Redefine photoprotection: Sun protection beyond sunburn.

Excessive exposure to ultraviolet (UV) light leads to acute and chronic UV damage and is the main risk factor for the development of skin cancer. In most countries with western lifestyle, the topical application of sunscreens on UV-exposed skin areas is by far the most frequently used preventive measure against sunburn. Further than preventing sunburns, increasing numbers of consumers are appreciating sunscreens with a medium- to high-level sun protective factor (SPF) as basis for sustainable-skin ageing or skin cancer prevention programs. However, recent investigations indicate that clinically significant DNA damages as well as a lasting impairment of cutaneous immunosurveillance already occur far below the standard of one minimal erythema dose (MED) sunburn level, which contributes to the current discussion of the clinical value of high-protective SPF values. Ex vivo investigations on human skin showed that the application of SPF30 reduces DNA damage for a day long sun exposure (24 MED) drastically by about 53% but is significantly surpassed by SPF100 reducing DNA damage by approx. 73%. Further analysis on different SPF protection levels in UV-exposed cell culture assays focusing on IL-18, cell vitality and cis/trans-urocanic acid support these findings. Whereas SPF30 and SPF50+ sunscreens already offer a solid UVB cover for most indications, our results indicate that SPF100 provides significant additional protection against mutagenic (non-apoptotic-) DNA damage and functional impairment of the cutaneous immunosurveillance and therefore qualifies as an optimized sunscreen for specifically vulnerable patient groups such as immunosuppressed patients, or skin cancer patients.

Translation and Validation of the Dutch Version of the Sun Exposure and Protection Index.

INTRODUCTION: Skin cancer is currently the most common cancer type worldwide, and numbers are rapidly increasing. To improve primary prevention, individualised prevention strategies may be of interest as this enhances the chance of long-term behavioural change. The Sun Exposure and Protection Index (SEPI), previously validated in multiple languages, is a tool that could help identify individuals with risky behaviour and tailor interventions to the person's propensity to change. The aim of the present study was to investigate the reliability and validity of a Dutch version of the SEPI for both usage in daily clinical practice and research. METHODS: Patients were included at primary care settings and dermatology outpatient settings in a 1:1 ratio. Participants were asked to fill out the SEPI together with some baseline characteristics and the previously validated FACE-Q Skin Cancer - Sun Protection module. Construct validity was tested by comparing SEPI part I and the FACE-Q module using Spearman's Rho. Internal consistency was assessed with Cronbach's Alpha for both SEPI parts separately. To assess test-retest reliability, the SEPI was again filled out 3 weeks later, and scores were compared with Cohen's weighted Kappa. RESULTS: Of the 171 participants completing the first questionnaire, 147 (86.0%) participants also completed the follow-up questionnaire. Comparison between the corresponding SEPI part I and FACE-Q module questions showed good correlations regarding sun exposure habits (correlation coefficients ranging from 0.61 to 0.85). Internal consistency of SEPI part I was 0.63 and SEPI part II was 0.65. The test-retest analysis indicated reproducibility over time (weighted Kappa ranging from 0.38 to 0.76). CONCLUSION: In conclusion, the Dutch version of the SEPI is shown to be a valid and reliable tool for both usages in daily clinical practice and research to evaluate individual ultraviolet exposure and measure a person's propensity to limit it.

Evaluation of social knowledge on photoprotection and its relationship with education and age in a Polish seaside town during summer holidays.

OBJECTIVE: This survey aimed to evaluate knowledge of photoprotection among individuals from a random group in a resort town in Poland, Kolobrzeg, and explore the correlation between their knowledge and demographics like age, gender, education, and residence. METHODS: An anonymous survey was conducted among a diverse group. This population comprised individuals from various backgrounds: health spa patients undergoing treatments, therapies and medical appointments, guests visiting the resort for leisure, passersby, and staff working at the spa and recreational facilities. The survey was designed by authors, encompassed 16 questions about knowledge on photoprotection, sunscreen use and related topics, and gathered demographic data. Responses from 142 individuals were statistically analyzed using PQStat Software. RESULTS: Only 7.7% use sunscreen all year-round. The majority apply sun protection factor (SPF) creams on sunny days or with prolonged sun exposure. Over half of the respondents (53.5%) are aware when to apply sunscreen but 43% reapply it less than every 4 h. 25.4% do not reapply at all. 38.7% think protection provided by higher SPF means longer sun exposure time. Over 50% believe SPF 30 offers double the protection of SPF 15. Almost half (46.8%) use extra sun protection, like sunglasses or hats. Significant correlations exist between education/age and certain survey responses. CONCLUSIONS: The findings emphasize the urgency to improve photoprotection knowledge in the Polish population, particularly regarding the year-round harmful solar effects and the correct use of sun protection products.

