dr.

Dwi Retno Adi Winarni, SpKK(K), FINSDV

Departemen Dermatologi Venereologi
Fakultas Kedokteran UGM/ RSUP DR Sardjito
Yogyakarta
 Overview

1. Types of sun protection

2. Dermocosmetics
3. Choosing the right sun protection in acne
4. How to use sun protection in acne
1. Types of sun protection

Solar UV radiation is 95% UVA & 5% UVB

 SUNSCREEN

Figure 1. Classification of sunscreening agents

There are two types of sunscreens,
Physical and Chemical.

Physical sunscreens:

• UV-blocking agents.
• They tend to work immediately,
• Broad-spectrum
• Two physical sunscreens: Zinc oxide & Titanium dioxide.
• Zinc oxide: the gentler & offers superior sun protection.
• Tend not to clog pores and stay effective all day long, no
matter how long you are in the sun.
• Drying to the skin, and due to the physical nature of zinc
oxide and titanium dioxide, most brands go on white and
leave the skin looking pale.
There are two types of sunscreens,
Physical and Chemical.

Chemical sunscreens:

• are Chemical agents in an aqueous base

• UV-absorbing (e.g., avobenzone),
• need to be absorbed before they work effectively.
• There are numerous chemical sunscreen ingredients
• Tend to have a less reliable record with acne-prone skin,
determined whether they are safe to use..
• Some products : safe for acne-prone skin, while others tend
to break out.
• Degrading once exposed to sunlight for 2 hours, clear, and
tend to be moisturizing.
 Broad-Spectrum

Broad-spectrum : sunscreens which block both UVA & UVB rays.

There are few fully effective UVA chemical sunscreens, except of
Avobenzone and Ecamsule.
 SPF (Sun Protection Factor)

• SPF tells you how much UV will be absorbed or reflected.

• SPF is a measure of UVB protection, not a measure of UVA protection.
• Broad spectrum sunscreen that blocks UVA and UVB.

• The higher the number, you can stay longer in the sun without burning.
• The SPF number is a multiplier.

• If you normally burn in 30 minutes, an SPF of 2 will allow you to stay in the sun
for 60 minutes without burning.
• An SPF of 3 will allow you to stay in the sun for 90 minutes,
• An SPF of 4 for 2 hours, and so on.
• An SPF of 15 would take this time up to 7 ½ hours.
 Another way to look SPF
by the amount of UVB rays that are blocked.

Strength of Protection

• Recommended
an SPF of 15 or greater.
• Nothing provides 100% support,
• the higher the number, the more likely the product will be
• drying (physical) or greasy (chemical).
 Length of Protection

Your Time To Burn Without Protection

x SPF of your sunscreen

= ____ MINUTES OF PROTECTION

Examples (fair skin):

12 minutes x SPF 15 = 180 minutes (3 hours) until sunburn
12 minutes x SPF 30 = 360 minutes (6 hours) until sunburn
12 minutes x SPF 45 = 540 minutes (9 hours) until sunburn
Guidelines for labelling of Sun Protection Factor (SPF) and
product categories are suggested by COLIPA (The European
Cosmetic Toiletry and Perfumery Association) in Europe.
These are as listed in the table below:
 The Six Skin Types

I. Always burns, never tans, sensitive to sun exposure

II. Burns easily, tans minimally
III. Burns moderately, tans gradually to light brown
IV. Burns minimally, always tans well to moderately brown
V. Rarely burns, tans profusely to dark
VI. Never burns, deeply pigmented, least sensitive
 2.Dermocosmetics
(cosmeceuticals)

skincare solutions, active ingredients selected

from a dermatologist, directly support or care for
the symptoms various skin conditions.

sensitive and/or intolerant skin,

dry skin aspects, irritated or
stressed skin, aging, skin cleansers,
Hyperpigmented, topical sebum-controllers,
oily skin, acne atau rosacea. skin antimicrobial/anti-
inflammatory agents,
moisturizers, sunscreens,
camouflage products
 Conventional acne treatment challenges such as
intolerable side effects and antibiotics resistance.
every skin type behave as Fitzpatrick type I.

If you have deep, dark black skin, use benzoyl peroxide, Retin-A
or Accutane, irritation, inflammation, and burning.

Dermocosmetics : unwanted effects

 Dermocosmetic use in Asian acne patients

A study on the treatment-seeking behaviors in Korean:

• Patients sought treatment advice on skin care from
internet, television, radio, magazines, and newspapers.
• Patients AV favored traditional medicine, visiting beauty clinics,
increasing water intake, using nonprescription topical therapies
over seeking treatment by a dermatologist.
• 77% of these patients were found to be dissatisfied with
treatment and had to eventually seek specialist care.
 Photoprotecting and bleaching agents

• Sunscreens strongly recommended in

acne patients at high risk of postinflammatory hyperpigmentation
(Fitzpatrick skin Type IV or higher, or significant occupational, or
recreational sun exposure), and in patients who already have
signs of postinflammatory hyperpigmentation.

Patients with oily skin & acne prefer UV-absorbing sunscreens

because of their cosmetic acceptability.

