Skin cancer is the most common cancer in the United States. American Academy of Dermatology estimates that one in five Americans will develop skin cancer in his or her lifetime. It is estimated that more than 8,500 people in the United States are diagnosed with skin cancer every day. In 2017, it is estimated that there will be 87,110 new cases of melanoma in the United States and 9,730 deaths from the disease. Exposure to natural and artificial ultraviolet light is a risk factor for all types of skin cancer. Avoiding this risk factor alone could prevent more than 3 million cases of skin cancer every year.

Sunscreen is necessary whenever people spend time outdoors. Dermatologists strongly recommend using a sunscreen with an SPF of 15 or greater year-round for all skin types. Even on a cloudy day, 80 percent of the sun's ultraviolet rays pass through the clouds. Those who ski or spend time in the mountains during the winter should also be cautious – ultraviolet radiation increases four percent for every 1,000-foot increase in altitude. A great way to limit the risk of sunburn is to go outdoors in the early morning or the late afternoon when the sun is lower in the sky. Another way to add additional protection is to wear opaque clothing; shirts, hats, shorts, and pants reduce the risk of burning by 27 percent by shielding the skin from the sun's ultraviolet rays.

Sunscreens are composed of a combination of two types of ingredients: those that reflect ultraviolet rays and those that absorb ultraviolet rays.

Clients should choose a broad-spectrum sunscreen that protects against both UVB and UVA radiation. In the past, para-aminobenzoic acid (PABA) was one of the original UVB-protecting ingredients in sunscreens. PABA esters only protect against UVB radiation, the sun's burning rays that are the primary cause of sunburn and skin cancer. UVA radiation penetrates deeper into the skin and causes premature aging and the formation of wrinkles. UVA-screening ingredients include oxybenzone (benzophenone-3), sulisobenzone (benzophenone-4), and avobenzone (Parsol 1789).

THE MEANING OF SPF
Early synthetic sunscreens were first used in 1928 and the first major commercial product was brought to market in 1936 by the founder of L'Oréal, French chemist Eugène Schueller. In 1932, Hamilton Sunscreen arrived on the Australian market, which was developed by chemist Milton Blake.

The sun protection factor (SPF) displayed on a sunscreen label ranges from two to 50 and refers to the product's ability to screen or block the sun's harmful rays. For example, if a client uses sunscreen with SPF 15, they can be in the sun 15 times longer than they would be able to without using sunscreen before burning. It might sound like an easy concept, but consumers need to be aware that SPF protection does not increase proportionally with an increased SPF number. According to the American Melanoma Foundation, while an SPF of two will absorb 50 percent of ultraviolet radiation, an SPF of 15 absorbs 93 percent and an SPF of 34 absorbs 97 percent.

High-SPF products are made with higher concentrations of sun-filtering chemicals than low-SPF sunscreens. Some of these ingredients may pose health risks such as tissue damage and hormone disruption when they are absorbed into the skin, yet they have not been proven to significantly reduce skin damage and skin cancer risk better than their low-SPF counterparts.

According to the Environmental Working Group's Guide for Sunscreens, "The FDA has long contended that SPF higher than 50 is inherently misleading." Australian authorities cap SPF values at 30; European and Japanese regulators cap SPF at 50 and Canada only allows for a maximum of "50+". In 2011, the FDA proposed a regulation to prohibit labels higher than 50+, but the agency has not completed work on this rule or put it into force.

The SPF number only reflects the product's ability to screen UVB rays. At present, there is no FDA-approved rating system that measures UVA protection levels.

PHYSICAL VERSUS CHEMICAL
Physical sunscreens contain minerals such as titanium dioxide and zinc oxide, which work by sitting on top of the skin and deflecting damaging ultraviolet rays away from the skin.

Zinc oxide is not only incredible at protecting the skin from the sun, but it is also excellent for the skin. Dr. James E. Fulton wrote that zinc helps cut down the inflammatory response of acne. He even recommends 100 milligrams or more daily as a supplement for Grade III and Grade IV acne sufferers. Zinc also helps reduce inflammation during rosacea flare-ups.

