Avoiding the Hazards of Ultraviolet Light in the Adolescent Population
Main Article Content
Keywords
UV light, Skin Cancer, adolescents, sun protection, tanning
Abstract
Exposure to UV light remains the major modifiable risk factor for skin cancer. Studies have shown that adolescents do not adequately use sun protection and frequently engage in tanning behaviors. This article will reinforce the known approaches to avoiding the hazards of UV light and provide tips and tricks that health care providers should emphasize to their adolescent patients.
References
1. Fisher, G. J., Wang, Z., Datta, S. C., Varani, J., Kang, S., & Voorhees, J. J. (1997). Pathophysiology of Premature Skin Aging Induced by Ultraviolet Light. New England Journal of Medicine, 337(20), 1419-1429. doi:10.1056/nejm199711133372003
2. Gilchrest, B., & Yaar, M. (1992). Ageing and photoageing of the skin: Observations at the cellular and molecular level. British Journal of Dermatology, 127(S41), 25-30. doi:10.1111/j.1365-2133.1992.tb16984.x
3. Yaar, M., Eller, M. S., & Gilchrest, B. A. (2002). Fifty Years of Skin Aging. Journal of Investigative Dermatology Symposium Proceedings, 7(1), 51-58. doi:10.1046/j.1523-1747.2002.19636.x
4. Fisher, G. J., Kang, S., Varani, J., Bata-Csorgo, Z., Wan, Y., Datta, S., & Voorhees, J. J. (2002). Mechanisms of Photoaging and Chronological Skin Aging. Archives of Dermatology, 138(11). doi:10.1001/archderm.138.11.1462
5. Media Centre - IARC News. (n.d.). Retrieved from https://www.iarc.fr/en/media-centre/iarcnews/2009/sunbeds_uvradiation.php
6. Green, A. C., Wallingford, S. C., & Mcbride, P. (2011). Childhood exposure to ultraviolet radiation and harmful skin effects: Epidemiological evidence. Progress in Biophysics and Molecular Biology, 107(3), 349-355. doi:10.1016/j.pbiomolbio.2011.08.010
7. Miller, D. L., & Weinstock, M. A. (1994). Nonmelanoma skin cancer in the United States: Incidence. Journal of the American Academy of Dermatology, 30(5), 774-778. doi:10.1016/s0190-9622(08)81509-5
8. Mackie, R. M., & Aitchison, T. (1982). Severe sunburn and subsequent risk of primary cutaneous malignant melanoma in scotland. British Journal of Cancer, 46(6), 955-960. doi:10.1038/bjc.1982.307
9. Zanetti, R., Franceschi, S., Rosso, S., Colonna, S., & Bidoli, E. (1992). Cutaneous melanoma and sunburns in childhood in a Southern European population. European Journal of Cancer, 28(6-7), 1172-1176. doi:10.1016/0959-8049(92)90480-p
10. Diffey, B., & Cheeseman, J. (1992). Sun protection with hats. British Journal of Dermatology,127(1), 10-12. doi:10.1111/j.1365-2133.1992.tb14816.x
11. Coyne, E. Q., Lichtman, M. K., Simons, J., Sarkar, A. K., & Rünger, T. M. (2018). In vitro assessment of the broad-spectrum ultraviolet protection of clothing. Journal of the American Academy of Dermatology, 79(2), 373-375. doi:10.1016/j.jaad.2017.12.078
12. Linos, E., Keiser, E., Fu, T., Colditz, G., Chen, S., & Tang, J. Y. (2011). Hat, shade, long sleeves, or sunscreen? Rethinking US sun protection messages based on their relative effectiveness. Cancer Causes & Control, 22(7), 1067-1071. doi:10.1007/s10552-011-9780-1
13. Gambichler, T., Hatch, K. L., Avermaete, A., Altmeyer, P., & Hoffmann, K. (2002). Influence of wetness on the ultraviolet protection factor (UPF) of textiles: In vitro and in vivo measurements. Photodermatology, Photoimmunology and Photomedicine, 18(1), 29-35. doi:10.1034/j.1600-0781.2002.180105.x
14. Montague, M., Borland, R., & Sinclair, C. (2001). Slip! Slop! Slap! and SunSmart, 1980-2000: Skin Cancer Control and 20 Years of Population-Based Campaigning. Health Education & Behavior,28(3), 290-305. doi:10.1177/109019810102800304
15. Hughes, M., Williams, G., Baker, P., & Green, A. (2013). Sunscreen and Prevention of Skin Aging. Annals of Internal Medicine, 158(11). doi:10.7326/0003-4819-158-11-201306040-00001
