot Australian weather. Ever increasing selections of swimwear and summer wear are showing UPF 50+ on their labels. Unlike SPFs, the UPFs in clothing remain constant because they only wash or wear off over months of laundering the material.
A broad brimmed hat is recommended to give a level of protection, especially to the ears and neck, not possible with caps. Legionnaire-style headwear also offers a higher level of protection.
The general rule with clothing is the more skin you cover, the better protected you are likely to be. However if you stand in the sun for instance as long as a cricket umpire it is imperative that everything you wear is UPF 50+.
For optimum UV protection for the eyes wear large, wrap-around sunglasses with polarised lenses. The glasses should be worn all the time in the sun to protect against a range of short term eye complaints and irritations. Long term exposure to UV radiation can cause permanent eye damage as well as skin cancer of the eyelids and other areas around the eyes.
Shadecloth and Staying in the Shade
The simple rule is to stay out of the sun as much as possible during the daylight saving period of 11am to 3pm and 10am to 2pm for the rest of the year.
Stay in the shade when the sun is at its strongest and spread shadecloth over those outdoor areas where the family spends summer leisure time at home.
Getting skin checked by dermatologist
Watch on as we head to the Skin & Cancer Foundation Australia to have my skin checked by dermatologist, Dr Hanna Kuchel.
Measures for Special Groups
Skin is more susceptible to UV radiation damage up to the age of 18. It is no exaggeration to claim that much of the premature skin ageing and skin cancers experienced in later life are set in train during the early years.
It is critical to protect babies comprehensively as their skin is the most vulnerable of all. Children need to be set a daily UV protection routine just as much as they need teeth cleaning and personal hygiene routines.
People with fair skin, with existing skin diseases such as acne need to take extra care and to follow UV protection measures with absolute rigour.
Changes of season obviously mark changes of emphasis in UV personal protection programmes.
In Australia UV radiation is simply not as intense from April to August as it is for the rest of the year. The extra clothing worn during those months gives further added protection.
However especially on sunny days the use of a sunscreen is recommended year round. There is hardly a day that goes by when UV radiation does not threaten some acceleration in skin ageing or bringing forward the time when skin cancer appears. It should always be kept in mind that clouds block out the sun but not UV radiation.
Skin Protection Guide
- Choose a sunscreen offering SPF 30+ and broad spectrum protection and water resistant for at least two hours. The product should be photostable.
- Apply the sunscreen in sufficient quantity to benefit from the maximum protection level it offers. Apply one dab (teaspoonful) to seven body points – head/neck, both shoulders/arms, back, torso and the top of both legs – prior to spreading. Fully effective coverage demands around 35mls.
- Apply a sunscreen fifteen minutes before sun exposure. Re-apply every two hours and immediately after swimming.
- Wear clothing and swimwear offering UPF 50+ protection. Cover up as much of the body as possible.
- Choose broad-brimmed hats and legionnaire style headwear rather than caps offering UPF 50+ protection.
- Choose wrap-around sunglasses with polarised lenses.
- Stay in the shade or under shadecloth when the sun is at its strongest between 11am and 3pm during daylight saving and between 10am and 2pm during the rest of the year. Remember that whilst cloud blocks out sunlight it does not block UV radiation.
It is vital, especially in Australia, to have a lifelong protection routine which limits your skin’s exposure to the UV radiation in sunlight. The deleterious effects of UV radiation exposure are cumulative throughout your life meaning that the main cause of skin cancer in later life can often date back to childhood, when the skin is most susceptible to UV radiation damage.
Personal protection routines should comprise use of sunscreens, wearing sun protective clothing, head-wear and eyewear, making optimum use of areas protected by shade or shadecloth and staying out of the sun as much as absolutely possible during its periods of maximum intensity. eg. 10am - 3pm.
Solabrella - Beach Umbrella
A beach umbrella like no other! The Solabrella is an Australian sun protection product for the long hot summer ahead. Australians love to enjoy the outdoors in the summer but with well established concerns over the effects of skin damage, we need to make sure that we protect ourselves and our families from the effects of the sun.
Solariums emit ultraviolet radiation (UVR); both UVA and UVB which contribute to skin cancer. Risk is increased with increased exposure whether the UVR is from the sun or from artificial sources such as solariums, sunbeds or sunlamps. Therefore the Skin & Cancer Foundation Australia does not support cosmetic tanning under any circumstances.
SPF Labelling and Nano Technology in Sunscreens
In Australia the labelling of sunscreen products differs depending on whether the product is a primary or secondary sunscreen product. A primary sunscreen product is one that represents itself on the label as being primarily to protect the skin from the sun's harmful rays. This differs from a secondary sunscreen product which may have some sunscreen properties but has another primary function such as being a moisturiser or a make-up. Secondary sunscreens can only claim a maximum SPF of 15+. Any product labelled SPF 30+ is a primary sunscreen.
