Sunscreen

FACTS

• 77% of people fail to rub sun cream onto the bridge of their nose.
• Eyelids are protected in almost 14% and the inner corners of the eyes
  and the side of the nose are forgotten. Warnings we have had in the
  past about avoiding the delicate eye area to blame for this.
• Sunglasses should be worn to help protect our faces and eyes from
  sun rays.
• More than 90% of the skin cancers occur in the head and neck area.

Studies show unequivocally that people are not putting sunscreen close enough to their eyes. They are leaving out parts of their face such as the bridge of the nose, the glabella between the eyebrows, the upper lids below the eye brows, the medial corners of the eyes, eyelids, the side wall of the nose going towards the medial corner and the lower lids. They are also leaving out the nasolabial folds, the lips and the chin.
Skin cancer diagnosis varies between doctors which can lead to both over and underreporting of life threatening conditions such as melanoma.
Moderate to severe cases of melanoma, which is a severe form of the disease, are often poorly judged with up to 40% of diagnoses being
inaccurate and this can put patients’ lives at risk. Fortunately mild cases more often in over 90% are correctly diagnosed. Efforts have been made to help improve clinical practice and help support doctors’ verdicts, however, the patient also must be very aware of new skin lesions which may be pigmented or non-pigmented and could represent early malignant melanoma.
Malignant melanoma is most often thought of as being pigmented, but a pigmented or non-pigmented versions can also occur. Although malignant melanoma is not the most common type of skin cancer, it can be the most severe and life threatening.
More common is basal cell carcinoma, which accounts the 90% of all skin cancers on the head and neck and 10% of all skin cancers are on the eyelids, hence a study from the University of Liverpool which was of 57 people is so important. See blog 1 on Sun Protection where they used a UV sensitive camera to take before and after photos of where the sun cream had been applied and found that people were missing almost 10% of the whole face most commonly around the eyelids, corners of the eyes and the bridge of the nose.
The British Association of Dermatologists says that people should go back to basics including thoroughly applying and then reapplying sun cream with a minimal factor of 30 with good UVA as well as UVB protection. People should also, spend time in the shade when the sun is at it hottest through 11 a.m. and 3 p.m.
People with Fitzpatrick skin types I to IV are more susceptible to sun damage and require SPF 50 even in London, April through to November, every day.
Jennifer Crawley is a Consultant Dermatologist at Clinica London with a special interest in dermatology. She is an expert in both adult and paediatric dermatology and has particular interests in research, teaching and leading audit projects.