Effect of education on sun-safe behaviour in kidney transplant recipients.

BACKGROUND: Organ transplant recipients (OTR) are more likely to develop skin cancer than the general population. One of the main components of the exposome that triggers the development of skin tumours is solar ultraviolet (UV) radiation. To reduce the incidence of harmful consequences of sun exposure, sun protection education is needed for patients taking long-term immunosuppressive drugs. METHODS: In a previous study, we assessed the sun-safe behaviour of 221 OTR using a questionnaire before and after transplantation and personally educated the patients about proper sun protection. After the education, there were no further reminder presentations. Presently, the sun protection and sun seeking habits of the available 176 of these patients were questioned to assess the long-term effect of the previous sun protection education. RESULTS: Two-four years after the education, more patients wore hats and protected their skin with long-sleeved clothing than before the education. In terms of sun seeking habits, both occupational and recreational sun exposure decreased significantly. Significantly fewer people went on holiday after transplantation, but those who went on holiday spent significantly less time in the sun. CONCLUSION: The long-term positive effects of education can be seen both in the patients' sun protection and in their sun seeking habits. However, the long-term goal is to maintain these results and thereby reduce the likelihood of skin tumours and consequently the associated tumour death.

Skin cancer survivorship and sun protection behaviors in the United States.

BACKGROUND: Skin cancer survivors are more vulnerable to subsequent skin cancers and other malignancies, but previous studies have not examined in detail their sun protection behavior prevalence by sociodemographic factors. We aimed to understand the sociodemographic disparities in the prevalence of three important types of sun protection behaviors: using sunscreen, seeking shade, and wearing protective clothing, among skin cancer survivors and those without skin cancer history. METHODS: We used the 2015 U.S. National Health Interview Survey to analyze 29,523 participants, of which 772 were skin cancer survivors and 28,751 were those without skin cancer history. We assessed overall and specific sun protection behavior prevalence based on using sunscreen, seeking shade, and wearing protective clothing. Weighted Poisson regression was used to estimate prevalence ratios. RESULTS: Melanoma and nonmelanoma skin cancer survivors had similar overall sun protection behavior (p > .05). Among all skin cancer survivors, 36.0% infrequently used sunscreen, 50.2% infrequently wore protective clothing, 47.8% infrequently sought shade, and 30.0% lacked frequent overall sun protection, which significantly differed from those without skin cancer history (p < .0001). The prevalence of frequent overall sun protection behavior was lower for those who were younger at survey, males, less educated, single or never married, or lived in poverty, regardless of their skin cancer history (p < .01). CONCLUSIONS: By identifying subpopulations with higher prevalence of infrequent sun protection among those with or without skin cancer history, our findings may encourage efforts to reduce sociodemographic disparities in sun protection behaviors and promote primary and tertiary skin cancer prevention.

Efficacy of a facial-aging web app on sun protection behaviors among primary school students in Iran: a randomized controlled trial.

BACKGROUND: Skin cancers resulting from excessive exposure to solar ultraviolet (UV) radiation are on the rise. This study aims to investigate the impact of facial-aging app intervention on promoting safe and healthy behaviors and its influence on reducing students' UV exposure. METHOD: Utilizing a Pretest-Posttest repeated-measures design, we developed a theory-guided web app on the WhatsApp platform, named the Sunshine and Skin Health app. This app allows users to visualize their altered faces in three stages of adolescence, middle age, and old age based on sun protection behavior. The intervention continued within WhatsApp, incorporating 27 health messages grounded in the PMT theory, eight educational files, and a skin cancer video clip. The primary outcome is the change in sun protection behavior between the two groups (intervention and control) immediately after the intervention (T2) and the secondary outcome is the change in sun protection behavior between the two groups at 3 months follow-up (T3). The data are analyzed in SPSS 22 and a significance level of 0.05 is considered. RESULTS: The results revealed no significant difference between the two groups before the intervention. However, in the intervention group, there were significant differences in the utilization of sunglasses, hats, and sunscreen in the last month, as well as sunscreen reapplication after washing their hands and face, both immediately after the intervention and at the 3-month follow-up, compared to the control group (P = 0.001). Furthermore, a significant intervention effect, time effect, and interaction effect between group and time were observed in behaviors related to using sunscreen in the last month and sunscreen reapplication after washing hands and face (P = 0.001). Specifically, the intervention group exhibited a significant difference from Time 1 to 2 and from Time 1 to 3 (p = 0.001), but no significant difference from Time 2 to 3. In contrast, the control group did not show any significant differences over time. CONCLUSIONS: This study indicated that the Facial-Aging web app can effectively encourage safe behaviors in sunlight. To ensure the maintenance and sustainability of these behaviors over the long term, it is crucial to consider implementing booster sessions. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20200924048825N1. Registered prospectively on 8 February 2021.

