Sun Damage, Tables

SUN DAMAGE, TABLES

Mark F. Naylor, MD

Kevin C. Farmer, PhD

Table 1. Correlation of sunburn times with UV index for skin types 1 and 4.

EXPOSURE CATEGORIES INDEX VALUES
MINUTES TO BURN FOR MOST SUSCEPTIBLE (SKIN TYPE 1)

MINUTES TO BURN FOR LESS SUSCEPTIBLE (SKIN TYPE 4)

Minimal
0-2
30

> 120

Low
3
20

90

4
15

75

Moderate
5
12

60

6
10

50

High
7
8.5

40

8
7.5

35

Very High
9
7

33

10
6

30

11
5.5

27

12
5

25

13
<5

23

14
4

21

15
<4

20

Table 2. Sun Protection Suggestions for Adults

DESIRED PROTECTION	CLOTHING RECOMMENDATIONS	RECOMMENDED SUNSCREEN	OUTDOOR ACTIVITY 10 AM to 2 PM
Maximum	Hat, protective clothing essential¹	At least SPF 30^2,3	schedule at other times when possible
Moderate	Hat and shirt advisable to cover high exposure areas⁴	SPF 15	schedule at other times when possible
Minimal	Hat and shirt advisable to cover high exposure areas	SPF 8-15	schedule at other times when possible

¹ Use a hat with a 2-3 inch all-around brim, and a shirt of heavy cotton fabric or equivalent (long sleeves desirable)
² Sunscreen should be applied heavily in the early morning, then reapplied in the early afternoon on days of outdoor activity. More frequent application may be necessary if sweating, rubbing, or swimming is removing the sunscreen. At least daily application is recommended for 3 seasons of the year. For individuals living in the southern United States, this should be done year round.
³ Heavy make-up (preferably with some sunscreen in the formulation) in conjunction with a hat and protective clothing may be sufficient for women.
⁴ The face, shoulders, and bald spots are at greatest risk for actinic damage by virtue of geometry and lifetime exposures.

Table 3. Sun Protection Suggestions for Infants and Children

AGE GROUP	SKIN TYPE	SPECIAL CLOTHING RECOMMENDATIONS	SUNSCREEN TO USE	OUTDOOR ACTIVITY 10 AM to 2 PM
Infants (0-1 months)	all	complete physical coverage	not recommended	not applicable
Infants (1-12 months)	all	hats essential	at least 30 SPF	schedule at other times when possible
Toddlers (1-3 years)	1 to 3	hats advisable	at least 30 SPF	schedule at other times when possible
	4 to 6		at least 15 SPF	schedule at other times when possible
Children (3-18 years)	1 to 3	T-shirt while swimming outdoors	at least 30 SPF	schedule at other times when possible
	4 to 6		15 SPF recommended	schedule at other times when possible

Table 4. Drugs Associated with Photosensitivity Reactions [169]

CATEGORY	DRUG
Anti-infectives	amantadine
	lomefloxacin, enoxacin, naldixic acid, ofoxacin, ciprofloxacin
	sulfisoxazone, trimethoprim
	democlocycline, doxycycline
	chloroquine, pyrimethamine
	griseofulvin, dapsone, pyrazinamide
Anti-inflammatory	desoximetasone, hydrocortisone
	ibuprofen, piroxicam
Cardiovascular	amiodarone, quinidine
	diltiazem, nifidipine
	hydrochlorothiazide, triamterene
CNS Agents	carbamazepine, clomipramine
	alprazolam, chlordiazepoxide
	chlorpromazine, thioridazine
Miscellaneous	glyburide, chlorpropamide, tolbutamide, diphenhydramine
	methotrexate, vinblastine, dacarbazine, flourouracil
	etretinate, isotretinoin
Topical agents	tretinoin, coal tar, benzoyl peroxide
Other misc. agents	gold salts, minoxidil, psoralens

EXPOSURE CATEGORIES	INDEX VALUES	MINUTES TO BURN FOR MOST SUSCEPTIBLE (SKIN TYPE 1)	MINUTES TO BURN FOR LESS SUSCEPTIBLE (SKIN TYPE 4)
Minimal	0-2	30	> 120
Low	3	20	90
	4	15	75
Moderate	5	12	60
	6	10	50
High	7	8.5	40
	8	7.5	35
Very High	9	7	33
	10	6	30
	11	5.5	27
	12	5	25
	13	<5	23
	14	4	21
	15	<4	20