Titanium dioxide is another physical sunscreen ingredient recommended by the American Academy of Dermatology and is the preferred ingredient of the Environmental Working Group. It is not a chemical sunscreen and is, therefore, nonreactive for people allergic to chemical sunscreens. This ingredient is preferred when shopping for children's sunscreen products. Like zinc, it also sits on top of the skin and deflects the sun's rays. Although this mineral ingredient offers exceptional protection, it may appear too white and chalky on ethnic clients with darker skin. Generally, sunscreens with a micronized titanium dioxide and zinc oxide will not leave the skin too chalky.

Today, since most people are sensitive to PABA, alternative UVB absorbers – such as padimate A, padimate O, salicylates, and cinnamates – are often used in place of the ingredient.

Oxybenzone is classified as a chemical sunscreen agent. It helps preserve the integrity of other cosmetic ingredients, preventing their deterioration under the sun. For this reason, oxybenzone is most often used in products in conjunction with other ingredients. Sulisobenzone (benzophenone-4) is approved by the FDA in concentration of five percent and in Canada is approved by Health Canada at concentration of six percent. It works to filter out both UVA and UVB rays.

LIP PROTECTION
Remembering to wear sunscreen is crucial, especially when it comes to protecting the lips. According to the Skin Cancer Foundation, the lips are highly susceptible to two of the most common skin cancers: basal and squamous cell carcinoma. The lower lip is more prone to cancerous events and males are three to 13 times more likely to develop cancer due to the nature of their occupation, alcohol, and tobacco usage.

In spite of their darker color, lips have almost no melanin, giving them no protection from the sun. There are several easy ways for clients to prevent their lips from sun damage. First, they should avoid using lip gloss and high-shine lipsticks. Glosses and lip product with shine have the same effect that the shiny surface of rivers, lakes, and oceans do on a sunny day. Instead of protecting the lips, these shiny glosses actually increase the chances of sun damage and lip cancer by directing the rays towards the lips. Clients should choose a matte product with an SPF of 30. These products have the added benefit of locking moisture into the lips longer and more effectively than thinner products.

MISCONCEPTIONS AND PRECAUTIONS
In addition to sunscreens, many manufacturers have been adding SPF to foundations and day creams. This labeling may be misleading to the consumer since sunscreens lose their effectivity with time; if clients apply SPF-fortified foundation in the morning, they will need to re-apply sunscreen throughout the day on top of it. Waterproof sunscreens are oil-based and highly comedogenic. Often, clients struggle with acne because their sunscreen will not let their skin breathe. Since people sweat throughout the day, waterproof sunscreen blocks all pore secretions, causing breakouts.

NOT ALL SKIN IS THE SAME
Darker skin has more protection from ultraviolet rays. In fact, skin cancer rarely develops in people with highly pigmented skin.

Melanocytes are the cells that synthesize melanin through a four-stage maturation process called melanogenesis. Melanogenesis leads to long-lasting pigmentation, which is in contrast to the pigmentation that originates from oxidation of already-existing melanin.

Clients of all races have the same number of melanocytes (typically between 1,000 and 2,000 melanocytes per square millimeter of skin). The difference in skin color between lightly and darkly pigmented individuals is not due to the number of melanocytes in their skin, but to the melanocytes' level of activity and in the size and distribution of melanosomes. Melanosomes of darker, deeply pigmented skin are large, singly dispersed, and packed with melanin. Dark skin, especially that of people of African descent, has the most mature melanosomes. This type of skin has melanosomes in every layer of the epidermis. Light-skinned people of African descent have a combination of large, singly dispersed melanosomes and clusters of small melanosomes. Fair skin has small melanosomes that are clustered together, mainly in the stratum corneum, in response to the sun's light.

Darker Skin Types
In deeply pigmented skin, ultraviolet radiation is filtered through the Malphigian layer. Darker skin types have a natural SPF of eight to 13. Approximately 17 percent of UVA and seven percent of UVB rays reach the dermis.