Ethnic and Gender Differences in Sun-Related Cognitions Among College Students: Implications for Intervention.

BACKGROUND: Skin cancer incidence and prognosis vary by ethnicity and gender, and previous studies demonstrate ethnic and gender differences in sun-related cognitions and behaviors that contribute to this disease. The current study sought to inform skin cancer interventions tailored to specific demographic groups of college students. The study applied the prototype willingness model (PWM) to examine how unique combinations of ethnic and gender identities influence sun-related cognitions. METHOD: Using data from a survey of 262 college students, the study tested whether self-reported sun-related cognitions were different for White women, Hispanic women, White men, and Hispanic men. Path modeling was also used to identify which PWM cognitions (e.g., prototypes, norms) were the strongest predictors of risk and protection intentions and willingness in each demographic group. RESULTS: Several differences in sun-related cognitions and PWM pathways emerged across groups, emphasizing the need for tailored skin cancer education and interventions. Results suggest that, for White women, interventions should primarily focus on creating less favorable attitudes toward being tan. CONCLUSION: Interventions for Hispanic women may instead benefit from manipulating perceived similarity to sun-related prototypes, encouraging closer personal identification with images of women who protect their skin and encouraging less identification with images of women who tan. For White men, skin cancer interventions may focus on creating more favorable images of men who protect their skin from the sun. Lastly, interventions for Hispanic men should increase perceived vulnerability for skin cancer.

Digital Interventions to Modify Skin Cancer Risk Behaviors in a National Sample of Young Adults: Randomized Controlled Trial.

BACKGROUND: Young adults engage in behaviors that place them at risk for skin cancer. Dissemination of digital health promotion interventions via social media is a potentially promising strategy to modify skin cancer risk behaviors by increasing UV radiation (UVR) protection and skin cancer examinations. OBJECTIVE: This study aimed to compare 3 digital interventions designed to modify UVR exposure, sun protection, and skin cancer detection behaviors among young adults at moderate to high risk of skin cancer. METHODS: This study was a hybrid type II effectiveness-implementation randomized controlled trial of 2 active interventions, a digital skin cancer risk reduction intervention (UV4.me [basic]) compared with an enhanced version (UV4.me2 [enhanced]), and an electronic pamphlet (e-pamphlet). Intervention effects were assessed over the course of a year among 1369 US young adults recruited primarily via Facebook and Instagram. Enhancements to encourage intervention engagement and behavior change included more comprehensive goal-setting activities, ongoing proactive messaging related to previously established mediators (eg, self-efficacy) of UVR exposure and protection, embedded incentives for module completion, and ongoing news and video updates. Primary outcome effects assessed via linear regression were UVR exposure and sun protection and protection habits. Secondary outcome effects assessed via logistic regression were skin self-exams, physician skin exams, sunscreen use, indoor tanning, and sunburn. RESULTS: The active interventions increased sun protection (basic: P=.02; enhanced: P<.001) and habitual sun protection (basic: P=.04; enhanced P=.01) compared with the e-pamphlet. The enhanced intervention increased sun protection more than the basic one. Each active intervention increased sunscreen use at the 3-month follow-up (basic: P=.03; enhanced: P=.01) and skin self-exam at 1 year (basic: P=.04; enhanced: P=.004), compared with the e-pamphlet. Other intervention effects and differences between the Basic and Enhanced Intervention effects were nonsignificant. CONCLUSIONS: The active interventions were effective in improving several skin cancer risk and skin cancer prevention behaviors. Compared with the basic intervention, the enhanced intervention added to the improvement in sun protection but not other behaviors. Future analyses will explore intervention engagement (eg, proportion of content reviewed). TRIAL REGISTRATION: ClinicalTrials.gov NCT03313492; http://clinicaltrials.gov/ct2/show/NCT03313492.

