First, let’s set the record straight
“But I wore sunscreen!”
It’s a line I hear every day in my office from a seriously tanned patient who insists they wore sunscreen; implying that the deep tan I’m seeing can’t possibly be an issue, when it is. The reality is that sunscreen is not perfect and in some cases I think it can even be harmful. It gives you a false sense of security: that it’s ok to bake in the sun all day because you applied a thin layer of sunscreen in the morning before you went out. The truth is that sunscreen is, at its best, a last ditch effort to make it possible to live an active life while trying to avoid damage to your skin. Nevertheless, you absolutely need it.
As dermatologists, we debate among ourselves in private and through the media about the best SPF number and the best ingredients. The FDA is pretty tough to get through and hasn’t approved a new sunscreen ingredient in over 15 years because sunscreens are considered over the counter drugs. This can be a problem because it adds to levels of bureaucracy and limits options that we might otherwise have in Europe, where sunscreens are categorized as cosmetics. However, this means that the burden of proof for safety and quality is set extremely high.
Knowing that, it’s amazing how much people complain about the safety of sunscreen ingredients after all the testing they have to go through to prove not just efficacy but consumer safety. I get questions every day about the dangers of “chemical” sunscreens and warnings about risks of cancer and three headed children. Never a laughing matter! But, if you read the data, you’ll see that the information trying to make the case against these sunscreens is either not published, not reproduced or simply not valid. But that doesn’t stop some people from trying to convince you it’s true.
Here’s what I know as a doctor and dermatologist
- Sunscreens FDA approved in the US are safe. The FDA, an organization I often take issue with, is doing it’s best to make sure we get new ingredients that are proven safe and they continue to evaluate ones already approved to make sure any concerns about safety are addressed.
- I also know that all wavelengths of ultra violet (UV) radiation are carcinogenic, meaning anyone exposed to enough of it will ultimately develop skin cancer, same as is true for smoking with lung cancer. They’re in the same category. Amazing and frightening, but true
Being sun smart
So now you know you need sunscreen, but wait, there’s more! You first need to be sun-smart.
First, this means trying to avoid being out in midday sun when possible. All you outdoor runners and exercisers, great, I’m happy for you and proud of you, but do it early in the morning or in the evening, and still wear sunscreen. Skin cancer really doesn’t care how fit and health you are!
Second, you need to wear a hat, sunglasses, sun protective clothing and seek shade when possible.
Finally, let’s really talk about sunscreen and how to choose the right one for you. It’s easier than you think.
- Start with the basics, anything SPF 50 or higher that also says broad spectrum is a great start. The argument against a higher than 50 SPF is that it doesn’t make a difference. The reality is that it does make a difference, but not as much as going from SPF 25 to SPF 50. That’s ok, every little bit helps. No matter which SPF number you wear, as long as you don’t go below SPF 15, you still need to reapply every 2 hours or so because you either wear it off or they lose efficacy. You also need to apply sunscreen every day all year round. I see the worst sunburns on cloudy days, the weather tends to be a little cooler and there’s often even a nice breeze so you spend more time outdoors and your skin burns. UV rays go through clouds, only about 20% is blocked, and that’s not enough to help you avoid skin damage and sunburn.
- You have a large variety of options to choose from and they are all equal as long as you use enough and reapply often enough. You can look for a gel if you’re acne prone, or if you’re very active when you’re outdoors try a powder, lotion, cream or spray. They all work. If you’re on the dry side you might prefer a cream and if you’re oily, try a lotion or gel.
- Powders are great for reapplying during the day over makeup. This saves you from having to remove any makeup and keeps you protected. A moisturizer with sunscreen is a sunscreen. It works just fine if you apply enough of it and if you reapply every 2 hours as with any other sunscreen.
While it’s hard to hear this when you’re excited about a ‘sun-kissed’ glow, it’s important to know that if you tan, you’re damaging your skin. The tan is your skin’s way of trying to protect itself when it’s being assaulted.
Don’t tan; not in the sun, not for fun, not in a tanning salon, not on your honeymoon.
Just don’t do it. Be sun smart, use sunscreen. Enjoy your time outdoors without damaging your skin!