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Stop Kidding Yourself About Sunscreen

Date: August 1, 2015      Publication: Bottom Line Health      Source:  Barney Kenet, MD, New York-Presbyterian/Weill Cornell Medical Center      Print:

What you need to know now…

It used to be that summer didn’t officially begin until that first sunburn.

What’s changed: Even though dermatologists have cautioned for years that burned—or even suntanned—skin can lead to skin cancer, far too many people are failing to heed that warning. In fact, only about 20% of men and 43% of women use sunscreen regularly, according to a new survey by the Centers for Disease Control and Prevention.

Why do so few of us take advantage of this basic form of skin protection? Part of the problem is that there are so many misconceptions about sunscreens and skin cancer.

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Among the most common myths…

MYTH #1: If you wear sunscreen, you’ll develop vitamin D deficiency.­ Truth: Our skin needs to be exposed to sunlight in order for our bodies to manufacture vitamin D. Deficiencies of this crucial vitamin are now being linked to everything from bone loss and multiple sclerosis to heart disease and dementia.

It’s true that if you were perfectly covered in sunscreen every minute of every day, then you could, theoretically, develop a vitamin D deficiency. This, however, isn’t a reality for most people.

Dr. Kenet’s take: To produce sufficient vitamin D, you need only about 10 to 15 minutes of sun exposure three times a week on your arms or face (without sunscreen). If you are worried because you live in an area where you get limited sun exposure, ask your doctor for a blood test to measure your vitamin D level. If your level is low, you may need to take a vitamin D supplement.

MYTH #2: Only fair-skinned people develop skin cancer. Truth: While it is true that fair-skinned people are at highest risk for melanoma, the deadliest form of skin cancer, olive-skinned and dark-skinned people are also at risk. Among African-Americans, for example, melanomas mainly occur on parts of the body that are not pigmented, such as the palms of the hands, the soles of the feet and the skin beneath the nails. 

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Dr. Kenet’s take: No matter what your skin tone, use sunscreen to help protect against skin cancer. Be sure to cover areas that frequently get overlooked—the back, behind the ears and the backs of the legs.

If you have dark skin, you might not need to wear sunscreen on a daily basis, but I advise using it when you are spending time outdoors in intense sunlight.

MYTH #3: Sunscreen is all you need to avoid skin cancer. Truth: Sunscreen is just one tool in skin cancer prevention.

Dr. Kenet’s take: When it comes to skin protection, think “belt and suspenders”—that is, no single approach will guarantee safe skin, so do as much as possible.

Reduce your exposure to ultraviolet (UV) radiation by avoiding outdoor activities during the peak UV-risk hours of 10 am to 4 pm.

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Hide your skin from the sun by seeking shady areas…using a wide-brimmed hat that shades your face and ears…and wearing a tight-weave, long-sleeved shirt. Also, consider wearing clothing made with UV-protective fabric. Check Coolibar.com…and SunPrecautions.com.

Important: Don’t forget sunglasses—ocular melanoma is a real risk, especially for people with light (blue or green) eyes. One in four Americans rarely or never wears sunglasses, according to a new survey. Be sure your sunglasses block out 99% to 100% of both UVA and UVB rays.

Also: Skin cancer can develop on the lips, too, so use a lip balm that includes sun protection factor (SPF). It doesn’t have to be anything fancy—ChapStick Ultra Lip Balm with SPF 30 works great.

MYTH #4: When it comes to SPF, the higher the better. Truth: Sunscreens with SPF 15 filter out 93% of UVB rays (the primary cause of sunburn)…SPF 30 filters 97%…and SPF 50 filters 98%. There is very little difference between the protection offered by SPF 30 and SPF 50+.

People often mistakenly assume that a high-SPF product that blocks sunburn is adequate, not realizing that it may not protect them from the effects of UVA exposure, which is more closely associated with skin cancer. “Broad-spectrum” products provide protection against both UVB and UVA exposure.

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Dr. Kenet’s take: For maximum sun protection, purchase a broad-­spectrum sunscreen with at least SPF 15, then be sure to reapply it every two hours (use a golf ball–size dollop—roughly one ounce). And yes, that means you’ll go through a bottle of sunscreen very quickly! Note: People who have lupus or a family history of skin cancer should use an SPF of at least 30.

It is a good idea to wear sunscreen year-round. Apply it before you get dressed (this helps reduce the chance that you’ll miss a spot).

MYTH #5: It’s fine to choose any form of sunscreen, as long as it’s broad-spectrum and has an SPF of at least 15. Truth: That’s true in theory, but the form of the sunscreen can make a big difference in whether you actually use it.

Dr. Kenet’s take: Spray-on sunscreens can be practical for people playing golf or tennis, for example, who need to reapply quickly and often. Because concerns have been raised about potential dangers due to inhaling spray-on sunscreens, these products shouldn’t be sprayed on the face. Instead, spray the sunscreen on your hands and then apply it to your face.

Gel sunscreens are water-based and easy on the skin for people who are prone to acne. However, gel sunscreens are not good if you plan to spend a lot of time in the water or tend to get very sweaty. For these people, sunscreens containing titanium dioxide and/or zinc oxide work well (they do leave a white coating on the skin).

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Dr. Kenet’s Top Sunscreen Picks

As a dermatologist and skin cancer expert, Barney Kenet, MD, recommends the following sunscreen products for his patients…

• Olay Complete All Day Moisture Cream with Sunscreen. Broad-spectrum, SPF 15. This product is designed for people with sensitive skin and good for daily use. It is also available in SPF 30.

• Avène Mineral Ultra-Light Hydrating Sunscreen Lotion (Face). Broad-spectrum, SPF 50+. This sunscreen is lightweight and free of parabens (chemicals used as preservatives). It’s more expensive than many other sunscreens (about $22 for a 1.3-ounce bottle) but provides good protection with a luxurious feel to the skin.

Source: Barney Kenet, MD, a board-certified dermatologist and dermatologic surgeon at New York-Presbyterian/Weill Cornell Medical Center and in private practice, both in New York City. He specializes in cosmetic dermatology and in the diagnosis of melanoma and other skin cancers. He is also a past president of the American Melanoma Foundation and author of Saving Your Skin and How to Wash Your Face.

  • Larry A.

    Experts, my a$$. These so call experts that claim sunscreen prevents skin cancer are just well funded talking heads for the big pharma industries that make sunscreen. There is no qualified real scientific research that shows sunscreens help prevent skin cancer. In fact studies show it is quite the opposite. It’s false statements like this that make dermatologist untrustworthy regarding this particular subject.

  • Diane Solander Thomas

    I would like to hear from a medical expert about the potential toxic chemicals in sunscreens. I was told by the child of a chemist, that benzenes are used in labs as catalysts by exposing them to light and that using them in sunscreens to help the sunscreen absorb into your skin is dangerous because of this. Can they actually cause cancer as I have heard?