There are different labelling requirements for primary and secondary sunscreens. Primary sunscreens are considered to be therapeutic goods and are regulated as medicines under the Therapeutic Goods Act 1989 and must comply with the Therapeutic Goods Labelling Order, The Therapeutic Goods Advertising Code and the Australia/New Zealand Standard AS/NZS 2604:1998 3.
Currently sunscreen products sold in Australia are required to show the sun protection factor on their label with a numerical value not greater than 30+ and clear/adequate directions for the use of the product. The name of all active ingredients must also be stated on the sunscreen including its broad spectrum and water resistance properties as well as the expiry date and storage conditions based on stability data to be shown on the container. The expiry date for sunscreens is usually one to two years but varies among manufacturers depending on the chemical constituents used.
The current Australian sunscreen standard (AS/NZS 2604:1998 'Sunscreen products - Evaluation and classification') limits the maximum protection claimed on labelling of sunscreen products to SPF 30+. This means that SPF 30+ is the highest rating that can be used for labelling sunscreen products in Australia. However this standard is currently under review and it is likely that the new standard will be in line with a new international or ISO standard and will allow higher SPF claims to be made.
Most people do not apply enough sunscreen to achieve the SPF rating on the label. There are concerns therefore that if labelling sunscreen with a higher SPF, the consumer may be likely to use less sunscreen and reapply less regularly so that the sunscreen protection becomes less effective even though it has a higher SPF number. It is important to remember that no matter how high the SPF some of the sun-burning radiation does get through.
Zinc oxide and titanium dioxide are visible when used in sunscreens, which gives the skin a white colour when applied. Nanotechnology breaks down these ingredients to minute particles so that when used in sunscreens they virtually disappear but still help effectively shield us from harmful rays. Nanoparticles of titanium dioxide and zinc oxide are routinely used in many sunscreens now for sale in Australia.
Concerns of nanoparticles in sunscreen relate to the theoretical possibility that if nanoparticles enter the human body through the lungs, skin or intestinal tract it is a concern to human health. Nanoparticles could possibly be absorbed into skin cells in people with eczema or acne or other conditions where the skin is damaged and the skins natural barrier function is not in tact. It is also possible that the particles can interact with sunlight to further increase the risk of damage to these cells.
There are many products that use nanotechnology which are already in our homes. A few examples include: clothing and material made of wrinkle, stain and odour resistant fabric, cosmetics and toiletries with nano-oxides of iron, aluminium, zirconium, silicon and manganese, and sunscreens with nanoparticles of titanium dioxide and/or zinc oxide for more transparent UV protection, teeth cleaners, toothpaste, condoms, wound dressings, dummies and other baby products with nanosilver. But whether the particles in sunscreens pose direct health risks to humans depends mainly on whether they penetrate the protective outer layers of dead skin. Studies suggest they do not reach live tissue under normal circumstances and has not shown any long term adverse effects from using sunscreens in humans. However, there is little research into the impact of these substances when the protective outer skin layers are damaged.
The TGA conducted a review which concluded that:
- The potential for titanium dioxide and zinc oxide nanoparticles in sunscreens to cause adverse effects depends primarily upon the ability of the nanoparticles to reach viable skin cells; and
- To date, the current weight of evidence suggests that titanium dioxide and zinc oxide nanoparticles do not reach viable skin cells; rather, they remain on the surface of the skin and in the outer layer of the skin that is composed of non-viable cells.
The Australian Medicines Evaluation Committee endorsed this conclusion.
The TGA is continuing to monitor the emerging scientific literature to ensure appropriate action is taken should any tangible safety concerns be identified and to date, mandatory labelling of nanoparticles in sunscreens has not been introduced anywhere in the world. The TGA does not require any specific warnings about nanoparticles to be placed on labels of sunscreens.
In Australia, all active ingredients, such as zinc oxide and titanium dioxide, must be declared on sunscreen labels, to help consumers make informed choices. However, it is not currently a requirement for sunscreen labels to declare the particle size of the active ingredients.
In general it is advisable to take a cautious approach particular in using preparations containing nanoparticles on skin where the protective surface is damaged.
It is well-established that ultraviolet radiation (i.e. the ‘harmful’ sun rays) from our environment are a major cause of skin damage, skin cancers and premature ageing of the skin. Sunscreens along with other sun-protection measures such as wearing protective clothing (long sleeves, rash shirts, hats and sun glasses) and seeking shade during the times of the day when the suns rays are at their most intense, are the most important tools in halting these effects.
A large trial conducted during the 1990s in Queensland demonstrated that daily sunscreen use can reduce the risk of developing melanoma (Green et al., 2011). Other non-melanoma skin cancers (including basal cell carcinoma and squamous cell carcinoma) are also related to high cumulative sun exposure and using daily sunscreen can also lessen the risk of developing these cancers.