16. Center for Drug Evaluation and Research. (n.d.). Understanding Over-the-Counter Medicines - Questions and Answers: FDA announces new requirements for over-the-counter (OTC) sunscreen products marketed in the U.S. Retrieved from https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/understandingover-the-countermedicines/ucm258468.htm
17. Center for Drug Evaluation and Research. (n.d.). Consumer Updates - Sunscreen: How to Help Protect Your Skin from the Sun. Retrieved from https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm239463.htm
18. Norris, J. F. (1996). Sunscreens, suntans, and skin cancer. Bmj, 313(7062), 941-942. doi:10.1136/bmj.313.7062.941d
19. Ekstein, N. (2018, July 19). This Bizarre Sunscreen Booth Is Driving Cocktail Sales at Hotel Pools. Retrieved from https://www.bloomberg.com/news/articles/2018-07-19/this-bizarre-sunscreen-booth-is-driving-cocktail-sales-at-hotel-pools
20. Sambandan, D. R., & Ratner, D. (2011). Sunscreens: An overview and update. Journal of the American Academy of Dermatology, 64(4), 748-758. doi:10.1016/j.jaad.2010.01.005
21. UVA & UVB. (n.d.). Retrieved from https://www.skincancer.org/prevention/uva-and-uvb
22. Heurung, A. R., Raju, S. I., & Warshaw, E. M. (2014). Adverse Reactions to Sunscreen Agents: Epidemiology, Responsible Irritants and Allergens, Clinical Characteristics, and Management. Dermatitis, 25(6), 289-326. doi:10.1097/der.0000000000000079
23. Monteiro-Riviere, N. A., Wiench, K., Landsiedel, R., Schulte, S., Inman, A. O., & Riviere, J. E. (2011). Safety Evaluation of Sunscreen Formulations Containing Titanium Dioxide and Zinc Oxide Nanoparticles in UVB Sunburned Skin: An In Vitro and In Vivo Study. Toxicological Sciences,123(1), 264-280. doi:10.1093/toxsci/kfr148
24. Cross, S. E., Innes, B., Roberts, M. S., Tsuzuki, T., Robertson, T. A., & Mccormick, P. (2007). Human Skin Penetration of Sunscreen Nanoparticles: In-vitro Assessment of a Novel Micronized Zinc Oxide Formulation. Skin Pharmacology and Physiology, 20(3), 148-154. doi:10.1159/000098701
25. Foley, P., Nixon, R., Marks, R., Frowen, K., & Thompson, S. (1993). The frequency of reactions to sunscreens: Results of a longitudinal population-based study on the regular use of sunscreens in Australia. British Journal of Dermatology, 128(5), 512-518. doi:10.1111/j.1365-2133.1993.tb00227.x
26. Final Report on the Safety Assessment of Urocanic Acid. (1995). Journal of the American College of Toxicology, 14(5), 386-423. doi:10.3109/10915819509083599
27 Schneider, L. S., & Lim, W. H. (2018). Review of environmental effects of oxybenzone and other sunscreen active ingredients. Journal of the American Academy of Dermatology
28. PDF. (n.d.). South Florida, Hawaii, U.S. Virgin Islands, American Samoa: National Park Service U.S. Department of the Interior.
29. Jung, K., Seifert, M., Herrling, T., & Fuchs, J. (2008). UV-generated free radicals (FR) in skin: Their prevention by sunscreens and their induction by self-tanning agents. Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy, 69(5), 1423-1428. doi:10.1016/j.saa.2007.09.029
30. O’Leary, R. E., Diehl, J., & Levins, P. C. (2014). Update on tanning: More risks, fewer benefits. Journal of the American Academy of Dermatology, 70(3), 562-568. doi:10.1016/j.jaad.2013.11.004
31. Pagoto, S. L., Schneider, K. L., Oleski, J., Bodenlos, J. S., Merriam, P., & Ma, Y. (2009). Design and methods for a cluster randomized trial of the Sunless Study: A skin cancer prevention intervention promoting sunless tanning among beach visitors. BMC Public Health, 9(1). doi:10.1186/1471-2458-9-50
32. Garone, M., Howard, J., & Fabrikant, J. (2015). A Review of Common Tanning Methods. The Journal of Clinical Aesthetic Dermatology, 8(21), 43-47.
