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For people with normal to oily skin, lotions tend to be more preferable because lotions have lower viscosity, spread more easily, and are less greasy Combination skin is also amenable to lotions, but patients with dry skin typi-
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for inclusion in makeup foundations, however For example, Parsol effectively blocks UVA, but is inactivated upon exposure to iron oxide and other pigments used in makeup foundations In addition, as stated above, the SPF on the label of a sunscreen powder and facial foundation is not an accurate reflection of how much sun protection these products offer This is because the average person applies much less sunscreen product than is used in FDA testing13 Within the last few years, manufacturers have produced hair care products, notably shampoos and conditioners, that contain sunscreen ingredients Such ingredients are probably rinsed away and rendered ineffective because many sunscreen ingredients are water soluble and many of the hair care products are intended to be rinsed out Although there are no data establishing their effectiveness, leave-in hair care products are more likely to provide some protection to the hair shaft The FDA has not recognized any of these products as having protective effects against the sun Until proper studies have been completed and data made available, including SPFlabeling, one should not rely on these products The best recommendation is to wear a hat to prevent sun damage to the hair
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A study by Montemarano et al found that insect repellent interferes with sunscreen efficacy66 However, a subsequent study by Murphy and Montemarano disputed this finding, showing that insect repellent has the same efficacy even when sunscreen is applied with it67 At this time, it is advisable to apply these products separately until further information is available
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the measurement of UPF69 Because clothing is not subject to the wide variation or inconsistency of sunscreen application, a fabric really does provide the level of sun protection that its UPF suggests15 Further, it is believed that approximately 90% of summer clothes have a UPF higher than 10 and offer protection equal to that of sunscreens of SPF 30 or higher; the UPF of approximately 80% of such clothing exceeds a reading of 15, and offers nearly complete protection under normal sun exposure patterns70,71 Washing clothes appears to strengthen the UPF It is well known that cotton clothes shrink from the washing process Therefore, it is reasonable to infer that the spaces, also known as pores, between a fabric s threads shrink from washing In fact, Welsh and Diffey demonstrated such a capacity in their study on the effects of fabric shrinkage (from laundry with water alone and detergent alone) on UPF measurement72 The relative size of these pores plays a significant role in limiting UV radiation transmission through clothing73 Wang et al compiled fabric porosity data that demonstrated a reduction in the total area of pores between threads or yarns in fabrics laundered in various methods74 They concluded that the reduction of pore size after washing was responsible for the observed increase in UPF measurements and the ensuing decrease in UV transmission through the fabric
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UPF can be further increased by washing fabrics with detergents that contain UV-absorbing agents Tinosorb, the UV-absorber used in the study by Wang et al, has a stilbene disulfonic acid triazine backbone that, when added to laundry, enables the chemical to vigorously bind to cotton fabric74 The result is a reduction in UV transmission through absorption of UV energy onto the ring structures of the compound The study results showed that the UPF increased significantly after multiple washings with detergent and UV absorber, though there was no noticeable change in the whiteness or texture of the fabric More UVA was transmitted through the fabrics than UVB, according to the authors While clothing obviously plays an integral role in protecting skin exposed to the sun, hats are also useful apparel adjuncts Wearing a broad-brimmed hat can provide an SPF of about 575 Hats can also add additional protection to the coverage that sunglasses provide by cutting down on the angles of sun exposure (Fig 29-7)
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