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I first started getting serious about sunscreen after a visit to the dermatologist about a bump on my nose that seemed to get worse when exposed to sunlight. The dermatologist explained that it was actinic keratosis (a crusty scaly growth that eventually turns into cancer if unchecked) and that I needed to be wearing sunscreen everyday. “Everyday?! Holy cow, I can’t do that,” I thought. But, after the treatment for the actinic keratosis, I was more than willing to give it a shot. The dermatologist burned my actinic keratosis off with liquid nitrogen, leaving me with a giant nickel-sized, quarter inch thick blister on my nose for a week. Cute. Since that treatment, I have had subsequent treatments for various other spots on my face, and a mole removed from my back and my leg. Being pretty fair skinned and enjoying the outdoors puts me at a significant risk for sunburns. I apply sunscreen everyday to my face. I use this one, which was recommended to me by my dermatologist.
If you don’t want to take my word for daily sunscreen use. Watch this video. This video made a significant impact on me and solidified my daily sunscreen habit.
How sunscreen works
“UVA” and “UVB” are terms commonly found on sunscreen bottles. UVA and UVB refer to types of UV rays. UV stands for “ultraviolet” which is a form of light not visible to humans. A and B refer to the different lengths of wavelengths. UVA penetrates deeper into the skin and is commonly used in tanning beds as it doesn’t cause a sunburn (read more about sunburns and tanning beds here). UVB is more superficial and causes the sunburns that we are all extremely familiar with. Both UVA and UVB cause skin cancer and sun damage, but UVB is responsible for sunburns.
SPF is a common word used in sunscreens. SPF stands for “sun protection factor” and gives a rating as to how strongly the sunscreen prevents UVB from affecting the skin. The SPF is a multiplication number. If it normally takes you about 10 minutes for you skin to get red, with an SPF of 15, it will take about 150 minutes for the skin to be affected. But, remember, sunscreen wears off easily, so it is best to apply every two hours, regardless of the SPF. Additionally, to make sure you have UVA protection in addition to the UVB protection afforded by the SPF, look for sunscreen that says “broad spectrum” on it, as that includes protection for UVA rays.
There are two main types of sunscreen–physical and chemical. The physical sunscreens are sometimes visible–think the lifeguards with white noses. When I was little, we had neat colored sunblock (affiliate) made from a physical sunscreen, likely zinc oxide or titanium dioxide. I distinctly remember smearing blue and pink all over ourselves and the bathroom sink before heading out to the pool for some cannonball contests..
Chemical sunscreens work by absorbing the UV rays and turning them into heat which is then dissipated. Chemical sunscreens are typically more viscous and easier to apply, but need to be reapplied more often. Chemical sunscreens are extremely common and you probably have a bottle of it in your house.
Types of Sunscreen
Many people think of cream when thinking about sunscreen. Cream is common and very effective. Sunscreen dispensers have been recently been installed in a variety of locations across the U.S.–beaches, playgrounds, ballparks, etc. The ultimate idea is to encourage sunscreen use and hopefully decrease the incidences of skin cancer.
Some people use a sunscreen stick to apply sunscreen to small children and to faces, as it gives more control over the sunscreen and is less likely to get into eyes. Currently, there are no sunscreens specially formulated for children. Dermatologists recommend babies start wearing sunscreen at 6 months of age. As with most products for children, before using the sunscreen do a patch test to see if the child has an adverse reaction. Physical sunscreens may provide less irritation to their sensitive skin.
My husband hates cream and refuses to use it. Instead, we buy the aerosol sunscreen spray. Sunscreen spray may not coat evenly or effectively, but it is fast and it is better than nothing. To help mitigate this, my husband applies the sunscreen to his body twice and rubs it in, so that he doesn’t miss any spots. Another concern with sunscreen spray is the potential for inhalation. To avoid this, my husband holds his breath while applying the sunscreen and makes sure that nobody is immediately downwind of him.
