Advances in sun protection

A friend of mine forwarded a recent letter published in The Times on protective sun screening, and a response from Dr Michael Boffa.

I must compliment the newspaper and the writers for these informative and positive contributions. As people in the developed world grow much older today, the incidence of skin cancer is rising, especially in those individuals with lighter skin tones. The decreasing ozone layer, popularity of outdoor sport, less conservative fashions in clothing and the unfortunate legacy of Madame Coco Chanel (the fashionable tan) all contributing to this growing ogre.

Clothes, including hats, need to be sufficiently dense not to let the light through, or should be specially manufactured to withstand ultra violet light. People who have exposure to sunlight through glass tend to forget that most types of glass in general use do not screen out UVA, which in cumulative dosages is responsible for the development of skin cancer over extended periods of time.

For instance, people who drive a great deal in their cars will have continuous and much exposure on their hands and arms to the damaging UVA rays unless the exposed skin is well covered up by UV-resistant material or a sunscreen that will reflect the harmful rays away from the skin.

The SPF factor is unfortunately a misleading index in that it is an indicator of how much longer a person can be exposed to sunlight with the sunscreen on, compared to the time before burning without the sunscreen on. The factor does unfortunately not equate to how well DNA is protected against the cumulative damage that results from repeated exposures. A further concern stems from recent publications which indicate that the molecules used in sunscreens to absorb the light energy may be turned into free radicals by the very process of absorption.

In fact UVA remains the biggest unsolved problem as only the reflectors found in some sunscreens (zinc oxide and titanium dioxide) are able to keep UVA at the 390 to 400nm wavelengths out. These reflectors are unfortunately opaque and many people find them cosmetically less than desirable to apply.

The other advance apparent is that inclusion of sufficient concentrations of anti-oxidants may well be directly protective of the DNA. This practice has become a standard in a unique South African product designed by Desmond Fernandes, an eminent international authority on the repair of sun damaged skin. He is very clear on the approach that sensible exposure to enough sunlight with suitable protection requires common sense and diligent use of all protective measures including a mostly reflective sunscreen formulated with ample anti-oxidants. This should be done against the background of skin well protected by high doses of vitamin A and the "central anti-oxidants", vitamin C and E. This is a unique approach known as Advanced Vitamin Skin Therapy or AVST.

It is only when such a multi-factorial protection approach to sun exposure is followed, that light-skinned people will really protect themselves from an increased risk of skin cancer during their much longer lives, whilst enjoying the outdoors and the benefits of adequate sun exposure.