33. Barsh, G., & Attardi, L. (n.d.). A Healthy Tan? The New England journal of medicine., 356(21), 2208–2210. doi:10.1056/NEJMcibr071775
34. Mahler, H. I., Kulik, J. A., Gerrard, M., & Gibbons, F. X. (2007). Long-term effects of appearance-based interventions on sun protection behaviors. Health Psychology, 26(3), 350-360. doi:10.1037/0278-6133.26.3.350
35. Tuong, W., & Armstrong, A. W. (2014). Effect of appearance-based education compared with health-based education on sunscreen use and knowledge: A randomized controlled trial. Journal of the American Academy of Dermatology, 70(4), 665-669. doi:10.1016/j.jaad.2013.12.007
36. Hillhouse, J., & Turrisi, R. (2002). Examination of the efficacy of an appearance-focused intervention to reduce UV exposure. Journal of behavioral medicine., 25(4), 395–409. doi:10.1023/A:1015870516460
37. Mahler, H. I., Kulik, J. A., Gibbons, F. X., Gerrard, M., & Harrell, J. (2003). Effects of appearance-based intervention on sun protection intentions and self-reported behaviors. Health Psychology,22(2), 199-209. doi:10.1037//0278-6133.22.2.199
38. Brinker, T. J., Faria, B. L., Gatzka, M., Faria, O. M., Heppt, M. V., Kirchberger, M. C., . . . Bernardes-Souza, B. (2018). A skin cancer prevention photoageing intervention for secondary schools in Brazil delivered by medical students: Protocol for a randomised controlled trial. BMJ Open, 8(3). doi:10.1136/bmjopen-2017-018299
39. Armstrong, A., Watson, A., Makredes, M., Frangos, J., Kimball, A., & Kvedar, J. (n.d.). Text-Message Reminders to Improve Sunscreen Use. Archives of dermatology., 145(11). doi:10.1001/archdermatol.2009.269
2. Gilchrest, B., & Yaar, M. (1992). Ageing and photoageing of the skin: Observations at the cellular and molecular level. British Journal of Dermatology, 127(S41), 25-30. doi:10.1111/j.1365-2133.1992.tb16984.x
3. Yaar, M., Eller, M. S., & Gilchrest, B. A. (2002). Fifty Years of Skin Aging. Journal of Investigative Dermatology Symposium Proceedings, 7(1), 51-58. doi:10.1046/j.1523-1747.2002.19636.x
4. Fisher, G. J., Kang, S., Varani, J., Bata-Csorgo, Z., Wan, Y., Datta, S., & Voorhees, J. J. (2002). Mechanisms of Photoaging and Chronological Skin Aging. Archives of Dermatology, 138(11). doi:10.1001/archderm.138.11.1462
5. Media Centre - IARC News. (n.d.). Retrieved from https://www.iarc.fr/en/media-centre/iarcnews/2009/sunbeds_uvradiation.php
6. Green, A. C., Wallingford, S. C., & Mcbride, P. (2011). Childhood exposure to ultraviolet radiation and harmful skin effects: Epidemiological evidence. Progress in Biophysics and Molecular Biology, 107(3), 349-355. doi:10.1016/j.pbiomolbio.2011.08.010
7. Miller, D. L., & Weinstock, M. A. (1994). Nonmelanoma skin cancer in the United States: Incidence. Journal of the American Academy of Dermatology, 30(5), 774-778. doi:10.1016/s0190-9622(08)81509-5
8. Mackie, R. M., & Aitchison, T. (1982). Severe sunburn and subsequent risk of primary cutaneous malignant melanoma in scotland. British Journal of Cancer, 46(6), 955-960. doi:10.1038/bjc.1982.307
9. Zanetti, R., Franceschi, S., Rosso, S., Colonna, S., & Bidoli, E. (1992). Cutaneous melanoma and sunburns in childhood in a Southern European population. European Journal of Cancer, 28(6-7), 1172-1176. doi:10.1016/0959-8049(92)90480-p
10. Diffey, B., & Cheeseman, J. (1992). Sun protection with hats. British Journal of Dermatology,127(1), 10-12. doi:10.1111/j.1365-2133.1992.tb14816.x
11. Coyne, E. Q., Lichtman, M. K., Simons, J., Sarkar, A. K., & Rünger, T. M. (2018). In vitro assessment of the broad-spectrum ultraviolet protection of clothing. Journal of the American Academy of Dermatology, 79(2), 373-375. doi:10.1016/j.jaad.2017.12.078
