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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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sunbatheFebruary 10 2016

Updated NICE guidance on protecting the skin from sunburn says health professionals should help to raise awareness of the amount of sunscreen people should use.

As most people do not apply enough sunscreen, “it is probably helpful to make them aware that ... the amount of sunscreen needed for the body of an average adult to achieve the stated SPF is around 35ml or 6 to 8 teaspoons of lotion,” says the new guideline NH34 ‘Sunlight exposure: risks and benefits’.

It warns that if spread too thinly, sun protection can be reduced, so that a sunscreen with an SPF of 15, may only achieve around an SPF5 level of protection or less. In addition, while using a higher SPF of SPF 30 or higher may partially overcome some of the problems of insufficient application, “it does not necessarily mean people can spend more time in the sun without the risk of burning.

“Sunscreen needs to be reapplied liberally, frequently and according to the manufacturer's instructions. This includes straight after being in water (even if it is 'water-resistant') and after towel drying, sweating or when it may have rubbed off.”

The guideline also advises that for people who will be exposed to the sun long enough to risk burning, “sunscreen needs to be applied twice to exposed areas of skin: half an hour before, and again around the time they go out in the sun. This includes the face, neck and ears (and head if someone has thinning or no hair), but a wide-brimmed hat is better.” People should use water-resistant sunscreen if they sweat or are going to be in contact with water.

The new guidelines replace recommendations 1 to 5 in the 2011 NICE guideline PH32 on skin cancer prevention.

Other recommendations in the updated guidance include:

  • professionals should offer one-to-one advice tailored to the individual’s level of risk;
  • 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, taking into account information from sources such as the Met Office UV index;
  • 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;
  • media campaigns should emphasise how the risks and benefits of sunlight will vary depending on the individual.

NICE said that the guideline committee “acknowledged that there is a need to provide clear advice on how to safely get vitamin D from sunlight,” and that the guideline “complements the existing NICE guideline on vitamin D which recommends that people who are at risk of low vitamin D should be given better access to supplements to protect their health.”

Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said: “How much time we should spend in the sun depends on a number of factors including geographical location, time of day and year, weather conditions and natural skin colour.”

“People with lighter skin, people who work outside and those of us who enjoy holidays in sunny countries all have a higher risk of experiencing skin damage and developing skin cancer. On the other hand, people who cover up for cultural reasons, are housebound or otherwise confined indoors for long periods of time are all at higher risk of low vitamin D levels”.

Links:

NICE announcement

NICE Guideline NG34 ‘Sunlight exposure: risks and benefits’

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