UK advice on sun creams 'not in the interests of public health,' warns DTB

May 31, 2011

The strength of sun cream recently recommended by the National Institute for Health and Clinical Excellence (NICE) to stave off sunburn is far too low and "not in the interests of public health," warns the Drug and Therapeutics Bulletin (DTB).

NICE should rethink its advice, and soon, it says.

NICE recommends sunscreens with a sun protection factor, or SPF, of 15 as sufficient to prevent sunburn and the subsequent potential risk of skin cancer.

But DTB says that this is based on standard test conditions in which manufacturers apply 2 mg/cm2 of product to the skin.

"In reality .. people using sunscreens typically apply much less than this and get no more than half, at best, of the protection indicated by the labelled SPF," says DTB in its editorial on the subject.

Indeed, evidence presented in its evidence review shows that at the levels typically applied - between 1.5 mg to 0.5 mg/ cm2 - a maximum sunscreen with an SPF of 50 will only afford an SPF of between 19 and 3.

To meet the NICE recommendation, a single application for an adult would require 35 ml of sunscreen, and if applied every two hours, as NICE also recommends, would use up a standard 200 ml bottle every two to three days, DTB points out.

This is impractical and expensive, and the conditions under which sun creams are tested should be changed to more accurately reflect the way people actually use these products, argues DTB.

The SPF refers to the amount of UVB (short wave sunlight which is the main cause of sunburn) protection afforded by a product. And in the UK, sunscreens often carry what has come to be referred to as the "Boots star rating system," which indicates the ratio of UVA (long wave) and UVB protection.

More stars mean more UVA protection, which makes up more than 95% of terrestrial UV radiation. But, cautions DTB, "a 5-star product at a lower SPF (say 15) could provide less UVA protection than a 3-star product at a higher SPF (say 30)."

"Products labelled with an SPF of 30 (together with a 4- or 5- star rating to indicate broad spectrum ultraviolent screening effect) will more reliably deliver adequate sun protection to most people who use sunscreens and would be sufficient to prevent sunburn under most circumstances. We believe this is what NICE should have recommended," says DTB.

Dr Ike Iheanacho, DTB editor comments: "In DTB's view, NICE's recommendation to use sunscreens with an SPF as low as 15 is a blunder that overlooks the key evidence and is not in the best interests of public health. This advice needs urgent review and correction."

The evidence in favour of sunscreen protection against two out of the three types of skin cancer, including the most dangerous - malignant melanoma, the incidence of which has at least tripled in the past 30 years - is also weak/equivocal, says DTB.

Nevertheless, if applied properly, sunscreen will prevent sunburn, and a history of sunburn is an important risk factor in the development of skin cancer. The evidence suggests that every five episodes of sunburn per decade add up to a threefold increased risk of developing malignant melanoma.

As summer approaches the DTB advice is therefore to:
-end-


BMJ

Related Public Health Articles from Brightsurf:

COVID-19 and the decolonization of Indigenous public health
Indigenous self-determination, leadership and knowledge have helped protect Indigenous communities in Canada during the coronavirus disease 2019 (COVID-19) pandemic, and these principles should be incorporated into public health in future, argue the authors of a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.200852.

Public health consequences of policing homelessness
In a new study examining homelessness, researchers find that policy such a lifestyle has massive public health implications, making sleeping on the street even MORE unhealthy.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.

The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.

The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.

The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.

BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.

The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.

Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.

Read More: Public Health News and Public Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.