Hautkrebsprävention und Sonnenschutzcreme: Ein Update

Zusammenfassung

In den letzten Jahren sind die Hautkrebsraten weltweit gestiegen. Die Anwendung von Sonnenschutzmitteln ist eine weit verbreitete Strategie in der Prävention gegen Hautkrebs, Sonnenbrand und Fotoalterung. Es sollten kombinierte Breitbandfiltersysteme mit hoher Wirkung gegen UV-B- und UV-A-Strahlung eingesetzt werden. Weitere Studien sind notwendig, um die Entwicklung von Sonnenschutzmitteln gegen die ebenfalls schädlichen IRA-Strahlen voranzutreiben. Obwohl die regelmäßige Anwendung von Sonnenschutzmitteln ein wesentlicher Bestandteil in der Hautkrebsprävention ist, sollten insbesondere bei Kindern kombinierte Schutzmaßnahmen angewendet werden: Sonnenkarenz bei starker Sonneneinstrahlung, textiler Sonnenschutz, Aufenthalt im Schatten und die Anwendung von Sonnenschutzmitteln.

Abstract

Skin cancer rates have been increasing worldwide over the last years. The use of sunscreen is a widely implemented strategy in the prevention against skin cancer, sunburn and photoaging. Combined broadband filter systems with a high efficacy against UV-A and UV-B radiation should be used. Further studies are necessary to further the development of sunscreens that protect against the likewise harmful IRA radiation. Even though the regular use of sunscreen is a key component in skin cancer prevention, combined protection measures particularly in children should include: avoiding high intensity sun, textile sun protection, staying in the shade and the use of sunscreens.

