[Cutaneous photoprotection. Suntan or no suntan? This is the question].
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Cultural Characteristics↗
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Tonality of suntan vs sunless tanning with dihydroxyacetone.
BACKGROUND/AIMS: Although there is an increasing awareness of the detrimental effects of solar irradiation on skin, a tanned look is still in fashion. To achieve the tanned look without sun exposure various sunless tanning formulations have become available. Most of these contain dihydroxyacetone (DHA) which binds to the proteins of the stratum cornium and imparts a brown color to skin. This color is similar to a suntan but can be somewhat more yellow, making it appear unnatural. The aim of this study was to determine a quantitative method to define a "natural" tan and to study methods to improve the tonality of sunless tanning on skin. METHODS: Tonality of suntan was determined as the marker for a "natural" tan. In order to achieve this, human volunteers were exposed to the sun and the change in skin color was observed after 3 days. Color measurements obtained with the Minolta Chromameter were plotted in two standard graphs labeled as the "natural universe of tan", which depicted a balance between Chroma and change in reflectance, while the "natural universe of color" determined the balance between changes in yellow and red components of the suntan. Change in skin color after treatment with DHA was then inserted in these graphs to observe how "natural" the tonality of sunless tan appeared relative to suntan. RESULTS: Results show a good balance between Chroma and change in reflectance for suntanned skin in the "natural universe of tan". Conversely, the "natural universe of color" exhibited a good balance between increase in yellow and red components of suntan. Sunless tan data inserted in these graphs showed that for several subjects with skin types I-II the tonality is not within the realm of "natural" but is unnaturally yellow. Addition of antioxidants, especially caffeic acid phenethyl ester (CAPE) in DHA formulation significantly shifted the tonality towards the center of the "natural universe of color". CONCLUSIONS: The "natural universes of tan and color" exhibit a simple and quantitative assessment of tonality of suntan and sunless tan. Although skin tonality from DHA-induced sunless tan can often lie outside the realm of the "natural" tan, it is possible to improve this tonality to a more "natural" look by addition of strong antioxidants in the DHA formulations.
Journal Article↗
The histological analysis, colorimetric evaluation, and chemical quantification of melanin content in 'suntanned' fish.
Human melanocytes respond to UV irradiation by increasing the synthesis of melanin. While much is now understood of the pathways governing this process and the nature of the melanin synthesized, little is known of melanins produced by lower vertebrates and their capacity to respond to UV. Here we report that a fish, red seabream, can undergo 'suntanning'. Histological, colorimetric and chemical assays were performed for suntanned red seabream fish bred in net cages to analyse the melanins and compared with shaded or wild red seabream fish. For color evaluation, the L* values of suntanned fish were dramatically lower than those in the other two groups. Pyrrole-2,3,5-tricarboxylic acid (PTCA), an indicator of eumelanin, was detected in suntanned fish at five times higher levels than in shaded or wild fish while 4-amino-3-hydroxyphenyl-alanine (4-AHP), a marker for pheomelanin, could not be detected in any of the samples. Histological analysis showed that melanocytes in the suntanned skin enlarged and increased in number to form a monolayer at the surface of the skin. Analysis of L* values and PTCA levels showed quite a high correlation coefficient (r = -0.843). When comparing shaded and wild red seabream fish, the scores were closer but some significant differences were still found in some body areas. These results indicate that eumelanin accumulates in suntanned fish during the increase in skin color, which is induced by sunlight, presumably by ultraviolet radiation.
Animals↗
Sunburn, suntan and the risk of cutaneous malignant melanoma--The Western Canada Melanoma Study.
A comparison of interview data on 595 patients with newly incident cutaneous melanoma, excluding lentigo maligna melanoma and acral lentiginous melanoma, with data from comparison subjects drawn from the general population, showed that melanoma risk increased in association with the frequency and severity of past episodes of sunburn, and also that melanoma risk was higher in subjects who usually had a relatively mild degree of suntan compared to those with moderate or deep suntan in both winter and summer. The associations with sunburn and with suntan were independent. Melanoma risk is also increased in association with a tendency to burn easily and tan poorly and with pigmentation characteristics of light hair and skin colour, and history freckles; the associations with sunburn and suntan are no longer significant when these other factors are taken into account. This shows that pigmentation characteristics, and the usual skin reaction to sun, are more closely associated with melanoma risk than are sunburn and suntan histories.