Patient demographic characteristics and risk factors associated with sun protection behaviours in specialist melanoma clinics.

OBJECTIVE: We investigated the association between sun protection behaviours and demographic and melanoma risk characteristics of patients attending Australian melanoma specialist clinics. This may assist in targeting and tailoring melanoma prevention patient education for people at high-risk and specific population subgroups. METHODS: A cross-sectional analysis of questionnaire data collected from participants attending the dermatology clinics at two major melanoma centres in Sydney, Australia between February 2021 and September 2023. The primary outcome was Sun Protection Habits (SPH) index (a summary score measured as habitual past month use of sunscreen, hats, sunglasses, a shirt with sleeves that covers the shoulders, limiting midday sun exposure and seeking shade, using a Likert scale). The primary analysis considered the SPH index and its component items scored as continuous. RESULTS: Data from 883 people were analysed. Factors associated with less frequent sun protection behaviours overall included male gender, no personal history of melanoma, lower perceived risk, lower calculated 10-year risk of developing melanoma, and no private health insurance. People aged >61 years reported lower use of sunscreen but higher use of hats and sleeved-shirts compared with people in the younger age group. There was no difference in overall sun protection behaviours according to family history of melanoma, country of birth or by lifetime melanoma risk among people without a personal history of melanoma. CONCLUSIONS: These findings highlight the potential for targeting high-risk individuals with less frequent use of sun protection for patient education, public health messaging and ultimately improving sun protection behaviours.

Behaviorally segmented audiences for managing sunscreen chemical pollution risk in protected coastal natural resource areas.

This audience segmentation of visitors at coastal parks in Hawaii and North Carolina addresses an emergent natural resource management concern and risk to aquatic ecosystems: sunscreen chemical pollution. Four audiences were identified that correspond to different behavioral profiles: sunscreen protection tourists, multimodal sun protection tourists, in-state frequent park visitors, and frequent beachgoers who skip sunscreen. The second-largest audience, sunscreen protection tourists, represents 29% of visitors at Cape Lookout National Seashore and 25% at Kaloko-Honokohau National Historical Park. This group ranks of most concern for chemical pollution because they use sunscreen, but not typically mineral formulations or other methods such as protective clothing, and they have lower levels of sunscreen chemical issue awareness. The identification of similar audience segments across regions with differing cultural characteristics and sunscreen regulation status suggests the robustness of the model and its indicator variables, with implications for both environmental protection and public health. Further, coastal visitors' interest in enacting pro-environmental sun protection behaviors during their next park or beach visit indicates the potential for natural resource managers to holistically address risks in both domains through targeted interventions with audiences of most concern.

Evaluating How a School-Based Skin Cancer Prevention Program Can Change Behavior Among North Carolina Highschoolers.

The incidence of skin cancer has risen steadily over recent decades. Childhood and adolescent sun exposure remains a critical risk factor in skin cancer development, making education of high schoolers imperative for promoting sun-safe behaviors. Medical students in North Carolina recognized this need and designed a skin cancer education program focused on portraying skin cancer in individuals with all Fitzpatrick skin phototypes. Eighty-seven students completed the pre-survey, and 84 completed the post-session survey. In the post-survey, 88% of students listed actionable behavioral changes they plan to make following the presentation. Following an educational session, students were able to demonstrate their new knowledge and provide meaningful behavioral changes. This program navigated challenges posed by COVID-19 and addressed the need for more inclusive skin cancer educational material.

Pulp or Peel? Comparative Analysis of the Phytochemical Content and Selected Cosmetic-Related Properties of Annona cherimola L., Diospyros kaki Thumb., Cydonia oblonga Mill. and Fortunella margarita Swingle Pulp and Peel Extracts.

