(Last Updated On: December 13, 2018)
Authors: Pearl Weena Marie E. Sabido, MD, FPDS

Abstract

• In the past, photoprotection focused on preventing damage from ultraviolet radiation (UVR).
• In 2012, the US FDA released regulations for sunscreen labeling, ensuring protection against both UVA and UVB.
• Patients are advised to use a broad spectrum sunscreen with a sun protection factor (SPF) of at least 30. This is to be applied daily,
at least 15 minutes before sun exposure, in amounts equivalent to 2mg/cm2, in combination with appropriate photoprotective
behavior. Sunscreens should be reapplied every 2 hours or after swimming or excessive sweating.
• While sunscreens have faced issues regarding safety in terms of hypersensitivity, toxicity, carcinogenicity and environmental
impact, they are still considered safe to use due to the lack of evidence to support the claimed hazards.
• Within the last decade, emerging evidence points to visible light and infrared contributing to skin damage.
• Oral and systemic agents have been tapped into as photoprotective agents to complement topical sunscreens and photoprotective
behavior. They have not been proven to work as monotherapy.
• Enzymes and proteins that repair skin damage due to UVR, visible light and infrared are also under development.
• Active photoprotection is a combination of photoprotective behavior, as well as topical and systemic sunscreens that protect
against UVR, visible light and infrared while repairing sun-induced skin damage

Citation

Sabido, PWM. (2017). Photoprotection: Review and Updates. Journal of the Philippine Dermatological Society, 26(2), 11-17

 

Keywords

Photoprotection, UV, Ultraviolet Radiation

 