A compromise between aerosol spray and cream from a bottle is a hand pump that squirts sunscreen onto the skin. This type of sunscreen will still require rubbing into the skin, but may be a good compromise between aerosol spray and thick cream.
There has been some research into oral pills which may provide some sunscreen protection. The pills usually contain a fern extract, and sometimes green tea extracts and vitamins C and E. The most common side effect of the oral sunscreen pills is “stomach upset.” During testing the pills provided, at most, an SPF of 3-5. While intriguing, sunscreen pills are not yet effective .
It is extremely important to wear “reef safe” sunscreen when you are going to go swimming in the ocean, snorkeling, or scuba diving. Researchers estimate between 4,000-6,000 metric tons of sunscreen wash off swimmers annually in oceans worldwide . Four common ingredients–oxybenzone, butylparaben, octinoxate, and 4-methylbenzylidine camphor–have been shown to cause coral bleaching and ultimately, coral death. There are many options available, and I have had good experiences with Mexitan products (affiliate). You have to shake it before you use it, so make sure you shake well. I usually apply it as I am getting ready, just before putting on my swimsuit. I completely cover my body with it, and then put on my swimsuit and head out to the ocean. I also typically wear a wetsuit when snorkeling, or at the very minimum, a long sleeved rashguard which also helps to reduce sun exposure.
Ultimately, the best type of sunscreen is physical protection. Long pants and sleeves, along with hats and sunglasses, will protect you better than any type of sunscreen. Staying in the shade helps too. But if you need to go outside, please wear sunscreen. Suntans damage your skin too.
Sunscreen is toxic
“Sunscreens are toxic!” “Sunscreen is poison!” “Chemicals are bad!” Sigh… well, I hate to break it to you, but the whole word is made up of chemicals (dihydrogen monoxide, anyone?). Also, the unproven risks associated with using sunscreen are significantly less than the very real risk of skin cancer from sun damage to the body. Even better, sunscreen helps prevent skin cancer, skin aging , and other sun damage. Even spray-on sunscreen delays melanoma formation and blocks UV-induced DNA damage .
Much of the concern surrounding toxicity of sunscreen seems to center on a few chemicals. Oxybenzone seems to be the major one, as it has been implicated as an endocrine disrupter (affects the body’s hormones) and as a potential carcinogen (cancer causing). The FDA approved its use in 1978 and there has been no data showing hormonal or health problems from its use. Additionally, the FDA approved its use for people aged 6 months and older.
Retinyl palmitate is another chemical that some people are concerned about. In the Journal of American Academy of Dermatology, the concerns of retinyl palmitate in sunscreen and other skin care products were addressed in 2010. In the commentary titled “Safety of retinyl palmitate in sunscreens: A critical analysis,” a brief overview of the role of retinyl palmitate in skin physiology is provided, along with a critical analysis of currently available data, with the ultimate conclusion that “there is no evidence that the inclusion of retinyl palmitate in sunscreens is photocarcinogenic in human beings” .
A 2010 study showed that the overwhelming majority of the zinc oxide applied to the skin did not cross the skin into the body. Some nanoparticles did cross the skin, to the amount of 1/1000th of the total zinc in the body. This 2017 study again analyzed zinc oxide and found it to be safe if the sunscreen is used as directed . Nanoparticles are used in physical sunscreens to help make the sunscreen invisible on the skin. There is worry that the nanoparticles will be absorbed through the skin.
Another argument against sunscreen is that sunscreen encourages people to stay outside longer, thus increasing their exposure to the sun’s rays. A thorough internet search dug up a study published in 1999 which may be the source of these rumors. The study showed that sunscreen use “seems to increase the recreational sun exposure of young white Europeans” . With a small and limited sample size and a weak conclusion, this study should not be used as definitive proof that sunscreen is bad and increases skin cancer risk. If anything, this study proves that people need to be educated on how to use sunscreen properly.