Fruit peels might be a valuable source of active ingredients for cosmetics, leading to more sustainable usage of plant by-products. The aim of the study was to evaluate the phytochemical content and selected biological properties of hydroglycolic extracts from peels and pulps of Annona cherimola, Diospyros kaki, Cydonia oblonga, and Fortunella margarita as potential cosmetic ingredients. Peel and pulp extracts were compared for their antiradical activity (using DPPH and ABTS radical scavenging assays), skin-lightening potential (tyrosinase inhibitory assay), sun protection factor (SPF), and cytotoxicity toward human fibroblast, keratinocyte, and melanoma cell lines. The total content of polyphenols and/or flavonoids was significantly higher in peel than in pulp extracts, and the composition of particular active compounds was also markedly different. The HPLC-MS fingerprinting revealed the presence of catechin, epicatechin and rutoside in the peel of D. kaki, whereas kaempferol glucoside and procyanidin A were present only in the pulp. In A. cherimola, catechin, epicatechin and rutoside were identified only in the peel of the fruit, whereas procyanidins were traced only in the pulp extracts. Quercetin and luteolinidin were found to be characteristic compounds of F. margarita peel extract. Naringenin and hesperidin were found only in the pulp of F. margarita. The most significant compositional variety between the peel and pulp extracts was observed for C. oblonga: Peel extracts contained a higher number of active components (e.g., vicenin-2, kaempferol rutinoside, or kaempferol galactoside) than pulp extract. The radical scavenging potential of peel extracts was higher than of the pulp extracts. D. kaki and F. margarita peel and pulp extracts inhibited mushroom and murine tyrosinases at comparable levels. The C. oblonga pulp extract was a more potent mushroom tyrosinase inhibitor than the peel extract. Peel extract of A. cherimola inhibited mushroom tyrosinase but activated the murine enzyme. F. margarita pulp and peel extracts showed the highest in vitro SPF. A. cherimola, D. kaki, and F. margarita extracts were not cytotoxic for fibroblasts and keratinocytes up to a concentration of 2% (v/v) and the peel extracts were cytotoxic for A375 melanoma cells. To summarize, peel extracts from all analyzed fruit showed comparable or better cosmetic-related properties than pulp extracts and might be considered multifunctional active ingredients of skin lightening, anti-aging, and protective cosmetics.

Overview of proficiency testing results for the in vivo determination of sun protection factor.

A sunscreen product is allowed to be marketed if a protection is provided against ultraviolets (UV) including UVA rays and UVB rays expressed by the sun protection factor (SPF). UVB is radiation that is in the region of the ultraviolet spectrum which extends from about 290 to 320 nm in wavelength and that is primarily responsible for sunburn, ageing of the skin, and the development of skin cancer. Thus, since April 2009, the Bureau Interprofessionnel d'Etudes Analytiques (BIPEA) set up a proficiency testing scheme (PTS) for the determination of SPF in vivo of sunscreen products according to ISO 24444 standard [Cosmetics - Sun protection test methods - in vivo determination of the sun protection factor (SPF)] to evaluate the analytical performances of laboratories on these analyses. This PTS gathers twenty-six laboratories around the world with one trial a year. For each test, the statistical treatment of the data is performed according to ISO 13528 standard [Statistical methods for use in proficiency testing by interlaboratory comparison]. The assigned and tolerance values are calculated from the participants' data and the performances of the laboratories are evaluated individually and collectively according to ISO 17043 standard [Conformity assessment - General requirements for proficiency testing]. This paper presents the design of the PT program, its development, and an attentive analysis of laboratories results, which highlight the global performances obtained by laboratories on this type of analysis. The evaluation of the results shows, in fact, a relatively constant dispersion of data since the implementation of the PT program (variability between 10% and 50%).

Un produit solaire peut être commercialisé s'il offre une protection contre les ultraviolets (UV), y compris les rayons UVA et UVB, exprimée par le facteur de protection solaire (FPS). Les UVB sont des rayonnements qui se situent dans la région du spectre ultraviolet dont la longueur d'onde s'étend d'environ 290 à 320 nm et qui sont principalement responsables des coups de soleil, du vieillissement de la peau et du développement du cancer de la peau. Ainsi, depuis avril 2009, le Bureau Interprofessionnel d'Etudes Analytiques (BIPEA) a mis en place un système d'essais d'aptitude pour la détermination du FPS in vivo des produits de protection solaire selon la norme ISO 24444 [Cosmétiques ­ Méthodes d'essai de protection solaire ­ Détermination in vivo du facteur de protection solaire (FPS)] afin d'évaluer les performances analytiques des laboratoires sur ces analyses. Ce programme d'essais d'aptitude regroupe vingt­six laboratoires dans le monde à raison d'un essai par an. Pour chaque essai, le traitement statistique des données est effectué selon la norme ISO 13528 [Méthodes statistiques utilisées dans les essais d'aptitude par comparaison interlaboratoires]. Les valeurs assignées et les valeurs de tolérance sont calculées à partir des données des participants et les performances des laboratoires sont évaluées individuellement et collectivement conformément à la norme ISO 17043 [Évaluation de la conformité ­ Exigences générales concernant la compétence des organisateurs d'essais d'aptitude]. Cet article présente la conception du programme d'essais d'aptitude, son développement, et une analyse attentive des résultats des laboratoires, qui mettent en évidence les performances globales obtenues par les laboratoires sur ce type d'analyse. L'évaluation des résultats montre en effet une dispersion des données relativement constante depuis la mise en place du programme (variabilité entre 10% et 50%).

