Diffey - Sun protection : a risk management approach

A risk management approach

Brian Diffey

Dermatological Sciences, Institute of Cellular Medicine, Newcastle University

IOP Publishing, Bristol, UK

IOP Publishing Ltd 2017

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Brian Diffey has asserted his right to be identified as the author of this work in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.

ISBN 978-0-7503-1377-3 (ebook)

ISBN 978-0-7503-1378-0 (print)

ISBN 978-0-7503-1379-7 (mobi)

DOI 10.1088/978-0-7503-1377-3

Version: 20171001

IOP Expanding Physics

ISSN 2053-2563 (online)

ISSN 2054-7315 (print)

British Library Cataloguing-in-Publication Data: A catalogue record for this book is available from the British Library.

Published by IOP Publishing, wholly owned by The Institute of Physics, London

IOP Publishing, Temple Circus, Temple Way, Bristol, BS1 6HG, UK

US Office: IOP Publishing, Inc., 190 North Independence Mall West, Suite 601, Philadelphia, PA 19106, USA

On the journey from solar radiation entering the skin to eventually causing clinical effects, a number of pathways are involved that encompass a variety of seemingly unconnected areas of knowledge ranging from climatology, optical physics, photochemistry, cellular and molecular biology through to epidemiology, dermatology and pathology. Each of these subjects could be the topic of a book in its own right and there exist many excellent texts exploring one aspect of this pathway in detail.

This book deliberately does not compete with these texts but rather dips into the various stages along the journey and attempts to draw them together so that the expert is likely to learn little from the chapter dealing with his or her specialism but may find the complementary topics in other chapters of some interest. The book is written at a level that the generalist should be able to follow and so gain an overall picture of how we can apply the principles of risk management to enjoying and benefitting from sun exposure, whilst at the same time limiting our risk to acceptable levels.

Over the last few days, since Professor Diffey kindly asked me to write this Foreword, I have been thinking about the significance of the timing of this invitation. Firstly, on a personal level, this month marks the start of my own thirtieth year within the sun protection industry. I will readily admit that I have lost not an ounce of excitement for the remarkably complete, elegant science that characterises this field, uniting the Physics of radiative transfer, the Biology of tissue response, and the Chemistry of sunscreens.

Secondly, on a global level, this past year has seen further recognition that skin cancer, linked inseparably to exposure to solar ultraviolet (UV) radiation, now constitutes the most common form of malignancy in humans. Furthermore, while thankfully only a minority will develop cancer, every human will nevertheless accumulate distinct deleterious changes in UV-exposed skin, serving as powerful perceptual cues for a loss of youth and health, with concomitant profound effects on self-worth and confidence.

The depth, breadth and longevity of Professor Diffey's contributions to this critical field of science are indisputable and unparalleled. Of equal significance, however, is the consistent manner in which the output of his research has been communicatedin a wonderfully clear, passionate, no-nonsense style which embraces the scientist and lay-person alike, whether in print, on platform or in conversation. Indeed, this present volume is no exception. Without a doubt, it represents the most comprehensive, authoritative and accessible text to yet cover this field and I recommend it to you warmly and without hesitation.

Professor Paul Matts

Research Fellow in Skin Care, Procter & Gamble

October 2017

I am indebted to the many individuals who kindly provided images and/or data for inclusion in this book, and to those colleagues who gave critical feedback on sections of the text specific to their respective expertise.

I hesitate to thank individuals by name for fear of omitting someone but will make one exception. My 40 year involvement with sun exposure and its effects in human skin would probably not have happened without the encouragement of the late Professor Ian Magnus. His wisdom and guidance were critical in my early development in the subject and for this I am forever grateful.

Brian Diffey

Brian Diffey is Emeritus Professor in Dermatological Sciences at Newcastle University, UK. His career was spent in the NHS, where he was Professor of Medical Physics and Clinical Director in the Newcastle Hospitals. His involvement with sun protection has spanned more than 40 years and his interests include the measurement of personal sun exposure, its effects in normal and diseased skin, and ways to minimise excessive exposure, especially through the use of topical sunscreens.

He has advised a number of bodies on sun exposure and skin health including the World Health Organization, Department of Health, and the Cancer Research UK SunSmart programme, as well as patient support groups concerned with sun-related diseases such as vitiligo and xeroderma pigmentosum.

He invented both the UVA Star Rating for sunscreens in conjunction with Boots in the UK, and the Critical Wavelength adopted by the Food & Drug Administration in the USA as the sole measure of broad spectrum protection.

In 1999 he was awarded the Medal of the Society of Cosmetic Scientists for his contributions to suncare, and in 2011 was honoured at the International Sun Protection Conference for significant innovation in the field of photoprotection.

He is an honorary member of the British Association of Dermatologists, the Swedish Society for Dermatology and Venereology, and the European Society for Photodermatology.

There is adequate evidence that exposure to solar ultraviolet (UV) radiation is a major aetiological factor in human skin cancer but managing the risk of skin cancer does not necessarily mean avoiding exposure to the Suns UV rays. For example, a young man who walks in the hills on a summers day is choosing not to minimise his risk of skin cancer, but rather to face it and embrace it as part of an attempt to maximise his enjoyment and quality of life. A pragmatic approach, therefore, is to adopt strategies that control the