12. Linos, E., Keiser, E., Fu, T., Colditz, G., Chen, S., & Tang, J. Y. (2011). Hat, shade, long sleeves, or sunscreen? Rethinking US sun protection messages based on their relative effectiveness. Cancer Causes & Control, 22(7), 1067-1071. doi:10.1007/s10552-011-9780-1
13. Gambichler, T., Hatch, K. L., Avermaete, A., Altmeyer, P., & Hoffmann, K. (2002). Influence of wetness on the ultraviolet protection factor (UPF) of textiles: In vitro and in vivo measurements. Photodermatology, Photoimmunology and Photomedicine, 18(1), 29-35. doi:10.1034/j.1600-0781.2002.180105.x
14. Montague, M., Borland, R., & Sinclair, C. (2001). Slip! Slop! Slap! and SunSmart, 1980-2000: Skin Cancer Control and 20 Years of Population-Based Campaigning. Health Education & Behavior,28(3), 290-305. doi:10.1177/109019810102800304
15. Hughes, M., Williams, G., Baker, P., & Green, A. (2013). Sunscreen and Prevention of Skin Aging. Annals of Internal Medicine, 158(11). doi:10.7326/0003-4819-158-11-201306040-00001
16. Center for Drug Evaluation and Research. (n.d.). Understanding Over-the-Counter Medicines - Questions and Answers: FDA announces new requirements for over-the-counter (OTC) sunscreen products marketed in the U.S. Retrieved from https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/understandingover-the-countermedicines/ucm258468.htm
17. Center for Drug Evaluation and Research. (n.d.). Consumer Updates - Sunscreen: How to Help Protect Your Skin from the Sun. Retrieved from https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm239463.htm
18. Norris, J. F. (1996). Sunscreens, suntans, and skin cancer. Bmj, 313(7062), 941-942. doi:10.1136/bmj.313.7062.941d
19. Ekstein, N. (2018, July 19). This Bizarre Sunscreen Booth Is Driving Cocktail Sales at Hotel Pools. Retrieved from https://www.bloomberg.com/news/articles/2018-07-19/this-bizarre-sunscreen-booth-is-driving-cocktail-sales-at-hotel-pools
20. Sambandan, D. R., & Ratner, D. (2011). Sunscreens: An overview and update. Journal of the American Academy of Dermatology, 64(4), 748-758. doi:10.1016/j.jaad.2010.01.005
21. UVA & UVB. (n.d.). Retrieved from https://www.skincancer.org/prevention/uva-and-uvb
22. Heurung, A. R., Raju, S. I., & Warshaw, E. M. (2014). Adverse Reactions to Sunscreen Agents: Epidemiology, Responsible Irritants and Allergens, Clinical Characteristics, and Management. Dermatitis, 25(6), 289-326. doi:10.1097/der.0000000000000079
23. Monteiro-Riviere, N. A., Wiench, K., Landsiedel, R., Schulte, S., Inman, A. O., & Riviere, J. E. (2011). Safety Evaluation of Sunscreen Formulations Containing Titanium Dioxide and Zinc Oxide Nanoparticles in UVB Sunburned Skin: An In Vitro and In Vivo Study. Toxicological Sciences,123(1), 264-280. doi:10.1093/toxsci/kfr148
24. Cross, S. E., Innes, B., Roberts, M. S., Tsuzuki, T., Robertson, T. A., & Mccormick, P. (2007). Human Skin Penetration of Sunscreen Nanoparticles: In-vitro Assessment of a Novel Micronized Zinc Oxide Formulation. Skin Pharmacology and Physiology, 20(3), 148-154. doi:10.1159/000098701
25. Foley, P., Nixon, R., Marks, R., Frowen, K., & Thompson, S. (1993). The frequency of reactions to sunscreens: Results of a longitudinal population-based study on the regular use of sunscreens in Australia. British Journal of Dermatology, 128(5), 512-518. doi:10.1111/j.1365-2133.1993.tb00227.x
26. Final Report on the Safety Assessment of Urocanic Acid. (1995). Journal of the American College of Toxicology, 14(5), 386-423. doi:10.3109/10915819509083599
27 Schneider, L. S., & Lim, W. H. (2018). Review of environmental effects of oxybenzone and other sunscreen active ingredients. Journal of the American Academy of Dermatology
28. PDF. (n.d.). South Florida, Hawaii, U.S. Virgin Islands, American Samoa: National Park Service U.S. Department of the Interior.