Enhanced sun protection factor of octocrylene with green tea and bhringraj extracts.

OBJECTIVES: The aim of this study of sun protection factor boosting effect sunscreen compositions with herbal extract and combination with octocrylene. MATERIALS AND METHODS: The standardized herbal extracts procured and studied their sun protection Factors. Camellia Sinensis (Green tea) leaf Extract, Eclipta prostrata (bhringraj) leaf extract are selected for the development of the herbal sunscreen composition along with octocrylene as synthetic sunscreen. The developed sunscreen composition contains defined concentration of herbal extracts and octocrylene were evaluated for their different physicochemical properties and stability. Sun protection factor boosting effect of herbal extracts is studied combination with octocrylene. RESULTS: Invitro SPF studied for herbal extract individually and combination with octocrylene. The results of Invitro SPF study revealed the presence of green tea extract and, Eclipta prostrata (bhringraj) leaf extract shows excellent sun protection factor (SPF) boosting value of sunscreen composition containing 5% concentration of herbal extract and octocrylene. The sunscreen formulation containing 5% herbal extracts are stable for 12 weeks in an oven (45 °C). CONCLUSION: The findings of this in-vitro SPF study revealed a sun protection boosting capacity of green tea extract and bhringraj extract confirmed. SUMMARY: The over exposure of human skin to Ultra-Violet Radiation (UVR) can trigger photodamage, UV burn, pigmentation, erythema, and enhance the chance of dermal carcinoma. UVR causes DNA damage, which leads to dermal cancer. Daily sunscreens protect the skin from the adverse effects of sun rays, especially UVB (290-320 nm) and UVA (320-400 nm). The ozone layer filters UVC (200-290 nm) radiation when it enters into atmosphere of the earth. UVB causes sunburn, photo damage and cause mutagenic changes in nucleic acids. UVA increases ROS (Reactive Oxygen Species) accumulation. ROS is responsible for cell repair which leads to carcinogenesis, and the cause of photodamage. Herbal extracts contain polyphenols, and flavonoids act as a natural sunscreen that will filter Ultra-Violet (UVB) light and contain antioxidant characteristics to modulate the photo-oxidative damage that results from UV-induced Reactive Oxygen Species production. The UVR protection of most herbal extracts are required to attain the higher UV protection in the sun care products. The approaches for preparing sun care products with higher Sun Protection Factor (SPF) possible through Oil in water formulation with herbal extract combinations of octocrylene. The developed sunscreen composition containing different concentration of herbal extracts were evaluated for their other physicochemical properties and stability. Invitro SPF was studied for Camellia Sinensis (Green tea) Leaf Extract and Eclipta prostrata (bhringraj) leaf extract individually and in combination with octocrylene. The results of the Invitro SPF study revealed the Camellia Sinensis (Green tea) Leaf Extract with octocrylene shows better Sun protection factor than Eclipta prostrata (bhringraj) leaf extract with octocrylene. The Sun Protection Factor (SPF) enhancement value of sunscreen compositions was compared to both sunscreen macroemulsion and nanoemulsion.

Women's skin care behaviors: How to influence sunscreen use.

BACKGROUND: It is well known that women have been plagued by various skin problems. However, research on the characteristics of women's skin at different ages is still inadequate. In addition, there is a lack of research on the extent of women's skincare habits and skin care awareness. METHODS: A cross-sectional survey on skin was carried out in Shanghai, China, which was conducted by means of a questionnaire. 3678 women, aged 18-59 years, participated in the study. The information collected focused on the importance they place on their skin, the skin problems they have, and their use and perception of skin care products. RESULTS: Before the age of 25, the most common skin problems that women face are dryness and oiliness, while after the age of 30, skin-ageing issues begin to appear and worsen with age. In addition, the higher the level of education, the higher the frequency of and compliance with sunscreen use, and the economy also affects women's use of sunscreen. Importantly, the importance women place on their skin and the level of sunscreen awareness affects women's use of sunscreen. CONCLUSIONS: This study was conducted to understand the skin characteristics of women of different age groups as well as to determine the factors that influence the use of sunscreens, which will not only promote women's skin care practices and product development, but also provide important clues for future activities on sunscreen use and health promotion.

