”[45] The concurrent applications of commercially available insect repellents and sunscreens are also of special significance find more for travelers to temperate and tropical areas where both UV exposures and arthropod-borne infectious diseases pose health risks. Although

few investigations have studied the potential for adverse effects following concurrent applications of insect repellents and sunscreens, concurrent applications of commercially available insect repellents containing N, N-diethyl-m-toluamide (DEET) and sunscreens containing oxybenzone have been studied in animal models and demonstrated that DEET permeation is potentiated by sunscreens and could promote DEET neurotoxicity, especially in children.[54, 55] According to the American

Academy of Pediatrics, insect repellents containing DEET should not be applied to children under 2 months of age, and DEET concentrations ranging from 10% to 30% are recommended for all other children.[56] As the broad-spectrum sunscreens were designed for their transdermal as well as topical effects, they should be applied prior to the application of insect repellants.[56] Single-product combinations of insect repellents and sunscreens are not recommended by the US Centers for Disease Control and Prevention (CDC) because the see more instructions for applying sunscreens and insect repellents usually differ.[57] In most cases, insect repellents

offer longer protection and do not need to be reapplied as frequently as sunscreens.[57] Dark-skinned persons are protected from UV radiation by increased epidermal melanin and have significantly lower annual incidence rates of NMSCs.[58] Epidermal melanin in dark-skinned persons filters twice as much UVB radiation as does that in Caucasians.[58] Dark epidermis transmits 7.4% of UVB and 17.5% of UVA rays to the dermis, compared with 24 and 55% in white epidermis, respectively.[58] The six skin types, their definitions, and the recommended Sinomenine SPF for sunscreens appropriately applied by skin type are listed in Table 6.[59] (Celtic) (European) (Dark European) (Mediterranean) Randomized controlled trials have demonstrated that regular sunscreen use can prevent the development of AK.[60] As AK is a precursor of SCC, sunscreens can prevent the development of SCC arising in AK.[60] In 1999, Green and colleagues in Queensland reported their results of a 4.5-year community-based randomized controlled trial among 1,621 adult residents of Nambour, a subtropical Australian township in Queensland.[61] Compared to those randomized to using sunscreen at their discretion if at all, study subjects randomized to the daily use of a broad-spectrum SPF 15+ sunscreen showed a 40% reduction in SCC.