1. Baron E, Suggs AK. Introduction to photobiology. Dermatol Clin. 2014; 32:255-66.
2. Bulat V, Situm M, Dediol I, Ljubicic I, Bradic Ll. The mechanisms of action of phototherapy in the treatment of the most common dermatoses. Coll Antropol 2011 Sep; 35 Suppl 2:147-51.
3. Wilson BD, Moon S, Armstrong F. Comprehensive review of ultraviolet radiation and the current status on sunscreens. J Clin Aesthet Dermatol. 2012; 5(9):18-23.
4. Hoel DG, Berwick M, de Grujil FR, Holick MF. The risks and benefits of sun exposure 2016. Dermatoendocrinol. 2016 Jan-Dec; 8(1):e1248325.
5. Gorman S, Lucas RM, Allen-Hall A, Fleury N, Feelisch N. Ultraviolet radiation, vitamin D and the development of obesity, metabolic syndrome and type-2 diabetes. Photochem Photobiol Sci. 2017 Mar 16; 16(3):362-73.
6. Fleury N, Geldenhuys S, Gorman S. Sun exposure and its effects on human health: Mechanisms through which sun exposure could reduce the risk of developing obesity and cardiometabolic dysfunction. Int J Environ Res Public Health. 2016 Oct 11; 13(10).
7. Young AR, Claveau J, Rossi AB. Ultraviolet radiation and the skin: Photobiology and sunscreen photoprotection. J Am Acad Dermatol. 2017 Mar; 76(3S1):S100-S109.
8. Philippine Dermatological Society Health Information Systems. Philippine Dermatological Society. c2011 [updated 06.08.2017; cited 11.2017]. Available by request from: pdshis@outlook.com.
9. Jou PC, Feldman RJ, Tomecki KJ. UV protection and sunscreens: What to tell patients. Cleve Clin J Med. 2012 Jun; 79(6):427-36.
10. Osterwalder U, Herzog B. Chemistry and properties of organic and inorganic UV filters. In: Lim HW & Draelos ZD, editors. Clinical guide to sunscreens and photoprotection. New York: Informa Healthcare USA, Inc. 2009; p.11-38.
11. Skotarczak K, Osmola-Mankowska A, Lodyga M, Polanska A, Mazur M, Adamski Z. Photoprotection: facts and controversies. Eur Rev Med Pharmacol Sci. 2015 Jan; 19(1):98-112.
12. Food and Drug Administration, HHS. Labeling and effectiveness testing; sunscreen drug products for over-the-counter human use; delay of compliance dates. Final rule; delay of compliance dates; request for comments. Fed Regist. 2012 May 11; 77(92):27591-3.
13. Draelos ZD, Lim HW, Rougier A. Sunscreens and photodermatoses. In: Lim HW & Draelos ZD, editors. Clinical guide to sunscreens and photoprotection. New York: Informa Healthcare USA, Inc. 2009; p.83-8.
14. American Academy of Dermatology. How to apply sunscreen. Retrieved from https://www.aad.org/public/spot-skin-cancer/learn-about-skin-cancer/prevent/ how-to-apply-sunscreen. 09 August 2017.
15. American Academy of Dermatology. Sunscreen FAQs. Retrieved from https://www. aad.org/media/stats/prevention-and-care/sunscreen-faqs. 09 August 2017.
16. Tuchinda C, Lim HW. Photoprotection by glass. In: Lim HW & Draelos ZD, editors. Clinical guide to sunscreens and photoprotection. New York: Informa Healthcare USA, Inc. 2009; p.243-55.
17. Lim HW, Arellano-Mendoza MI, Stengel F. Current challenges in photoprotection. J Am Acad Dermatol. 2017 Mar; 76(3S1):S91-S99.
18. Heurung AR, Raju SI, Warshaw EM. Adverse reactions to sunscreen agents: epidemiology, responsible irritants and allergens, clinical characteristics, and management. Dermatitis. 2014 Nov-Dec; 25(6):289-326.
19. Warshaw EM, Wang MZ, Maibach HI, Belsito DV, Zug KA, Taylor JS, et al. Patch test reactions associated with sunscreen products and the importance of testing to an expanded series: retrospective analysis of North American Contact Dermatitis Group data, 2001 to 2010. Dermatitis. 2013 Jul-Aug; 24(4):176-82.
20. Beleznay K, de Gannes G, Kalia S. Analysis of the prevalence of allergic contact dermatitis to sunscreen: a cohort study. J Cutan Med Surg. 2014 Jan-Feb; 18(1):15-9.
21. de Groot AC, Roberts DW. Contact and photocontact allergy to octocrylene: a review. Contact Dermatitis. 2014 Apr; 70(4):193-204.
22. Okereke CS, Barat SA, Abdel-Rahman MS. Safety evaluation of benzophenone-3 after dermal administration in rats. Toxicol Lett 1995 Oct;80(1-3):61-7.
23. American Academy of Dermatology. Is sunscreen safe? Retrieved from https://www. aad.org/public/spot-skin-cancer/learn-about-skin-cancer/prevent/is-sunsceensafe. 24 August 2017.
24. Chen T, Yan J, Li Y. Genotoxicity of titanium dioxide nanoparticles. J Food Drug Anal. 2014 Mar; 22(1):95-104.
25. Kwon JY, Koedrith P, Seo YR. Current investigations into the genotoxicity of zinc oxide and silica nanoparticles in mammalian models in vitro and in vivo: carcinogenic/ genotoxic potential, relevant mechanisms and biomarkers, artifacts, and limitations. Int J Nanomedicine. 2014 Dec 15; 9 Suppl 2:271-86.
26. Kim KB, Kim YW, Lim SK, Roh TH, Bang DY, Choi SM. Risk assessment of zinc oxide, a cosmetic ingredient used as a UV filter of sunscreens. J Toxicol Environ Health B Crit Rev. 2017; 20(3):155-182.
27. Osmond-McLeod MJ, Oytam Y, Rowe A, Sobhanmanesh F, Greenoak G, Kirby J, et al. Long-term exposure to commercially available sunscreens containing nanoparticles of TiO2 and ZnO revealed no biological impact in a hairless mouse model. Part Fibre Toxicol. 2016 Aug 17; 13(1):44.
28. Bratkovics S, Wirth E, Sapozhnikova Y, Pennington P, Sanger D. Baseline monitoring of organic sunscreen compounds along South Carolina’s coastal marine environment. Mar Pollut Bull. 2015 Dec 15; 101(1):370-7.
29. Li Y, Qiao X, Zhou C, Zhang YN, Fu Z, Chen J. Photochemical transformation of sunscreen agent benzophenone-3 and its metabolite in surface freshwater and seawater. Chemosphere. 2016 Jun; 153:494-9.
30. Vesper I. (2017, Feb 03). Hawaii seeks to ban ‘reef-unfriendly’ sunscreen. Nature. Retrieved from https://www.nature.com/news/hawaii-seeks-to-ban-reefunfriendly-sunscreen-1.21332. 24 August 2017.
31. Grether-Beck S, Marini A, Jaenicke T, Krutmann J. Photoprotection of human skin beyond ultraviolet radiation. Photodermatol Photoimmunol Photomed. 2014 AprJun; 30(2-3):167-74.
32. Grether-Beck S, Marini A, Jaenicke T, Krutmann J. Effective photoprotection of human skin against infrared A radiation by topically applied antioxidants: results from a vehicle controlled, double-blind, randomized study. Photochem Photobiol. 2015 Jan-Feb; 91(1):248-50.
33. Parrado C, Mascaraque M, Gilaberte Y, Juarranz A, Gonzalez S. Fernblock (Polypodium leucotomos extract): Molecular mechanisms and pleiotropic effects in light-related skin conditions, photoaging and skin cancers, a review. Int J Mol Sci. 2016; 17(1026):1-21.
34. Aguilera P, Carrera C, Puig-Butille JA, Badenas C, Lecha M, Gonzalez S, et al. Benefits of oral Polypodium leucotomos extract in MM high risk patients. J Eur Acad Dermatol Venereol. 2013 Sep; 27(9):1095-1100.
35. Megna M, Lembo S, Balato N, Monfrecola G. “Active” photoprotection: sunscreens with DNA repair enzymes. G Ital Dermatol Venereol. 2017 Jun; 152(3):302-307.
36. Zhang M, Wang L, Zhong D. Photolyase: Dynamics and Mechanisms of Repair of Sun-Induced DNA Damage. Photochem Photobiol. 2017 Jan; 93(1):78-92.
37. Carducci M, Pavone PS, De Marco G, Lovati S, Altabas V, Altabas K, et al. Comparative Effects of Sunscreens Alone vs Sunscreens Plus DNA Repair Enzymes in Patients With Actinic Keratosis: Clinical and Molecular Findings from a 6-Month, Randomized, Clinical Study. J Drugs Dermatol. 2015 Sep; 14(9):986-90.
38. Navarrete-Dechent C, Molgo M. The use of a sunscreen containing DNA-photolyase in the treatment of patients with field cancerization and multiple actinic keratoses: a case-series. Dermatol Online J. 2017 Jan 15; 23(1).
39. Habbema L, Halk AB, Neumann M, Bergman W. Risks of unregulated use of alphamelanocyte-stimulating hormone analogues: a review. Int J Dermatol. 2017 Mar 7. doi: 10.1111/ijd.13585. [Epub ahead of print].
40. Langendonk JG, Balwani M, Anderson KE, Bonkovsky HL, Anstey AV, Bissell DM, et al. N Engl J Med. 2015 Jul 2; 373(1):48-59.
41. Haylett AK, Nie Z, Brownrigg M, Taylor R, Rhodes LE. Systemic photoprotection in solar urticaria with α-melanocyte-stimulating hormone analogue [Nle4-D-Phe7]α-MSH. Br J Dermatol. 2011 Feb; 164(2):407-14.

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