At risk patients, recommended - a broad-spectrum

photoprotecting agent UVB & UVA filter
(SPF 30–50, protective clothing when exposed to the sun).
Dyspigmentation: a common outcome of AV in
Asians,

Dermocosmetics with a skin bleaching (e.g.,

azelaic acid, hydroquinone) in combine with a
photoprotecting agent (e.g., dioxybenzone,
oxybenzone) may improve patient compliance in
skin phototype above IV.

Salicylic acid: effective and safe therapy for the

treatment of AV in Asians to improve
postinflammatory hyperpigmentation in dark-
skinned patients.
Acne prone skin requires Extremely sensitive and
skin care products prone to redness and
not irritate inflammation

Read labels and find The wrong makeup products

products that are clogged pores, aggravates
non-comedogenic. the skin & more breakouts
 3. Choosing the right sun protection in acne

• Some acne treatments potential to cause photosensitivity.

• Sun protection & tan prevention is encouraged.
• This requires identifying a suitable sunscreen for daily routine. .
• Most sunscreens are too oily for acne patients and tend to
aggravate it.
• Lately, some sunscreen gels and oil-free lotions have become
available that are suitable for acne patients.
• Oily skin need water based sunscreen while those with dry
skin need an oil-based one.
For allergy, Acne, and Rosacea-prone skin:

Patients with allergy-prone skin / acne / rosacea

should avoid: preservatives, fragrances, PABA,
oxybenzone

The ingredients least likely to cause skin reactions :

Physical sunscreens, as well as those made with
Salicylates and Ecamsule.

Avoid sunscreens containing alcohol, or gel

formulas,
more drying and less likely to aggravate acne.

Acne-prone - avoid greasy sunscreens (as

“creams”), exacerbate breakouts; the UVB filter
ensulizole has a lighter, less oily consistency than
most other chemical sunscreens
If you tend to break out due to “whatever,” that is, you have
sensitive skin, avoid :
– avobenzones,
– benzophenones,
– oxyphenones,
– methoxycinnamate (most commonly found in waterproof
sunscreens),
– para-aminobenzoic acid (PABA).
These ingredients can cause pimples.
 WATER RESISTANCE

Sunscreens which claim

"water-resistant," "very water-resistant," or "waterproof"
include ingredients which create a water repellant layer
on top of the skin

irritating to acne-prone skin

because specifically formulated to be difficult to wash off,

irritation when attempting to remove the sunscreen, further
aggravate acne.
 4. How to use sun protection in acne

Select a sunscreen with an SPF of at least 15.

Use SPF 30 or more if you’ll be in the sun all day.
Make sure protects you from both UVA and UVB.
The label : “Blocks UVA/ UVB” or "broad spectrum sunscreen”.

Lotion, Gel , Stick,

Towelette
How to Apply Sunscreen
Make up, Lip balm
• Apply about 15-30 minutes
before going out.
• all exposed skin, not open wounds. When to Reapply
• Don’t forget : ears, neck and hands. • after 20 minutes to cover missed
spots.
• Don’t rub too hard – <<
• every two hours to keep it powerful.
effectiveness by at least 25%.
• more often after sweating.
 How much

You must apply an adequate amount of sunscreen.

This equates to a full 1 ounce (30mL)--a shot glass worth
—for the average 150 pound person’s entire body, or
¼ to ⅓ teaspoon (about 2mL) for your face.

Most people apply much less than is recommended and

on average are only getting ¼ the protection the product claims.
Once you have the right amount dispensed, apply it very gently as you would
moisturizer to avoid

Body Face
 The Rule of Two Fingers:
How Much Sunscreen to Apply

TWO FINGERS TO SUNSCREEN

the 'fingertip unit' is a measure used in dermatology to quantify the amount

of a product to be used. it is a strip of cream or ointment squeezed out of
the tube onto the fingertip, from the distal crease of the index finger to the
end of the finger itself. using a standard 5mm nozzle, such a fingertip
measure (for adults) equates reasonably accurately to 0.5g of product8.
 Dermatologists should
labeled as
familiarity with skin care
“noncomedogenic” or “tested
products,
for comedogenicity”,
recommended as part of acne
hypoallergenic ingredients
management.

Conclusion,

Use sunscreen variant

Incorporating cosmetics in acne
according to your skin
treatment regimens supports
condition.
the concept of the
Select SPF as needed. Use
dermatologist as the skin care
appropriately.
expert
 References

• Latha M.S, Martis J, V. Shoba. Sunscreening Agents: A Review. The Journal of

Clinical and Aesthetic Dermatology. Januari 2013. Vol. 6, Number 1
• Goh C.L, Noppakun N, Micali G, et all. Meeting the Challenges of Acne Treatment
in Asian Patients: A Review of the Role of Dermocosmetics as Adjunctive Therapy
J Cutan Aesthet Surg. 2016 Apr-Jun; 9(2): 85–92.
• Savant SS. Personal care and cosmetic products. In: Textbook of dermatosurgery
and cosmetology. 2nd ed. Vol. 62. Mumbai: ASCAD; 2005. p. 500-15
• Ritu Saini, MD, and Andrea Szemplinski, MS, RPA-C, How to choose the right
sunscreen for your skin type. 2016 The Skin Cancer Foundation | 149 Madison
Avenue Suite 901 New York, NY 10016 | (212) 725-5176