As a supplement to more reliable methods of
reducing skin exposure to ultraviolet (UV)
radiation (such as sun avoidance, clothing, and
hats) sunscreen can be very useful.
However, limitations to the effectiveness of
sunscreen include the following common user
errors:
Failure to apply enough
Uneven application / missed spots
Failure to re-apply
Because some amount of UV radiation might pass
by the sunscreen, unintentional sunburn can
occur. Think of these products as a
back-up to other, more effective, sun safety
strategies.
The sun emits a broad spectrum of radiation that
includes harmless visible light as well as
ultraviolet radiation. The bands of
wavelengths that damage human skin are
categorized as UVA and UVB. UVB rays are
the main cause of the skin turning red, or
exhibiting a sunburn. They can fracture
the DNA in skin cells, resulting in mutations.
UVA rays penetrate deeper into the skin and are
the main cause of wrinkling, and discoloration.
They cause the formation of damaging atoms
called free radicals, and can inhibit the immune
system from doing its job to prevent cancer.
It is important to protect the skin from both
UVA and UVB.
The SPF (Skin Protection Factor) only indicates
how well a product screens UVB rays. Even
if a product has a high SPF, it might not
effectively screen UVA rays.
Unfortunately, the FDA has not yet agreed upon a
rating system for informing consumers about the
relative strength of one product versus another
in screening UVA rays.
The ingredients in sunscreen products are of two
broad types. “Chemical” indredients absorb
UV rays and convert their energy to heat.
The tiny amount of heat given off is believed to
be harmless. There are numerous chemical
ingredients approved by the FDA for use in
sunscreens. Most of them screen UVB but
many do not screen UVA, or only screen a portion
of the UVA range. Additional agents are
expected to be approved soon, but two chemicals
that effectively screen the entire UVA spectrum
are Mexoryl™ and avobenzone (Parsol 1789®)
“Physical” ingredients are particles that
reflect all UV rays off of the skin (UVA as well
as UVB.) The two that are used in
sunscreens are zinc oxide and titanium dioxide.
Some products contain a mixture of chemical and
physical agents.
In choosing a sunscreen to provide or sell at
school, the sunscreen selection on this website
includes products that block the full range of
UVA as well as UVB.
Probably the greatest drawback with sunscreen is
that most people do not apply a sufficient dose.
The SPF number is determined by the manufacturer
using a “standard” application amount (required
by the FDA) of 2 milligrams of product per
square centimeter of skin. For the
average adult in a bathing suit this would be a
little more than one ounce, or approximately a
shot glass full. (That’s one quarter of
the typical 4 oz. sunscreen bottle.) When
a person applies less than the “standard”
amount, only a fraction of the labeled SPF will
be achieved. Studies have shown that the
average person applies less than half the
“standard” amount of sunscreen, which results in
an SPF of only about one third of that labeled
on the bottle. Spray on sunscreens are
particularly subject to underdosing. By
contrast, if more than the “standard” amount is
applied, the SPF achieved will exceed that
labeled on the bottle.
UV causes some sunscreen ingredients to
gradually deteriorate on the skin’s surface in
response to sun exposure. Sunscreen can
also dissipate due to sweating, rubbing, and
penetration into the skin. To maintain
maximum effect, sunscreen should be re-applied
every two hours. A single application
before coming to school cannot be expected to
adequately protect a child for afternoon
physical education.
These products must be applied liberally and, as
with paint, two coats are better than one.
Thus, Sun Safety for Kids coined the phrase:
“Put on a lot. And don’t miss a spot!”
Because sunscreens are regulated by the FDA as
over the counter drugs, many California schools
either refrained from encouraging their use or
prohibited them under a “zero tolerance for
drugs” policy. To overcome this hurdle, in
2002 the California state government amended the
Education Code as follows:
Section 35183.5 (b)
(1) Each schoolsite shall allow pupils the use
of sunscreen
during the schoolday without a physician's note
or prescription.
(2) Each schoolsite may set a policy related to
the use of
sunscreen by pupils during the schoolday.
(3) For purposes of this subdivision, sunscreen
is not an
over-the-counter medication.
(4) Nothing in this subdivision requires school
personnel to
assist pupils in applying sunscreen.
Schools should actively encourage sunscreen use
as a supplement to other sun safety strategies
such as hats, long clothing, sun avoidance, etc.
Parents should be asked to ensure that their
child has a sufficient supply for use at school.
Reminders from the teacher, as well as
announcements, posters, etc. will help to
increase compliance.
Adopt a plan to accomodate children who forget
or run out of sunscreen. Product can be
sold in the student store and a supply can be
stocked in the nurse’s office. If funding
allows, a large pump bottle can be supplied in
primary school classrooms, and in the gym at
secondary schools. (A P.E. uniform with
longer sleeves and pants will lessen the amount
of sunscreen necessary.)
Although teachers in Australia commonly assist
young children in applying their sunscreen when
necessary, American teachers tend to be fearful
of touching a student. Nonetheless primary
teachers can be a tremendous help by
demonstrating application technique on
themselves and by providing appropriate
supervision and reminders, focusing most closely
on students who have light skin.
When it’s suggested that U.S. schools could
follow the Australian example of providing a
supply of sunscreen in classrooms,
administrators commonly raise an unfounded
concern that some child might be allergic.
Fortunately, allergic reaction to sunscreen is
very uncommon and, if one does occur, it is
generally a minor reversible skin rash.
This is in sharp contrast to the potentially
serious type of allergy that can occur in
reaction to certain foods, such as shellfish or
peanuts. Any concerns about possible
misuse or allergy to sunscreen should be on a
par with those regarding other skin products
already found at school, such as the hand soap
supplied in the restroom.
A simple and appropriate risk reduction strategy
would be to inform parents of the availability
of sunscreen at the school. If the parent
objects to the school’s sunscreen, they should
be advised to counsel their child not to use it.
Summary
Due to UV, the outdoors during daylight is akin
to a radiation chamber. To help protect
children from sustaining damage on the
playground, schools can and should strongly
promote the use of sunscreen as a supplement to
other sun protection methods.