Adult↗
Suntanning and sun protection: a review of the psychological literature.
Excessive sun exposure has been linked to skin cancer and to premature aging, drying and wrinkling of the skin, predominantly among Caucasians. This review examines the psychological literature on suntanning and sun protection behaviours among Caucasians. The research is examined in relation to: methods of study; attitude and normative beliefs towards suntanning and sun protection; differences in suntanning and sun protection knowledge and behaviour as a function of age and sun protection; differences to change sun related behaviours. A consistent finding across studies is that many people show a high level of knowledge of the dangers of excessive sun exposure and the need for sun protection, however, this knowledge often does not transfer into behaviour, with many people, particularly adolescents, still desiring and actively seeking a suntan. The implications of these findings for intervention studies are discussed.
Adolescent↗
Evaluation of a super long pulsed 810-nm diode hair removal laser in suntanned individuals.
BACKGROUND: Laser hair removal is based on the dual concepts of selective photothermolysis and thermal relaxation time. In most laser hair removal systems, light with emitted pulse durations of 2-50 ms targets hair follicles. Such pulse durations usually lead to post-inflammatory pigmentary changes in suntanned individuals. OBJECTIVE: In this pilot study, we evaluated the clinical efficacy and side effect profile of a modified 810-nm diode laser device (Palomar SLP 1000, Burlington, MA, USA) operating in a super long pulse mode (200-1000 ms). METHODS: Five suntanned subjects with Fitzpatrick skin types II-IV received either one or two laser treatments at eight test sites. Treatments were delivered to suntanned skin. Pulse durations of 200-1000 ms were evaluated with delivered fluences ranging from 23 to 115 J/cm(2). Subjects were followed for 6 months after the first treatment. Subjects were evaluated for hair removal efficiency, optimal pulse duration and delivered fluence, one versus two treatments, and associated complication rate. RESULTS: The average hair reduction, 34%, did not significantly vary with pulse duration or fluence. Clinical evaluations rated two treatments superior to one. CONCLUSION: The results show that efficacious and safe hair removal can be accomplished with an 810-nm diode laser delivering super long pulse durations at a wide range of settings in suntanned individuals. For optimal safety in tanned patients, the highest fluence (115 J/cm(2)) and pulse duration (1000 ms) should be avoided.
Adult↗
Presence of benzo[a]pyrene and other polycyclic aromatic hydrocarbons in suntan oils.
Column and thin-layer chromatography followed by spectrophotofluorometry were used to determine the carcinogen benzo[a]pyrene and other polycyclic aromatic hydrocarbons (PAH) in commercial samples of four suntan iols based on mineral and/or vegetable oils liable to contain traces of PAH. The analyses showed that all the samples contained benzo[a]pyrene together with three other mutagenic, co-carcinogenic or non-carcinogenic PAH (perylene, fluoranthene and benzo]k]fluoranthene). One sample also contained the carcinogen anthanthrene. The total PAH content of the samples varied from 88 . 5 to 188 . 7 ng/g while benzo[a]pyrene levels were in the 1 . 5-4 . 7 ng/g range. The results suggest that users of suntan oils may be exposed to low levels of potentially hazardous PAH; however, in comparison with many other cosmetics that are presumably based on similar oils, suntan oils are only used intermittently and for relatively short periods.
Benzo(a)pyrene↗
The effect of suntan parlor exposure on delayed and contact hypersensitivity.