Evaluation of the awareness of Western Australian SunSmart campaigns between 2008 and 2022.

ISSUE ADDRESSED: It is unknown whether SunSmart health promotion campaigns in Western Australia are still effectively reaching their target audience of young people (under 45 years). This study examined trends over time in awareness, relevancy and believability of SunSmart advertisements and identified socio-demographic characteristics and risk factors associated with campaign awareness. METHOD: Linear regression and log-binomial modelling were undertaken using data from the annual SunSmart post-campaign evaluation surveys between 2008/2009 and 2021/2022. SunSmart campaigns were analysed and categorised into the following themes: (1) personal real-life stories; (2) daily activities/sun exposure leads to skin cancer; or (3) cartoon/animated. RESULTS: Between 2008 and 2022, there were declines in total awareness (74.2% to 20.4%), unprompted awareness (33.7% to 4.9%) and relevancy (89.5% to 54.8%) of SunSmart advertisements (representing annual percent decreases of 3.6%, 3.1% and 1.8%, respectively). However, believability remained high over time (>94% in each annual survey). Trends were inconsistent between the awareness of campaign themes and socio-demographic characteristics and risk factors. Several campaigns had greater awareness in their subsequent years, compared with the first campaign year. CONCLUSION: In more recent years, SunSmart advertisements and campaigns may not have reached their target audience. In addition to socio-demographic characteristics, particularly age, advertisement factors may also affect the awareness of specific campaigns. SO WHAT?: Given the changing advertising landscape and its rising costs, ongoing funding is pertinent to increase the reach of future SunSmart campaigns. Increasing advertisements on alternative platforms and designing campaigns which separately target adolescents and adults need to be considered.

The formative evaluation and pre-testing of a SunSmart policy implementation support toolkit targeting sun safe hat-wearing in NSW primary schools.

ISSUE ADDRESSED: Strategies that support the implementation of the SunSmart program in primary schools are essential to optimising policy uptake. Evidence outlining the type of support required, however, is lacking. This project explored the usefulness of an implementation support approach to sun safe hat-wearing in schools. METHODS: Formative research was undertaken with 16 primary schools in Greater Western Sydney to explore current sun protection behaviours and practices, perceived barriers and motivators of sun safe hat-wearing, and resource needs. Based on these insights, a resource toolkit was developed and tested in 14 demonstration sites. Follow-up interviews evaluated the usefulness of the toolkit and implementation support approach. RESULTS: Sun safe hat-wearing practices varied among schools. Commonly reported motivators included school policies, role modelling, incentives and knowledge. Commonly reported barriers included negative social norms, forgetfulness, cost and lack of understanding. Formative insights informed the development of the 'Motivation, Access, Triggers' Model and a 23-resource toolkit. Following toolkit rollout, champions reported that the ability to select resources according to local needs was useful, and most found that the toolkit supported their school with sun safe hat-wearing. CONCLUSIONS: A toolkit with local champions and leadership buy-in has the potential to improve policy implementation. The opportunity to prioritise resource selection enables schools to address their specific needs in line with their sun protection policy. SO WHAT?: The provision of policy implementation support can help schools overcome the challenges of transforming a written SunSmart policy into practice.

In situ study of the effect of endogenous and exogenous agents on color stability, hardness, and surface roughness of an elastomer for facial prostheses.

PURPOSE: To evaluate in situ the influence of sweat, oil, sunscreen, and disinfectant solution on the color stability, hardness, and roughness of elastomer for facial prostheses. MATERIALS AND METHODS: Standardized and intrinsically pigmented specimens remained in contact with human skin from the same person for 30 days, considering exposures (n = 36 per group), absent of exposition (Control, C); sweat and oiliness contact (SO); sweat and oiliness associated with sunscreen (SOS); 0.12% chlorhexidine digluconate immersion (CD0.12%); and all agents exposed (SOSCD). The main variables were color change (CIELab and National Standard Bureau system, NBS), Shore A hardness, and surface roughness, measured at baseline and 30 days. Qualitative analyses were performed by atomic force microscopy (AFM) and scanning electron microscopy (SEM). The data were analyzed by Kruskal-Wallis tests (color) and two-way ANOVA (hardness and roughness) with Sidak post-test (α = 0.05). RESULTS: CD0.12% (1.54 ± 0.49) and SOSCD (2.10 ± 1.03) had similar effects and caused the smallest color changes, considered mild and noticeable (NBS), respectively. SOS promoted the greatest color change (6.99 ± 1.43, NBS: large) and hardness (17.97 ± 0.56); SOS promoted intermediate roughness (3.48 ± 1.05) between SOSCD (2.25 ± 0.53), and two similar groups: C (4.46 ± 0.95), and CD0.12% (4.39 ± 1.26). The qualitative analysis showed an irregular, dense, dry, and whitish layer on the surface of the specimens exposed to sunscreen, which was reduced when in contact with 0.12% chlorhexidine digluconate. CONCLUSIONS: Endogenous and exogenous factors are capable of altering elastomer properties. The 0.12% chlorhexidine digluconate minimized the changes caused by sweat, oil, and sunscreen.

