Sunscreen use in ichthyosis

 

Author: Dr. Pablo Lopez Balboa. Great Ormond Street Hospital for Children

 

Supervisors: Dr. Anna Martinez, Dr. Gabriela Petrof. Great Ormond Street Hospital for Children

 

Sunscreens are used to reduce the risk of sunburn and reduce the risk of skin cancer. They also reduce skin ageing and skin darkening. Ideally sunscreen should be applied all year round as the sun’s rays can still penetrate through clouds in winter. Checking the daily UV index may be helpful. As a rule, avoid prolonged direct sun exposure, maintain a cool temperature and stay hydrated and do a test patch of any new sunscreen before applying to larger areas.

 

  • Aim to use a high factor sunscreen product with SPF50. Those formulated for children and for sensitive skin may be better tolerated for individuals with ichthyosis.

 

  • There are two main types of sunscreens: Physical sunscreens: active ingredients are zinc oxide and/or titanium dioxide and chemical sunscreens: have many ingredients and absorb UV radiation. Physical sunscreens work like a shield on the surface of the skin reflecting UV radiation. These may be better suited for individuals with ichthyosis.

 

It is advisable to apply your emollient at least 30 minutes before applying the sunscreen.

 

  • You should always patch test a product – ask the chemist if they have any samples you could try before purchasing a sunscreen product. Apply it on the inside of the forearm and leave it for 24 hours before applying it to larger areas and the face.

 

  • Apply your regular emollients and after 30-40 minutes apply the sunscreen. It should be the last thing you apply before you leave the house. You will need to reapply the sunscreen during the day every 2-3 hours and you can follow the same process if you also need to use an emollient. Reapply sunscreen after each emollient application. If individuals find the sunscreen too drying, they could try sunscreens which are in lotion or spray form rather than cream.

 

  • If you find that the sunscreen sits on top of the emollient try switching to a less thick emollient, especially on the face, during the summer months. Don’t stop your regular emollients unless advised by your dermatologist.

 

  • For children it may be easier to apply sunscreen in a spray or stick form.

 

  • Individuals with ichthyosis can develop increased facial or body redness because the skin barrier is abnormal and does not function normally. Ichthyosis skin is very sensitive and can react to many things. There are many factors that contribute to the redness and prolonged sun exposure could be one of them. Doing a patch test first as advised above is very important.

 

  • Individuals who have reduced sun exposure, (perhaps if you keep your skin covered up, or spend a lot of time indoors), may be at risk of vitamin D deficiency especially during the winter months. It is advisable to have your vitamin D levels checked and supplement it if low. You can find further information here Vitamin D - NHS (www.nhs.uk) and www.ichthyosis.org.uk/FAQs/vitamin-d.

 

  • Using sunscreen will not make you Vitamin D deficient. Most people get enough vitamin D from daily life outdoors and you do not need to seek out extensive sun to increase your Vitamin D levels. · Further information on how to apply sunscreen Sunscreen and sun safety - NHS (www.nhs.uk)

 

 

The British Association of Dermatologist recommend the following sun protection tips:

 

  1. Spend time in the shade during the sunniest part of the day when the sun is at its strongest, which is usually between 11am and 3pm in the summer months.

 

  1. Avoid direct sun exposure for babies and very young children.

 

  1. When it is not possible to limit your time in the sun, keeping yourself well covered, with a hat, T-shirt, and sunglasses, can give you additional protection.

 

  1. Apply sunscreen liberally to exposed areas of skin. Re-apply every two hours and straight after swimming, sweating or towelling to maintain protection.

 

Some of the physical sunscreens, unfragranced products in the market are:

 

  • Isdin Fotoprotector Pediatrics Fusion Fluid Mineral Baby SPF50

 

  • La Roche-Posay Anthelios range SPF50

 

  • Mustela Very High Protection Sun Lotion SPF50

 

  • SunSense Kids SPF50

 

  • SunSense Sensitive SPF50

 

  • SunSense Ultra SPF50