An additional argument is that sunscreen causes a Vitamin D deficiency, so sunscreen should be avoided. However, 5-30 minutes of sun exposure without sunscreen twice a week is adequate for the manufacture of Vitamin D and most regular people receive that from their day to day activities, even while wearing sunscreen. Normal use of sunscreen does not result in Vitamin D insufficiency .
Ultimately, to avoid excessive sun exposure this summer:
- Wear sunscreen
- 30 SPF or higher
- Water resistant
- Broad Spectrum (which helps to block UVA and UVB rays)
- Reapply every 2 hours, or after swimming or sweating
- Limit sun exposure
- Seek shade whenever possible
- Sun protective clothing
- Long sleeves and pants
Sunburns are easily preventable and action should be taken to prevent sun exposure. To date, scientists and dermatologists continue to recommend the use of sunscreen. Daniel M. Siegel, former president of the American Academy of Dermatology, sums it up eloquently, “Scientific evidence supports the benefits of sunscreen usage to minimize short- and long-term damage to the skin from UV radiation and outweighs any unproven claims of toxicity or human health hazard.”
 “Could Protecting Your Skin from the Sun Be as Easy as Popping a Pill.” American Academy of Dermatology, Inc. American Academy of Dermatology, Inc, 07 Aug. 2014. Web. 29 May 2017.
 Than, Ker. “Swimmers’ Sunscreen Killing Off Coral.” National Geographic News. National Geographic Society, 29 Jan. 2008. Web. 29 May 2017.
 Hughes, M. C. B., G. M. Williams, P. Baker, and A. C. Green. “Sunscreen and Prevention of Skin Aging. A Randomized Trial.” Annals of Internal Medicine 158 (2013): 781-90. Annals of Internal Medicine. American College of Physicians, 04 June 2013. Web. 29 May 2017.
 Hennessey, R. C., A. M. Holderbaum, A. Bonilla, C. Delaney, J. E. Gillahan, K. L. Tober, T. M. Oberyszyn, J. H. Zippin, and C. E. Burd. “Ultraviolet Radiation Accelerates NRas-mutant Melanomagenesis: A Cooperative Effect Blocked by Sunscreen.” Pigment Cell & Melanoma Research. (n.d.): n. pag. PubMed. U.S. National Library of Medicine, 24 May 2017. Web. 29 May 2017.
 Wang, Steven, MD, Stephen Dusza, DrPH, and Henry Lim, MD. “Safety of Retinyl Palmitate in Sunscreens: A Critical Analysis.” Journal of the American Academy of Dermatology 63.5 (2010): 903-06. American Academy of Dermatology, Inc. Elsevier, Inc, Nov. 2010. Web. 29 May 2017.
 Kim, K. B., Y. W. Kim, S. K. Lim, T. H. Roh, D. Y. Bang, S. M. Choi, D. S. Lim, Y. J. Kim, S. H. Baek, M. K. Kim, H. S. Seo, M. H. Kim, H. S. Kim, J. Y. Lee, S. Kacew, and B. M. Lee. “Risk Assessment of Zinc Oxide, a Cosmetic Ingredient Used as a UV Filter of Sunscreens.” Journal of Toxicology and Environmental Health. Part B, Critical Reviews.20.3 (2017): 155-82. PubMed. U.S. National Library of Medicine. Web. 28 May 2017.
 Autier, Phillippe, Jean-Francois Dore, Sylvia Negrier, Daniele Lienard, Renato Panizzon, Ferdy J. Lejeune, David Guggisberg, and Alexander M. M. Eggermont. “Search Results | JNCI: Journal of the National Cancer Institute | Oxford Academic.” Journal of the National Cancer Institute 91.15 (1999): 1304-309. Oxford University Press. 04 Aug. 1999. Web. 28 May 2017.
 Norval, M., and H. C. Wulf. “Does Chronic Sunscreen Use Reduce Vitamin D Production to Insufficient Levels?” The British Journal of Dermatology 161.4 (2009): 732-36. PubMed. U.S. National Library of Medicine, Oct. 2009. Web. 28 May 2017.
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