29. Jung, K., Seifert, M., Herrling, T., & Fuchs, J. (2008). UV-generated free radicals (FR) in skin: Their prevention by sunscreens and their induction by self-tanning agents. Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy, 69(5), 1423-1428. doi:10.1016/j.saa.2007.09.029
30. O’Leary, R. E., Diehl, J., & Levins, P. C. (2014). Update on tanning: More risks, fewer benefits. Journal of the American Academy of Dermatology, 70(3), 562-568. doi:10.1016/j.jaad.2013.11.004
31. Pagoto, S. L., Schneider, K. L., Oleski, J., Bodenlos, J. S., Merriam, P., & Ma, Y. (2009). Design and methods for a cluster randomized trial of the Sunless Study: A skin cancer prevention intervention promoting sunless tanning among beach visitors. BMC Public Health, 9(1). doi:10.1186/1471-2458-9-50
32. Garone, M., Howard, J., & Fabrikant, J. (2015). A Review of Common Tanning Methods. The Journal of Clinical Aesthetic Dermatology, 8(21), 43-47.
33. Barsh, G., & Attardi, L. (n.d.). A Healthy Tan? The New England journal of medicine., 356(21), 2208–2210. doi:10.1056/NEJMcibr071775
34. Mahler, H. I., Kulik, J. A., Gerrard, M., & Gibbons, F. X. (2007). Long-term effects of appearance-based interventions on sun protection behaviors. Health Psychology, 26(3), 350-360. doi:10.1037/0278-6133.26.3.350
35. Tuong, W., & Armstrong, A. W. (2014). Effect of appearance-based education compared with health-based education on sunscreen use and knowledge: A randomized controlled trial. Journal of the American Academy of Dermatology, 70(4), 665-669. doi:10.1016/j.jaad.2013.12.007
36. Hillhouse, J., & Turrisi, R. (2002). Examination of the efficacy of an appearance-focused intervention to reduce UV exposure. Journal of behavioral medicine., 25(4), 395–409. doi:10.1023/A:1015870516460
37. Mahler, H. I., Kulik, J. A., Gibbons, F. X., Gerrard, M., & Harrell, J. (2003). Effects of appearance-based intervention on sun protection intentions and self-reported behaviors. Health Psychology,22(2), 199-209. doi:10.1037//0278-6133.22.2.199
38. Brinker, T. J., Faria, B. L., Gatzka, M., Faria, O. M., Heppt, M. V., Kirchberger, M. C., . . . Bernardes-Souza, B. (2018). A skin cancer prevention photoageing intervention for secondary schools in Brazil delivered by medical students: Protocol for a randomised controlled trial. BMJ Open, 8(3). doi:10.1136/bmjopen-2017-018299
39. Armstrong, A., Watson, A., Makredes, M., Frangos, J., Kimball, A., & Kvedar, J. (n.d.). Text-Message Reminders to Improve Sunscreen Use. Archives of dermatology., 145(11). doi:10.1001/archdermatol.2009.269
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May 8, 2020
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Auchus, A., Brodell, R.T., Nahar, V.K. and Ward, K.H. 2020. Avoiding the Hazards of Ultraviolet Light in the Adolescent Population. SKIN The Journal of Cutaneous Medicine. 4, 3 (May 2020), 189–199. DOI:https://doi.org/10.25251/skin.4.3.1.
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