By Aaron Le Poire, PharmD Student Cedarville University
We have often sought healthy and youthful complexions throughout history. One way people have tried to prevent aging is by using creams and lotions to protect themselves from wrinkling and the damaging effects of the sun on the skin.1,2 Exposure to the harmful A and B ultraviolet components of sunlight is one of the leading causes of skin aging and skin cancer.3,4 One of the most common ways used to prevent the aging of skin from the sun is sunscreen.5
Recently, a news article from USA Today was published lauding the benefits of sunscreen based on a study issued in the Annals of Internal Medicine.6 The study, which followed hundreds of people over a four and a half year period, found 24% less skin aging in people who regularly applied sunscreen.7 The researchers studied people who were less than 55 years old because their skin-aging is primarily from the sun and not due to their age. The study made replicas of the skin on the back of the subject’s hands in order to measure the deterioration of the skin at the beginning and end of the trial. The study concluded that the regular use of sunscreen by young and middle-aged adults could slow down the aging of their skin from the sun.7
There are other studies that support the same opinion that sunscreen can limit the effects of aging from the sun.8,9 Studies have found sun exposure can damage skin and can be avoided by protecting oneself from harmful UV rays.10 The FDA also suggests that skin aging and cancer can be avoided by the use of sunscreen.11 The difference between this study and others is this particular one actually put those findings to the test in a large-scale trial examining many subjects over a long period of time. The study was also completed in a sunny part of Australia that is as close to the equator as Florida.6
One of the limitations of the study was one-third of the people enrolled in the study only completed one reading of their skin, usually the first time. Another limitation of the study could be the use of lotions or moisturizers by the subjects to protect their skin affecting how much it deteriorated over time. Using less effective sunscreen than what is on the market today is also another limitation of the study. More research needs to be done to see if newly developed sunscreens help even more with the aging of skin. There are some studies that could suggest the chemicals in sunscreen could be harmful to the body. One study found some ingredients in sunscreen to cause genetic damage in mice, but this has not been tested in humans.12 Another study found sunscreen use tied to increased free radicals in the body, which could lead to an increased risk for cancer.13
The trial had a solid study design, as it was a randomized, controlled, clinical trial. Along with the study design, the location of the study and efforts by the researchers to make sure the people enrolled were complying with the design make the results even more pertinent. Any study longer than the one in the article is unlikely to be implemented because it would be considered unethical to keep people from using sunscreen for such long periods of time.6
The practice of sun protection as laid out by the FDA includes reducing time in the sun, wearing appropriate clothing such as hats, long pants, sunglasses, and long sleeve shirts.11 Another recommendation is the use of sunscreen. The sunscreen used should be at least 15 SPF, which is what was used in the study. It is also recommended to use a water resistant and “broad spectrum” sunscreen that protects against the different types of UV radiation from the sun. Make sure to apply it evenly to all exposed skin at least 15 minutes before going out and reapply at least every 2 hours.11
Protecting your skin from the sun is very important, not only for it’s appearance but also for preventing the risk of skin cancer. Sunscreen is one easy way to protect your skin from both aging and cancer. Studies have shown the effectiveness of sunscreen for protection against UV radiation.8 The study mentioned in the article delivers confirmation of the benefits regular use of sunscreen can have on the aging of your skin over a prolonged time period.
So, do you think this trial provides enough evidence for the beneficial effects of sunscreen? Or do you think sunscreen has too many harmful effects? Does this evidence change your opinion on how you will use sunscreen in the future?
 Brandt FS, Cazzaniga A, Hann M . Cosmeceuticals: current trends and marker analysis. Semin Cutan M ed Surg. 2011;30:141-3. [PMID: 21925366]
 Yaar M , GUchrest BA. Aging of skin. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, et al, eds. Fitzpatrick’s Dermatology in General Medicine. 5th ed. New York: McGraw Hill; 1999:1697-706.
 Rabe JH, Mamelak AJ, McElgunn PJ, Morison WL, Sauder DN. Photoag- ing: mechanisms and repair. J Am Acad Dermatol. 2006;55:l-19. [PMID:
 Foote JA, Harris RB, Giuliano AR, Roe DJ, Moon TE, Cartmel B, et al. Predictois for cutaneous basal- and squamous-cell carcinoma among actinically damaged adults. Int J Cancer. 2001;95:7-ll. [PMID: 11241303]
 Antoniou G, Kosmadaki MG, Stradgos AJ, KaKambas AD. Photoaging: prevention and topical treatments. Am J Clin Dermatol. 2010;l 1:95-102. [PMID: 20141230]
 Painter K. Regular sunscreen use slows skin aging, study shows. USA Today. June 3, 2013.
 Hughes MC, Williams GM, Baker P, Green AC. Sunscreen and prevention of skin aging: a randomized trial. Ann Intern Med. 2013;158(11):781-90.
 Gilchrest, B.A. A review of skin ageing and its medical therapy. Br. J. Dermatol. 1996;135: 867–875.
 Naylor, M.F. & K.C. Farmer. The case for sunscreens: a review of their use in preventing actinic damage and neoplasia. Arch. Dermatol. 1997;133: 1146–1154.
 Taylor CR, Stern RS, Leyden JJ, Gilchrest BA. Photoaging/photodamage and photoprotection. J Am Acad Dermatol. 1990;22(1):1-15.
 FDA. Sun safety: save your skin! FDA website. 2012 available at http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049090.htm. Accessed October 1, 2013.
 Trouiller B, Reliene R, Westbrook A, Solaimani P, Schiestl RH. Titanium dioxide nanoparticles induce DNA damage and genetic instability in vivo in mice. Cancer Res. 2009;69(22):8784-9.
 Hanson KM, Gratton E, Bardeen CJ. Sunscreen enhancement of UV-induced reactive oxygen species in the skin. Free Radic Biol Med. 2006;41(8):1205-12.
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