Cutaneous and systemic immune function are believed to play an important role in cutaneous carcinogenesis. We therefore sought to determine whether the suntan parlor radiation sources commonly used in the United States cause measurable qualitative suppression of immune function and quantitative alterations in circulating T cell subpopulations. Subjects (n = 22) were recruited and randomly assigned to receive suntan parlor exposures (10 full-body UV exposures over a 2 week period, shielding only the right flexural arm) or no exposure. Baseline circulating T lymphocyte subpopulations (T helper lymphocyte, CD4; T suppressor/cytotoxic lymphocyte, CD8) were measured. Two weeks later (upon completion of UV exposures for those in this group), circulating T cell subpopulations were measured and dinitrochlorobenzene (DNCB) sensitization (in the UV group, on the UV-exposed buttock) was performed. Subsequent DNCB elicitation was performed in a bilateral fashion (in the UV group, on the right UV-shielded and the left UV-exposed upper arm). We found that subjects in the UV group demonstrated localized suppression of contact hypersensitivity sensitization and elicitation and also an increase in circulating CD8 cells when compared to the control group (P < or = 0.05). We conclude that suntan parlor exposures, as typically received in this country, suppress contact hypersensitivity and increase the circulating T suppressor/cytotoxic cell number quantity.
Adult↗
Development and optimization of an analytical method for the determination of UV filters in suntan lotions based on microemulsion electrokinetic chromatography.
Microemulsion electrokinetic chromatography (MEEKC) has been applied to the separation of some UV filters (Eusolex 4360, Eusolex 6300, Eusolex OCR, Eusolex 2292, Eusolex 6007, Eusolex 9020, Eusolex HMS, Eusolex OS, and Eusolex 232) commonly found in suntan lotions. The composition of the microemulsion employed was optimized with respect to the best possible separation of the selected analytes using artificial neural networks (ANNs). Two parameters namely the composition of the mixed surfactant system comprising the anionic sodium dodecyl sulfate (SDS) and neutral Brij 35 and the amount of organic modifier (2-propanol) present in the aqueous phase of the microemulsion were modeled. Using an optimized MEEKC buffer consisting of 2.25 g SDS, 0.75 g Brij 35, 6.6 g 1-butanol, 0.8 g n-octane, 17.5 g 2-propanol, and 72.1 g of 10 mM borate buffer (pH 9.2), eight target analytes could be separated in under 25 min employing a diode-array detector to segregate the overlapping signals obtained for Eusolex 9020 and Eusolex HMS. Detection limits from 0.8 to 6.0 nug/mL were obtained and the calibration plots were linear over at least one order of magnitude. The optimized method could be applied to the determination of Eusolex 6300 and Eusolex 9020 in a commercial suntan lotion.
Chromatography, Micellar Electrokinetic Capillary↗
[Determination of 5-methoxypsoralen in suntan cosmetics].
A method for the determination of 5-methoxypsoralene in suntan-cosmetics is described. After liquid chromatographic clean-up, the final extract is screened by twodimensional thin layer chromatography. For positive extracts 5-methoxypsoralene is analysed quantitatively by capillary gas chromatography, using 5-alpha-cholestane as an internal standard and flame ionization detection (FID). The results were confirmed by gas chromatography-mass spectrometry (GC-MS). The recoveries for suntan-cosmetics of emulsion type were 70% and for tanning oils 90%. Detection limits of the method were 0,1 to 0,5 mg/kg, depending on the sample type. By application of this method 5-methoxypsoralene was detected in 6 of the 21 cosmetic products at levels up to 28 mg/kg.
5-Methoxypsoralen↗
The impact of the kidskin sun protection intervention on summer suntan and reported sun exposure: was it sustained?
BACKGROUND: Recognition that early sun exposure is an important risk factor for cutaneous melanoma in white populations has led to efforts to reduce children's sun exposure. 'Kidskin' was a non-randomized, school-based sun protection intervention trial in Perth, Western Australia (1995-1999). Its aim was to determine the extent to which such a program could reduce children's sun exposure. METHODS: Kidskin involved 1614 children assigned to one of three groups: a Control, a 'Moderate' and a 'High' intervention group of 14, 11 and 8 schools respectively. The unit of assignment was the school. Control schools received the standard health education curriculum, while intervention schools received a multi-component intervention including a specially designed curriculum. The High intervention group received additional components. Outcomes included parent reported sun-related behaviors and objectively measured suntan at the end of summer vacation. These outcomes were observed every 2 years. Statistical analyses allowed for correlations between students within schools. RESULTS: Kidskin initially had favorable effects on reported sun exposure and measured suntan. However, at the end of the 4-year program, and again 2 years later, little evidence of a favorable effect remained. CONCLUSIONS: The benefits of childhood sun protection interventions may not last beyond the life of the program.
