Photoprotection in Special Situations

After-sun products

After spending many hours in the sun, the skin can benefit from the use of “after-sun products”. These are creams, lotions (emulsions) or, in some cases, oils that contain ingredients capable of rehydrating the stratum corneum, which has been stressed by prolonged exposure to sunlight and seawater.

After showering with fresh water, these products should be applied gently to dry skin. Many formulations also contain natural ingredients with soothing and anti-inflammatory properties.

Women often use these products regularly and also apply them to their children. Men, however, tend to neglect this simple but beneficial habit.

Maintaining the integrity of the stratum corneum helps preserve the skin barrier and its protective function.

Creams or gels containing analgesic or anti-inflammatory drugs should never be applied to skin that will be exposed to sunlight, for example after bruises, sprains or joint pain, because they may cause severe phototoxic reactions.

Special situations

1. Brown spots on the face

These are often solar lentigines—not to be confused with the freckles associated with Red Hair Phenotype—or melasma. Diagnosis and treatment are beyond the scope of this guide, and consultation with a dermatologist is recommended. For cruises or other marine activities, high-SPF tinted sunscreens are generally advisable. Their pigments provide additional protection against visible light and also help conceal existing blemishes.

2. Scars after trauma or procedures

This includes scars resulting from trauma, surgery or aesthetic procedures such as chemical peels, fillers, botulinum toxin injections, laser treatments and intense pulsed light. See Answer 19.

3. Taking or applying medications

See Answer 6.

4. People who have had skin cancer

This topic deserves particular attention because previous skin cancer increases the need for careful, continuous photoprotection and specialist follow-up.

How UV-induced skin cancer develops

a. UV-induced DNA damage;

b. failure to repair the damaged DNA;

c. failure to eliminate cells carrying unrepaired DNA damage;

d. uncontrolled proliferation of mutated cells, which may eventually escape immune surveillance.

The skin cancers most closely associated with solar ultraviolet radiation are:

Basal cell carcinoma

Squamous cell carcinoma

Cutaneous melanoma

Squamous cell carcinoma and actinic keratoses are primarily associated with chronic cumulative sun exposure.

Basal cell carcinoma and cutaneous melanoma appear to be more strongly associated with intermittent intense UV exposure accompanied by repeated episodes of sunburn.

Advice for people who have had skin cancer

All patients should adopt careful and continuous photoprotection, because ultraviolet radiation can increase the risk of additional DNA mutations, reduce immune function and interfere with certain drug therapies prescribed after treatment.
Patients who have had cutaneous melanoma should avoid intentional sun exposure, even when using sunscreens.
Patients who have had basal cell carcinoma or squamous cell carcinoma should adopt particularly rigorous measures, especially protective clothing and frequent sunscreen application to all exposed skin.
Men with thinning hair or baldness should consistently wear a hat to reduce the risk of new actinic keratoses or progression to squamous cell carcinoma.
All patients should follow their dermatologist's recommendations regarding additional treatments and follow-up care.