• Literatur

• 1 Barnes B, Bertz J, Buttmann-Schweiger N. et al. Bericht zum Krebsgeschehen in Deutschland 2016. In: Robert-Koch-Institut 2016
• 2 Diepgen TL, Mahler V. The epidemiology of skin cancer. Br J Dermatol 2002; 146 (Suppl. 61) 1-6
• 3 Garbe C, Blum A. Epidemiology of cutaneous melanoma in Germany and worldwide. Skin Pharmacol Appl Skin Physiol 2001; 14: 280-290
• 4 Bauer A, Beissert S, Knuschke P. Prävention von durch berufliche solare UV-Exposition bedingtem epithelialem Hautkrebs. Hautarzt 2015; 66: 173-178
• 5 English DR, Armstrong BK, Kricker A. et al. Sunlight and cancer. Cancer Causes Control 1997; 8: 271-283
• 6 El Ghissassi F, Baan R, Straif K. et al. A review of human carcinogens – Part D: Radiation. The Lancet Oncology 2009; 10: 751-752
• 7 Grether-Beck S, Wlaschek M, Krutmann J. et al. Photodamage and photoaging--prevention and treatment. J Dtsch Dermatol Ges 2005; 3 (Suppl. 02) S19-S25
• 8 Green AC. Premature ageing of the skin in a Queensland population. Med J Aust 1991; 155: 473-474 , 477–478
• 9 Bavinck BJN, Vermeer BJ. Skin cancer in transplant recipients. Lancet 1995; 346: 403-406
• 10 Garbe C. Sonnenschutz: Was ist zuviel, was ist zuwenig?. In: Plewig G, Kaudewitz P, Sander CA. Hrsg. Fortschritte der praktischen Dermatologie und Venerologie. Berlin, Heidelberg: Springer; 2005
• 11 Mang R, Krutmann J. Sonnenschutz im Urlaub. Hautarzt 2003; 54: 498-505
• 12 Green AC, Williams GM, Logan V. et al. Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol 2011; 29: 257-263
• 13 Hughes MC, Williams GM, Baker P. et al. Sunscreen and prevention of skin aging: a randomized trial. Ann Intern Med 2013; 158: 781-790
• 14 Moyal DD, Fourtanier AM. Broad-spectrum sunscreens provide better protection from solar ultraviolet-simulated radiation and natural sunlight-induced immunosuppression in human beings. J Am Acad Dermatol 2008; 58: S149-S154
• 15 Zastrow L, Groth N, Klein F. et al. The missing link--light-induced (280–1,600 nm) free radical formation in human skin. Skin Pharmacol Physiol 2009; 22: 31-44
• 16 Schroeder P, Calles C, Benesova T. et al. Photoprotection beyond ultraviolet radiation--effective sun protection has to include protection against infrared A radiation-induced skin damage. Skin Pharmacol Physiol 2010; 23: 15-17
• 17 Grether-Beck S, Marini A, Jaenicke T. et al. Photoprotection of human skin beyond ultraviolet radiation. Photodermatol Photoimmunol Photomed 2014; 30: 167-174
• 18 Akhalaya MY, Maksimov GV, Rubin AB. et al. Molecular action mechanisms of solar infrared radiation and heat on human skin. Ageing Res Rev 2014; 16: 1-11
• 19 Grether-Beck S, Marini A, Jaenicke T. et al. Effective photoprotection of human skin against infrared A radiation by topically applied antioxidants: results from a vehicle controlled, double-blind, randomized study. Photochem Photobiol 2015; 91: 248-250
• 20 Schroeder P, Lademann J, Darvin ME. et al. Infrared radiation-induced matrix metalloproteinase in human skin: implications for protection. J Invest Dermatol 2008; 128: 2491-2497
• 21 Vandersee S, Beyer M, Lademann J. et al. Blue-violet light irradiation dose dependently decreases carotenoids in human skin, which indicates the generation of free radicals. Oxid Med Cell Longev 2015; 2015: 579675
• 22 Lohan SB, Muller R, Albrecht S. et al. Free radicals induced by sunlight in different spectral regions – in vivo versus ex vivo study. Exp Dermatol 2016; 25: 380-385
• 23 Darvin ME, Richter H, Ahlberg S. et al. Influence of sun exposure on the cutaneous collagen/elastin fibers and carotenoids: negative effects can be reduced by application of sunscreen. J Biophotonics 2014; 7: 735-743
• 24 Souza CC, Schanzer S, Albrecht S. et al. Radical-scavenging activity of a sunscreen enriched by antioxidants providing protection in the whole solar spectral range. Skin Pharmacol Physiol 2017;
• 25 Iannacone MR, Hughes MC, Green AC. Effects of sunscreen on skin cancer and photoaging. Photodermatol Photoimmunol Photomed 2014; 30: 55-61
• 26 Thompson SC, Jolley D, Marks R. Reduction of solar keratoses by regular sunscreen use. N Engl J Med 1993; 329: 1147-1151
• 27 Naylor MF, Boyd A, Smith DW. et al. High sun protection factor sunscreens in the suppression of actinic neoplasia. Arch Dermatol 1995; 131: 170-175
• 28 Darlington S, Williams G, Neale R. et al. A randomized controlled trial to assess sunscreen application and beta carotene supplementation in the prevention of solar keratoses. Arch Dermatol 2003; 139: 451-455
• 29 Krutmann J, Berking C, Berneburg M. et al. New Strategies in the Prevention of Actinic Keratosis: A Critical Review. Skin Pharmacol Physiol 2015; 28: 281-289
• 30 Green A, Williams G, Neale R. et al. Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet 1999; 354: 723-729
• 31 Ulrich C, Jurgensen JS, Degen A. et al. Prevention of non-melanoma skin cancer in organ transplant patients by regular use of a sunscreen: a 24 months, prospective, case-control study. Br J Dermatol 2009; 161 (Suppl. 03) 78-84
• 32 Berg D, Otley CC. Skin cancer in organ transplant recipients: Epidemiology, pathogenesis, and management. J Am Acad Dermatol 2002; 47: 1-17 ; quiz 18–20
• 33 Garbe C, Buttner P, Weiss J. et al. Associated factors in the prevalence of more than 50 common melanocytic nevi, atypical melanocytic nevi, and actinic lentigines: multicenter case-control study of the Central Malignant Melanoma Registry of the German Dermatological Society. J Invest Dermatol 1994; 102: 700-705
• 34 Olsen CM, Carroll HJ, Whiteman DC. Estimating the attributable fraction for cancer: A meta-analysis of nevi and melanoma. Cancer Prev Res (Phila) 2010; 3: 233-245
• 35 Garbe C, Buttner P, Weiss J. et al. Risk factors for developing cutaneous melanoma and criteria for identifying persons at risk: multicenter case-control study of the Central Malignant Melanoma Registry of the German Dermatological Society. J Invest Dermatol 1994; 102: 695-699
• 36 MacKie RM, McHenry P, Hole D. Accelerated detection with prospective surveillance for cutaneous malignant melanoma in high-risk groups. Lancet 1993; 341: 1618-1620
• 37 Green AC, Williams GM. Point: sunscreen use is a safe and effective approach to skin cancer prevention. Cancer Epidemiol Biomarkers Prev 2007; 16: 1921-1922
• 38 Wiecker TS, Luther H, Buettner P. et al. Moderate sun exposure and nevus counts in parents are associated with development of melanocytic nevi in childhood: a risk factor study in 1,812 kindergarten children. Cancer 2003; 97: 628-638
• 39 Gallagher RP, Rivers JK, Lee TK. et al. Broad-spectrum sunscreen use and the development of new nevi in white children: A randomized controlled trial. JAMA 2000; 283: 2955-2960
• 40 Ling TC, Faulkner C, Rhodes LE. A questionnaire survey of attitudes to and usage of sunscreens in northwest England. Photodermatol Photoimmunol Photomed 2003; 19: 98-101
• 41 Holman DM, Berkowitz Z, Guy Jr GP. et al. Patterns of sunscreen use on the face and other exposed skin among US adults. J Am Acad Dermatol 2015; 73: 83-92 e81
• 42 Reinau D, Weiss M, Meier CR. et al. Outdoor workers’ sun-related knowledge, attitudes and protective behaviours: a systematic review of cross-sectional and interventional studies. Br J Dermatol 2013; 168: 928-940
• 43 Lademann J, Schanzer S, Richter H. et al. Sunscreen application at the beach. J Cosmet Dermatol 2004; 3: 62-68
• 44 Lademann J, Darvin ME, Weigmann HJ. et al. Sunscreens – UV or light protection. In, IFSCC. Paris, France: 2014
• 45 Solky BA, Phillips PK, Christenson LJ. et al. Patient preferences for facial sunscreens: a split-face, randomized, blinded trial. J Am Acad Dermatol 2007; 57: 67-72
• 46 Bauer A, Hault K, Puschel A. et al. Acceptance and usability of different sunscreen formulations among outdoor workers: a randomized, single-blind, cross-over study. Acta Derm Venereol 2014; 94: 152-156
• 47 Faurschou A, Wulf HC. The relation between sun protection factor and amount of suncreen applied in vivo. Br J Dermatol 2007; 156: 716-719
• 48 Bauer A, Ronsch H, Hault K. et al. Sun exposure: perceptions and behaviours in outdoor workers. Br J Dermatol 2014; 171: 1570-1572