Child↗
Should subjects who used psoralen suntan activators be screened for melanoma? Epidemiology and Prevention Subgroup, EORTC Melanoma Cooperative Group EORTC Prevention Research Division.
BACKGROUND: Psoralens are potent tanning activators that have been introduced in France and in Belgium in some tanning lotions and sunscreens. It was shown that poor tanners who ever used psoralen tanning activators display a four-fold increase in melanoma risk when compared to poor tanners using regular sunscreens. Although psoralens have now banned from suntan lotions, it is likely that the increase in melanoma risk linked to their previous use will persist for several years. METHODS: The melanoma risk attributable to psoralens use was calculated to evaluate the population at risk in France and Belgium. RESULTS: Melanoma incidence for the year 1995 was estimated to be of 10.2 per 100,000 in France and of 10.0 per 100,000 in Belgium, representing 5,900 and 1,000 melanoma cases. From the melanoma incidence among poor tanner who ever used psoralens (52 per 100,000) and estimation of the percentage of psoralen users among poor tanners, it can be derived that, for the year 1995, 267 melanoma cases could be attributed to psoralen tanning activators. CONCLUSIONS: Subjects who used psoralen suntan activators should be informed of their increased melanoma risk and be encouraged to participate in clinical programmes for early detection of melanoma, more especially when they are poor tanners and display a high naevi count. Such an action could save a significant number of lives.
Ficusin↗
Effects of indomethacin on sunburn and suntan reactions in hairless descendants of Mexican hairless dogs.
The inhibitory effects of topical indomethacin (IM)-treatment on sunburn and suntan reactions after ultraviolet (UV)-irradiation were investigated in the dorsal skin of hairless descendants of Mexican hairless dogs. Skin color, plasma prostaglandin E2 (PGE2) and histological features were examined. At 1 day after UV-irradiation, the IM-untreated sites showed prominent erythema, while the IM-treated sites exhibited few visible erythematous reactions. From 4 days after UV-irradiation, both the IM-treated and -untreated sites began to develop skin pigmentation. Assessment of skin color changes, using a colorimeter, reflected precisely the color changes in visual sunburn and suntan reactions. Plasma PGE2 concentration began to increase from 2 hours after UV-irradiation, reached the maximal values at 24 hours and recovered at 96 hours after UV-irradiation. Histologically, at 1 day after UV-irradiation, the IM-untreated sites showed remarkable epidermal degeneration (thickening and sunburn cells) and moderate alteration in the dermis. On the other hand, the IM-treated sites showed only minor histological changes. At 4 days after UV-irradiation, deposition of melanin granules was found in both the IM-treated and -untreated sites. At 7 days after UV-irradiation, pigmentation became more prominent in the stratum basale. These results revealed that UV-induced erythematous reactions of hairless dogs were closely related to the action of PGE2. Visually and histologically, topical IM-treatment had apparent inhibitory effects on erythematous reactions, while this agent showed no protective effects on epidermal pigmentation after UV-irradiation.
Administration, Topical↗
[Suntanning and risk of cutaneous melanoma: a literature review].
Epidemiological studies suggest a relationship between suntanning habits and high risk of melanoma. A literature review was carried out for the period between 1977 and 1998 using Medline and Embase (Excerpta Medica) databases. The analysis showed that intentional sun exposure is highly prevalent among youths, despite their awareness of the risks involved in excessive exposure to ultraviolet radiation and their knowledge on skin protection measures. Intentional exposure is a habit fostered by certain beliefs and attitudes towards suntanning and stimulated by peer pressure and aesthetic referents. The most common tanning practices involve a high risk of developing melanoma. It was concluded that the most effective means to prevent melanoma is mass media dissemination of the concept that having a tanned skin is not healthy -- since it implies the skin being damaged by solar ultraviolet radiation -- and education campaigns for effectively changing people's behaviors and their motivations.
