Sandbox:Sara

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]

Knowing individual skin type and using the right sunscreen accordingly

Skin type by the Fitzpatrick Scale	Skin color	Skin tone or other common descriptors	Sun exposure effects	Recommended sunscreen SPF
I	Pale white	Pale or albino, freckles common (Celtic)	Always burns Never tans	30+
II	White	Light or fair (European)	Always burns Rarely tans
III	White	Light‐intermediate (Dark European)	Sometimes burns Sometimes tans	15+
IV	Light brown	Olive with/without brown tint (Mediterranean)	Tans easily Burns less
V	Dark brown	Brown	Tans easily Rarely burns
VI	Black	Black	Does not burn

Different sunscreen recommendations and recommendations' grading according to Canadian Task Force on Preventive Health Care (CTFPHC) GRADE System

Sunscreen property	Recommendation	Grade of Recommendations
SPF (Sun Protection Factor)	An ideal sunscreen should have the following properties: Broad-spectrum Both UVA & UVB filters Atleast SPF 30	Strongly recommended
Water resistance	Sunscreen providing water-resistance for 40-80 minutes must be worn in following conditions: Water immersion Excessive sweating Contact with sand Physical contact causing increased skin friction
Organic vs inorganic sunscreens	Whether the components of sunscreen are organic or inorganic, recommended sunscreen must be broad spectrum with both UVA & UVB filters
Lip protection	Whole lip should be generously covered by high-SPF (>/= 30) and reapplication of lip sunscreen
Sunscreen application	Sunscreen is recommended to be applied according to following guidelines: Should be applied liberally (approximately 45 ml) to all the exposed areas Strong reapplication within a period of 8 hours is mandatory only after activities that may remove the sunscreen layer such as sweating, swimming, or friction Should be applied before any sun exposure and at least 20 minutes before the water activities	Strongly recommended
Patient education on sunscreen	Patients should be educated about the meaning of SPF and its effectivesness
Sunscreen safety	Sunscreens have a favorable risk-benefit profile, hence, are considered to be safe overall There is still a risk of following few complications due to sunscreen application in some people: Photoallergy (most common, but quite rare) Reproductive toxicity
Sunscreen benefits	Prevents photoaging Prevents melanoma and non–melanoma skin cancer
Sunscreen vehicle	Highest SPF and water resistance properties of sunscreen can be obtained by using a water-in-oil emulsion formulation for sunscreens	Weakly recommended
Expiry date	Avoid using sunscreens past the manufacturer-specified expiry date/recommended period after opening Sunscreens should be stored at normal room temperature in order to ensure their proper stability