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This month’s Drug and Therapeutics Bulletin (DTB) argues that the National Institute of Clinical Excellence’s guidelines, which state that SPF 15 if applied adequately is sufficient to prevent sunburn, is far to low.
A paper in the Bulletin recommends the use of an SPF of 30, together with a four or five star UVA rating, for adequate protection from the sun. SPF refers to the amount of protection given against UVB, ultraviolet rays responsible for most sunburn, which can cause skin cancer.
NICE’s latest guidance for healthcare professionals and practitioners, published in January, advises the use of at least a SPF 15 to protect against UVB and offer high UVA protection. It says that sunscreen should be applied liberally half an hour before and after going out in the sun, and re-applied every two hours. It recommends that children be encouraged to seek shade and when this is not possible to wear hats and other clothing or sunscreen.
However the DTB says that NICE should review its guidance as people using sunscreens typically apply much less than what is recommended, and get no more than half the protection indicated by the labelled SPF. According to their research, a SPF of 50 typically provided a protection of between SPF 19 and three.
Dr Ike Iheanacho, editor of DTB said, ‘In our view, NICE’s recommendation to use sunscreens with an SPF as low as 15 is a blunder that overlooks the key evidence and is not in the best interests of public health. This advice needs urgent review and correction.’
Prof. Mike Kelly, director of the Centre for Public Health Excellence at NICE said, ‘The NICE guidance referred to by the DTB was not an assessment of which sun protection factor is optimal, but rather was concerned with the most effective ways of reducing skin cancer in England through provision of information, supply of resources and changes to the physical environment. It also sought to make clear that sunshine can be good for us, in that it provides a good source of vitamin D, and the opportunity to be physically active out of doors.
‘We commissioned an expert report on the use of sunscreen in preventing skin cancer in England. According to this evidence, which was presented to the committee, SPF 15 should be sufficient as long as it is applied adequately. However, the guidance also acknowledges that to take account of people not applying sufficient quantities of sunscreen, SPF 30 was also recommended in an expert paper.’
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