Female↗
Suntanning: differences in perceptions throughout history.
In ancient times, the sun was venerated as a source of life in some cultures. Scientifically, the relationship between vitamin D and sunlight and the deficiency of vitamin D in patients with rickets were ultimately discovered. In 1903, Niels Finsen was awarded the Nobel Prize in medicine or physiology for his "Finsen light therapy" for infectious diseases, especially lupus vulgaris. In the 1930s and 1940s, the medical profession promoted sunbathing as beneficial for children. From these bases, the popularity of suntanning emerged, promoted by the availability of more leisure time and, eventually, the development of sunlamps and commercial tanning salons. Although the precise role of ultraviolet light in the pathogenesis of melanoma is uncertain, a melanoma epidemic began to be noticed in the 1970s. During the past 15 years, campaigns have attempted to educate the public about the potential dangers of suntanning and exposure to ultraviolet light. Whether the melanoma epidemic can be reversed remains to be seen.
Attitude to Health↗
Assay of suntan lotions for the carcinogenic, non-volatile N-nitrosamine N-nitrosodiethanolamine.
N-nitrosodiethanolamine (NDELA) is a carcinogenic, non-volatile nitrosamine that has been shown to pass readily through the skin of animals and humans. It has often been found as a contaminant in cosmetics. Twenty different suntan lotions, available in Israel, both liquids and creams, were analyzed for NDELA content. Most products contained undetectable or trace levels, but 3 were found to be contaminated with as much as 27 ppb of the nitrosamine. Continual use of such products, especially by small children and infants, may significantly increase their exposure to NDELA.
Carcinogens↗
Skin type and optimistic bias in relation to the sun protection and suntanning behaviors of young adults.
The study examined the roles of general and personal beliefs and skin type in relation to suntanning and sun protection, by assessing various perceptions of risk of skin cancer both for the self and for the average person. A sample of 355 people aged 16 to 25 years was selected randomly from the telephone directory of a coastal provincial city. Highly structured interviews were conducted over the telephone. The findings were presented in relation to three research questions. First, skin type, classified as burn only, burn then tan, or tan without burning, influenced both general and personal beliefs. Compared to the tan-only group, the burn-only group perceived earlier age at onset, greater number of years of life lost, and greater severity of skin cancer, for both the average person and the self, and greater susceptibility to skin cancer for the average person. Second, differences were found between personally relevant and population-relevant beliefs on susceptibility to skin cancer, time of onset, and years of life lost due to skin cancer but not for perceptions of severity and curability. Finally, skin cancer beliefs were poor correlates of tanning and protecting behaviors. The factor explaining the greatest proportion of variance in both behaviors was skin type.
Adolescent↗
5-Methoxypsoralen, an ingredient in several suntan preparations, has lethal, mutagenic and clastogenic properties.
Many furocoumarins found in several species of plant are potent photosensitizing agents known to cause lethal and mutagenic effects in a wide range of organisms, from viruses to man. Their role in the aetiology of cancer is debatable, but work has focused on the PUVA (psoralen-UVA) treatment of psoriasis with 8-methoxypsoralen (8-MOP) and near UV radiation. Bergaptene (5-methoxypsoralen, 5-MOP) is a major constiutent of oil of bergamot, and might be expected to have qualitatively similar photosensitizing properties to 8-MOP. Although 5-MOP is widely used as a stimulus to melanin deposition in several suntan preparations surprisingly little is known about its basic photobiology. We report here that 5-MOP has the expected properties of other biologically active furocoumarins. These properties include lethal and mutagenic photosensitization of bacteria, 'dark' induced frameshift mutagenesis in bacteria, and lethal and clastogenic effects on mammalian cells in tissue culture.
Animals↗