title: Sun exposure behavior and protection: recommendations for travelers.
abstract: BACKGROUND
  Although there have been recent advances in the development of photoprotective clothing and broad-spectrum sunscreens, few peer-reviewed publications have focused on photoprotection recommendations for travelers.
  
  
  METHODS
  In order to describe the adverse health effects of excessive ultraviolet (UV) radiation exposures; review recent studies of public perceptions regarding photoprotection and sun exposure behaviors; identify special populations at increased risks of drug-induced photosensitivity reactions and UV-induced skin cancers; and recommend several effective photoprotection strategies for travelers, Internet search engines were queried with the key words as search terms to examine the latest references on photoprotection and the epidemiology of UV-associated skin cancers.
  
  
  RESULTS
  Observational studies have demonstrated that the public knows little about proper sunscreen protection, selection, and use, and often abuses sunscreens for intentional UV overexposures. Cohort studies have identified special populations at increased risks of UV-associated skin cancers without the proper use of sunscreens and photoprotective clothing including children, fair-skinned persons, patients taking photosensitizing drugs, and organ transplant recipients (OTRs). Clinical investigations support the regular use of broad-spectrum sunscreens to prevent the development of premalignant actinic keratoses (AK) in all sun-exposed subjects, especially OTRs; to prevent the development of squamous cell carcinomas from new AK in sun-exposed subjects, especially OTRs; to possibly prevent the development of cutaneous malignant melanomas in children and adults; and to possibly prevent the development of basal cell carcinomas in OTRs.
  
  
  CONCLUSIONS
  Recommended photoprotection strategies for travelers should include avoiding intense sunlight, wearing photoprotective clothing, wearing sunglasses, and selecting the right sunscreen for their skin type. Travel medicine practitioners should counsel travelers about photoprotection and encourage travelers to take advantage of recent advances in the development of more effective broad-spectrum sunscreens and photoprotective clothing for themselves and their children.
authors: Program in Environmental and Occupational Health Sciences, Schools of Public Health and Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA. jdiaz@lsuhsc.edu
authors: James H
authors: JH
authors: Diaz
authors: Lee T
authors: LT
authors: Nesbitt
mesh_terms: D000328:Adult; D002648:Child; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis / Q000517:prevention & control; D006801:Humans; D010353:Patient Education as Topic; D010787:Photosensitivity Disorders / Q000139:chemically induced / Q000150:complications; D020011:Protective Agents / Q000494:pharmacology / Q000592:standards; D011481:Protective Clothing / Q000592:standards / Q000706:statistics & numerical data; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012867:Skin / Q000187:drug effects / Q000528:radiation effects; D012878:Skin Neoplasms / Q000145:classification / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D013472:Sunlight / Q000009:adverse effects*; D013473:Sunscreening Agents / Q000494:pharmacology / Q000592:standards; D014195:Travel; D014466:Ultraviolet Rays / Q000009:adverse effects*
chemical_list: D020011:Protective Agents; D013473:Sunscreening Agents