Awareness and knowledge of sun exposure and use of sunscreen among adults in Aseer region, Saudi Arabia.

Background: Excessive sun exposure and inadequate sunscreen use can lead to skin cancer and other harmful effects on the skin, eyes, and immune system. Purpose: This observational cross-sectional study aimed to assess awareness and knowledge of sun exposure and sunscreen use among adults in the Aseer region, Saudi Arabia. This study also focused on evaluating the risks of skin cancer and participants' sun-protective attitudes and practices. Methods: A population-based cross-sectional study was conducted among adults in the Aseer region, Saudi Arabia. Data were collected using a questionnaire from November 2022 to January 2023 that assessed participants' knowledge, practices, and beliefs regarding sun exposure and sunscreen use. A total of 400 participants were selected for the study. Approval for the study was granted by the Local Research Ethics Committee of the University of Bisha, Saudi Arabia. Results: The results revealed that (59.8 %) of the participants were female, while (40.3 %) were male. Regarding age, the majority fell within the 26-35 age range (37.5 %), with (16.0 %) of participants using sunscreen regularly, with a total of (74.0 %) of participants using sunscreen. Men exhibited a higher prevalence of negative attitudes towards sun protection, while women demonstrated more favourable sun protection practices. In addition, (1.25 %) of the participants had skin cancer in the past; (81.0 %) of participants agreed that skin cancer could cause death, while (19.0 %) were unsure of the effects of skin cancer. Moreover, the results indicated that sun exposure had a significant positive effect on awareness levels (p < 0.05), indicating that increased sun exposure was associated with higher awareness of the harmful effects of the sun. Additionally, awareness level significantly positively affected sunscreen use (p < 0.01), suggesting that individuals with higher awareness were more likely to use sunscreen. Conclusion: There was an average awareness of sun exposure and its detrimental effects. In addition, a significant portion of the population demonstrates proactive measures to minimize sunlight exposure. However, sunscreen usage among Saudi adults was low despite having knowledge and awareness. Future research must enhance sun protection practices and reduce sun-related skin damage in the Aseer region.

Time spent in the sun and the risk of developing non-Hodgkin lymphoma: a Canadian cohort study.

PURPOSE: The objective was to explore the relationship of sun behavior patterns with the risk of developing non-Hodgkin lymphoma (NHL). METHODS: Sun behavior information from Alberta's Tomorrow Project, CARTaGENE, and Ontario Health Study were utilized. The relationship between time in the sun during summer months and risk of NHL was assessed using Cox proportional hazard models with age as the time scale and adjustment for confounders. Cohorts were analyzed separately and hazard ratios (HR) pooled with random effects meta-analysis. Joint effects of time in the sun and use of sun protection were examined. Patterns of exposure were explored via combinations of weekday and weekend time in the sun. RESULTS: During an average follow-up of 7.6 years, 205 NHL cases occurred among study participants (n = 79,803). Compared to < 30 min daily in the sun, we observed HRs of 0.84 (95% CI 0.55-1.28) for 30-59 min, 0.63 (95% CI 0.40-0.98) for 1-2 h, and 0.91 (95% CI 0.61-1.36) for > 2 h. There was suggestive evidence that > 2 h was protective against NHL with use of sun protection, but not without it. Compared to < 30 min daily, moderate exposure (30 min to 2 h on weekdays or weekend) was associated with a lower risk of NHL (HR 0.63, 95% CI 0.43-0.92), while intermittent (< 30 min on weekdays and > 2 h on weekends) and chronic (> 2 h daily) were not. CONCLUSION: This study provides evidence of a protective effect of moderate time spent in the sun on NHL risk.