Since its inception in 1979, The Skin Cancer Foundation has always recommended using a sunscreen with an SPF of 15 or higher as one important part of a complete sun protection regimen . There have been recent attacks on sunscreens by the Environmental Working Group (EWG) and the media has blown this out of proportion to “make news” in my opinion. The criticisms have not been based on hard science. In fact, The Chair of the Skin Cancer Foundations, an independent volunteer panel of top experts on sun damage and sun protection, reviewed the same studies reviewed by the EWG, and found that their determination of what made a sunscreen bad or good was based on “junk science”. Below are a series of questions and answers you may find useful.
Q. Why are sunscreens important for our well-being?
A. The government has placed ultraviolet radiation (UVR) both from the sun and from tanning machines on its list of known human carcinogens. UVR produces DNA damage that may lead to mutations in genes involved in the pathogenesis of skin cancer. Therefore, along with other sun safety strategies, sunscreens that absorb or block UVR serve an important protective function. Photoaging is another long-term result of sun exposure. While not threatening to life, it is threatening to quality of life. Excessive unprotected time in the sun leads to premature wrinkling, sagging, a leathery texture and hyperpigmentation.
Q. Should sunscreen be used only by people at high risk?
A. Although people with dark skin are not as high-risk as those with light skin, they develop skin cancer too and should use sunscreen. Dyspigmentation is also a major concern for many dark-skinned individuals, and can be minimized by photoprotection, including regular sunscreen use. For adequate protection against melanoma, nonmelanoma skin cancers and photoaging, everyone over the age of six months should use sunscreen daily year-round, in any weather. Sunscreen should not be neglected on overcast days, as 70-80 percent of the sun’s rays – above all, long-spectrum UVA rays – go through clouds and fog. In addition, according to the World Health Organization, UVR levels rise by about 10-21 percent for every 1000 feet of altitude, and reflection from sand, water, snow or concrete magnifies their effects by up to 80 percent.
Q. Many people mistakenly believe that an SPF 30 rating gives twice as much sun protection as an SPF 15 and an SPF 50 more than three times that much. What is really the difference?
A. In vitro tests have shown that SPF 15 sunscreens filter out 93% of UVB rays, while SPF 30 protects against 97% and SPF 50 98%.
Q. Is there any truth to the claim that a “base tan” helps prevent skin cancer?
A. No. Tanning is the skin’s response to DNA damage that may affect the melanocytes and keratinocytes.14 The activation and proliferation of these cells increase the risk of skin cancer and photoaging. UV tanning lamps can be as or more dangerous than the sun; in fact, their use has now been documented to be associated with skin cancers. There is no such thing as a healthy tan. Therefore, if people insist on being bronzed, they should be advised to use self-tanners, now offered by many cosmetics companies. The active ingredient, dihydroxyacetone (DHA), interacts with proteins in the skin to cause darkening without requiring UV exposure. Some self-tanners include sunscreen, but even if one with an SPF is used, a separate sunscreen should be applied after two hours outdoors.
Q. What is the FDA’s position on SPF limits?
A. Though the FDA’s Monograph on Sunscreens is not final, it currently proposes that sunscreen manufacturers not be allowed to claim an SPF rating above 30; the highest rating would be 30+”. The Foundation’s Photobiology Committee disagrees, pointing out that high-risk individuals can benefit from higher SPFs up to 45 or 50.
Q. What is the protocol for applying sunscreen?
A. It should be applied one-half hour before going outside. Because sunscreen tends to be rubbed or washed off with sweating and water exposure, it should be reapplied at least every two hours, and immediately after swimming or heavy sweating. At least one ounce (two tablespoons) is needed to cover the entire body surface. As facial skin is thin and highly exposed, it is particularly important to apply sunscreen there liberally. Many sunscreens are now incorporated in facial moisturizing creams; in routine daily activity, if the face is untouched and there is no sweating, it is acceptable to apply the sunscreen just once at the beginning of the day. Wear your sunscreen, seek shade, cover up with clothing including a wide-brimmed hat and UV-blocking sunglasses and avoiding tanning and UV tanning booths.
Sincerely Dr. Anil Rajani