Fair Skin
Ultraviolet rays are filtered through the stratum corneum in fair skin types. Caucasian skin has a natural SPF of three to four, and the dermis receives five times as much ultraviolet light.

ULTRAVIOLENT PROTECTION FACTOR

To maximize solar protection, it is recommended that clients wear special solar protection clothing from a list of approved fabrics. Fabrics can be made from many types of fibers, including cotton, wool, and nylon. Most fibers naturally absorb some ultraviolent radiation. Synthetic fibers, such as polyester, lycra, nylon, and acrylic, are more protective than bleached cottons and shiny or lustrous semi-synthetic fabrics, like rayon, reflect more ultraviolet radiation than matte fabrics, such as linen, which tend to absorb rather than reflect ultraviolet rays.

Ultraviolet protection factor (UPF), a concept originally standardized in Australia in 1996, quantifies how effectively a piece of clothing shields against the sun. It is actually possible to choose clothing with UPF on the tag. Whenever there is a UPF label attached, it means the fabric has been tested in a laboratory and consumers can be confident about the listed level of protection. It is based on the content, weight, color, and construction of the fabric and indicates how much ultraviolet radiation can penetrate the fabric. Unlike SPF measurements that traditionally use human sunburn testing, UPF is measured using a laboratory instrument (spectrophotometer or spectroradiometer) and an artificial light source; a sunburn weighting curve is then applied (erythemal action spectrum) across the relevant ultraviolet wavelengths.

For instance, a shirt with a UPF of 50 allows just 1/50th of the sun's ultraviolet radiation to reach the skin. This shirt would provide excellent sun protection in contrast to a thin white cotton shirt, which has a UPF of about five, which allows 1/5th of the sun's ultraviolet radiation through the shirt; even more is permitted when the shirt is wet. In studies done in Australia, lycra/elastane fabrics were the most likely to have UPFs of 50 or higher, followed by nylon and polyester.

NUTRITION AND SUPPLEMENTS
UVB rays trigger the synthesis of vitamin D, otherwise known as the sunshine vitamin. According to recent Harvard University data, an estimated 1
billion people in the United States are low in vitamin D. One study found that vitamin D deficiency was a contributing factor in recurrent major depressive disorder with seasonal patterns, a form of depression that only occurs during certain times of
year. Another study found that vitamin D deficiency was linked with faster growth of breast cancer cells in mice.

Vitamin D deficiency can cause: impaired immune system functioning, which puts people at a higher risk for infection; rickets, a condition
that most commonly occurs in children that causes bone softening; insulin resistance, which affects a person's ability to use insulin to process blood sugar; and thin or brittle bones, which increases the risk of osteoporosis.

Research shows that vitamin D plays a very important role in preventing disease and maintaining optimal health. There are about 30,000 genes in the human body and vitamin D affects nearly 3,000  of them. The skin creates the same vitamin D in response to sunlight as the vitamin D it gets from an oral supplement; it is also a much safer alternative to tanning!

The Institute of Medicine has set the Recommended Dietary Allowance (RDA) of vitamin D at 600 international units for everyone under the age of 70 and 800 international units for adults over 70. Many experts believe that number is too low; physicians will most-likely advise 2,000 international units daily, especially for those with low blood levels.

Clients should consider taking 5,000 international units of vitamin D daily and adding vitamin D-rich foods to their diet. Vitamin D is present in foods such as fatty fish (mackerel, salmon, tuna, sardines, and trout), fish roe, beef, beef liver, cheese, egg yolks, fish liver oils, and mushrooms. Of course, all systems work well for different people, so finding a perfect combination of sunscreen, clothing, supplements and diet changes is key to a healthier lifestyle.

Dasha Saian is the co-founder and CEO of SAIAN® and has over 17 years of experience in the spa industry. In addition to her Business/Marketing degree, she is a licensed aesthetician, certified nutrition and wellness consultant, official ambassador of the Aesthetics International Association (AIA), and certified family herbalist. Saian gives lectures and classes internationally and regularly contributes to global trade publications. She is an expert adviser on natural living, alkaline diet, alternative oncology protocols, and positive body image.