Sunscreen is the most effective anti-ageing product. It helps to decrease the development of wrinkles, discoloured skin (poikiloderma, freckles/lentigos) and other signs of photo-ageing. Sunscreen is tested rigorously to ensure it meets high standards. Moisturisers and foundations may contain ‘SPF’ (sun protection factor), but these may not provide adequate protection.
Your sunscreen should be:
- Broad spectrum – cover against UVB and UVA. The ‘SPF’ number relates to the UVB cover, the sunscreen label should state that UVA cover is also high.
- High factor. You should be using at least SPF30 daily, ideally SPF50+.
- Not referred to as a ‘block’, no sunscreen completely blocks out the suns rays.
For sunscreens to give the greatest benefit they must be used correctly. Sunscreen should be applied:
- Daily. Sunscreen should be part of the every-day routine and not only be used on beach days. In Australia, sunscreen must be considered in the winter months too. Even if it is cloudy or a cooler day, the skin can be exposed to strong UV rays. The UV index demonstrates the strength of these rays on real time basis. Check the UV index to see how strong the suns rays are at a particular day or time, there are many phone apps which make this quick and easy. Careful sun protection measures should be employed when the UV index is 3 and above.
- Generously. Many studies have shown that people usually use too little sunscreen. When we do this, the SPF 50+ sunscreen might only be working as a SPF10-15. As a general rule, to cover your whole body you should use 35ml of sunscreen per application.
- Reapply. Do this according to the manufacturer’s instructions. Different products have different stability and therefore different reapplication times. Most require reapplication every 2-4 hours. Reapplication also has the advantage of covering parts initially missed.
- Store your sunscreen out of direct sunlight and hot conditions. Protective effects can lessen if stored incorrectly.
- Discard old sunscreens. Sunscreens have a ‘use by date’ and will loose their protective ability over time, check the date. Older products may not have use by dates, if it’s been sitting in a cupboard for a number of years throw it out and start again!
At The Skin Hospital
You can talk to any of our specialists at The Skin Hospital about sun protection. The Skin hospital/Skin and Cancer Foundation endorses a number of quality sun protection products including hats, sun shades and sunscreens. (Link to Skin and Cancer Foundation shop/ our partners.)
Link to UV index and sun protection app via The Australian Bureau of Meteorology:
Link to information on sun sunscreens and sun protection from other trusted websites:
Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol 2011; 29: 257–263.
Authors: Dr Charlotte Thomas & Dr Nicholas Stewart, last updated 18 September 2015
UVA - major contributor to skin cancer
UVA and UVB are the harmful sunrays that reach our earth’s surface. UVB rays are largely absorbed by the outer skin layers and are responsible for causing sunburn. Greater amounts of UVA rays however penetrate deeper into the skins living layers and are also highly damaging. UVA induced skin damage can occur without the skin burning. UVA is responsible for causing accelerated ageing of the skin (photoageing).
Recent research has highlighted an increasingly important role for UVA in the causation of skin cancer, not just UVB.* UVA also reduces the skin’s ability to identify and destroy early skin cancers. In families prone to skin cancer, UVA has been shown to have a greater suppressive affect on their skin's immune system, resulting in the development of more and more skin cancers over time. This is a particularly important issue for patients on immunosuppressive therapies following organ transplant.
Many Sunscreens on the Australian Market do not adequately protect against UVA rays. Sunscreens contain UV absorbing ingredients, which protect you against the sun's harmful rays. Unfortunately, the UV-absorbing ingredients of many sunscreens on the market are not photostable, particularly at UVA wavelengths. This instability causes some sun protective ingredients to degrade with sun exposure, thus reducing UV protection. This degradation can begin to happen within just one hour of application. To be sure you are protecting your skin in an adequate way; you need to use a photostable broad-spectrum sunscreen.
Increased UVA toxicity in a range of common skin and medical disorders means those individuals particularly require sunscreens with a high level of UVA protection. If you are using over the counter and prescription treatment products for acne or rosacea including retinoids, benzoyl peroxide, and salicylic acid, along with those on tetracycline antibiotics, metronidazole or isotretinoin for example have greatly increased sensitivity to UVA. This similarly occurs with many other antibiotics including the quinolones, sulphonamide anti-microbials, along with diuretics, anti-arrhythmics particularly amiodarone, and chemotherapeutic agents including the new targeted TKI’s such as erlotanib. Anyone using any of these agents from Spring to Autumn must also use a sunscreen providing a high level of UVA protection. Ask your doctor for a recommendation if you are unsure.
The importance of UVB for vitamin D production by the skin also emphasizes the benefits of more balanced sun protective products that do not provide far greater UVB than UVA protection. Studies increasingly link low vitamin D levels with a number of internal risks including cancer.
Ultraviolet A within sunlight induces mutations in the epidermal basal layer of engineered human skin,Huang XX, Bernerd F, Halliday GM. Am J Pathol 2009 Apr;174(4):1534-43.