sunbathing advice

Last reviewed 01/2018

The sunbather is in danger of potentially serious damage to their skin. Common sense dictates that the following warnings should be given:

• those who burn easily should be advised to use a preparation with a high Sun Protection Factor, i.e. 15 or more
• darker individuals can use suncreems with a lower SPF, i.e. a minimum of 10
• simple lotions are best for normal skin, while moisturizing oils and creams are more suitable for dry skin
• water resistant emulsions are advisable for swimming and water sports
• children and sensitive parts of the body, e.g. back and scalp regions, warrant extra care
• the individual should be advised to acclimatize gradually and to avoid exposure between the hours of 11am and 3pm when the sun is at its most intense

The sun protection factor

• the higher the factor the greater the protection provided against the burning rays of the sun (ultraviolet B)

The star rating

• the more stars there are the better the level of protection against the aging rays of the sun (ultraviolet A). The maximum protection available is five stars.

Using your suncream

• You should wear a sunscreen that protects you against both UVA and UVB.
• Photosensitive patients should use an SPF of 30 or higher combined with a four or five star rating.
• Sunscreens should be worn by all when the weather is bright and sunny, but photosensitive patients may need to wear then throughout the year, even when the light is dim.
• Sunscreens should be applied thickly and evenly.
• Application of sunscreen should become part of your daily routine: sunscreen should be applied following your morning wash and then re-applied regularly throughout the day as it is easily removed from the skin surface.
• You should aim to re-apply your sunscreen every two to three hours, especially if you have been swimming

How to minimise the risks and maximise the benefifits of sunlight exposure (3)

People need to be aware of the following:

• how daily exposure to sunlight can affect their skin and why it is important to protect it. Unless someone has a very dark skin type, they should protect their skin when out in strong sunlight for more than a short period of time, both in the UK and abroad
• the UV index provides an indicator of the sun's strength for a given location, date and time. This information, combined with skin type and behaviour, can be used to assess someone's risk of sunburn. The Met Office provides daily information on UV levels in the UK
• when possible, only a limited amount of time should be spent in strong sunlight. It is preferable to spend more time in the shade
• people who choose to expose their skin to strong sunlight to increase their vitamin D status should be aware that prolonged exposure (for example, leading to burning or tanning) is unlikely to provide additional benefit
• exposing commonly uncovered areas of skin such as forearms and hands, for short periods when in strong sunlight provides vitamin D. (Longer periods of exposure may be needed for those with darker skin.)
• protection from the sun can be achieved by covering up with suitable clothing, seeking shade and applying sunscreen. Suitable clothing includes: a broad-brimmed hat that shades the face, neck and ears, a long-sleeved top, and trousers or long skirts in close-weave fabrics that do not allow sunlight through. It also includes sunglasses with wraparound lenses or wide arms (to provide side protection) that have the CE Mark (an indication that they meet the relevant European Standard - at the time of publication this was EN 1836:2005)
• because many young people and adults will have experienced sunburn, they can use this experience to:
  • know what their skin looks like normally and how it reacts to sunlight
  • know how long they can be exposed without risking sunburn and how to protect their skin accordingly
• skin that is not usually exposed to sunlight (for example, the back, abdomen and shoulders) is particularly likely to burn, so extra care is needed

Advice according to people's skin type (3)

People with genetically darker skin (skin types V and VI) are at relatively lower risk of burning and, therefore, skin cancer. But they are at higher risk of vitamin D deficiency in the UK. This means:

• they may need more time in sunlight to produce the same amount of vitamin D as people with lighter skin
• generally they can be exposed for longer before risking sunburn and skin cancer, but should not get to the point where their skin is likely to burn
• they need advice on vitamin D supplements

People with naturally very light skin or fair or red hair or freckles (skin types I and II):

• do not need much time in the sun (less than the time it takes them to burn) to produce vitamin D
• are at greater risk of sunburn and skin cancer - including after shorter periods of exposure than people with darker skins.

Reference:

• 1) Ratnavel, R.C. & Norris, P.G. (1993). Sunscreens and their medical uses. Prescribers' Journal, 33(2), 63-71.
• 2) Salford Royal NHS Foundation Trust (Accessed 8/6/14). Sun Protection.
• 3) NICE (February 2016).Sunlight exposure: risks and benefits