Guide To Sunscreen

Seeking shade, wearing protective clothing — including a lightweight and long-sleeved shirt, pants, a wide-brimmed hat and sunglasses with UV protection — and wearing sunscreen on all skin not covered by clothing — are all important behaviors to reduce your risk of skin cancer. Sunscreen products are regulated as over-the-counter drugs by the U.S. Food and Drug Administration (FDA).

Scientific evidence supports the benefits of using sunscreen to minimize short-term and long-term damage to the skin from the sun’s rays.

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Who needs sunscreen?
Everyone. Sunscreen use can help prevent skin cancer by protecting you from the sun’s harmful ultraviolet (UV) rays. Anyone can get skin cancer, regardless of age, gender, or skin tone. In fact, it is estimated that one in five Americans will develop skin cancer in their lifetime.1 Sunscreen can also help prevent premature skin aging, such as wrinkles and age spots, caused by too much unprotected UV exposure.2-4

What sunscreen should I use?
The American Academy of Dermatology recommends that everyone use sunscreen that offers the following:

• Broad-spectrum protection (protects against UVA and UVB rays)
• SPF 30 or higher
• Water resistance

A sunscreen that offers the above helps to protect your skin from sunburn, early skin aging,3,4 and skin cancer. However, sunscreen alone cannot fully protect you. In addition to wearing sunscreen on skin not covered by clothing, dermatologists recommend taking the following steps to protect your skin.

• Seek shade
  • The sun’s rays are strongest between 10 a.m. and 2 p.m. If your shadow is shorter than you are, seek shade.5,6
• Wear Sun-Protective Clothing
  • Such as a lightweight and long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses with UV protection, when possible. For more effective sun protection, select clothing with an ultraviolet protection factor (UPF) number on the label.
• Avoid tanning beds
  • Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling.3,7,8 If you want to look tan, you may wish to use a self-tanning product, but continue to use sunscreen with it.
• Use extra caution near water, snow, and sand
  • As they reflect the damaging rays of the sun, which can increase your chance of sunburn.9

When should I use sunscreen?
You should apply sunscreen every day on skin not covered by clothing if you will be outside. The sun emits harmful UV rays year-round. Even on cloudy days, up to 80% of the sun’s harmful UV rays can penetrate the clouds.9

How much sunscreen should I use, and how often should I apply it?

• Apply enough sunscreen to cover all skin not covered by clothing. Most adults need about 1 ounce — or enough to fill a shot glass — to fully cover their body.
• Don't forget to apply to the tops of your feet, your neck, your ears, and the top of your head.
• Apply sunscreen to dry skin 15 minutes before going outdoors.
• Skin cancer also can form on the lips. To protect your lips, apply a lip balm or lipstick that contains sunscreen with an SPF of 30 or higher.
• When outdoors, reapply sunscreen approximately every two hours, or after swimming or sweating, according to the directions on the bottle.

Broad-spectrum sunscreens protect against both UVA and UVB rays. What is the difference between the rays?
Sunlight consists of two types of harmful rays that reach the earth — UVA rays and UVB rays. Overexposure to either can lead to skin cancer. In addition to causing skin cancer, here’s what each of these rays do:

• UVA rays (or aging rays) can prematurely age your skin, causing wrinkles and age spots, and can pass through window glass.
• UVB rays (or burning rays) are the primary cause of sunburn and are blocked by window glass.

The United States Department of Health & Human Services and the World Health Organization’s International Agency of Research on Cancer have declared UV radiation from the sun and artificial sources, such as tanning beds and sun lamps, as a known carcinogen (cancer-causing substance).8,11

There is no safe way to tan. Every time you tan, you damage your skin. As this damage builds, you speed up the aging of your skin and increase your risk for all types of skin cancer.

Do I need to protect myself from visible light from the sun?
Visible light from the sun can worsen skin darkening, also known as hyperpigmentation, particularly for people with darker skin tones.¹² To protect yourself from visible light, seek shade, wear sun-protective clothing, and apply a broad-spectrum sunscreen that says “tinted” on the label and has an SPF of 30 or higher. Tinted sunscreens contain iron oxide, which research shows helps protect people’s skin against the negative effects of visible light from the sun.¹²

What type of sunscreen should I use?
The best type of sunscreen is the one you will use again and again.  Just make sure it offers broad-spectrum (UVA and UVB) protection, has an SPF of 30 or higher, and is water-resistant.

The kind of sunscreen you use is a matter of personal choice and may vary depending on the area of the body to be protected. Available sunscreen options include lotions, creams, gels, ointments, wax sticks, and sprays.

• Creams are best for dry skin and applying on the face.
• Gels are good for oily complexions and hairy areas, such as the scalp or male chest.
• Sticks are good to use around the eyes.
• Sprays are sometimes preferred by parents since they are easy to apply to children. However, the challenge in using sprays is that it is difficult to know if you have used enough sunscreen to cover all sun-exposed areas of the body, which may result in inadequate coverage. When using spray sunscreen:
  • Spray until your or your child’s skin glistens and rub it in afterwards to ensure even coverage.
  • Do not inhale these products or apply near heat, open flame, or while smoking. To avoid inhaling spray sunscreen, never spray it around or near the face or mouth.
  • Spray the sunscreen into your hands and then use your hands to apply it on your face.
  • When applying spray sunscreens on children, be aware of the direction of the wind to avoid inhalation.
• Tinted sunscreens protect the skin from UVA, UVB, and the visible light from the sun and can help reduce the white “cast” that can be left on the skin from some sunscreens.
• There also are sunscreens made for specific purposes, such as for sensitive skin and babies.

Some sunscreen products are also available in combination with moisturizers and cosmetics. However, while these products are convenient, remember that sunscreen needs to be reapplied approximately every two hours when you’re outdoors.

Sunscreen may also be sold in combination with an insect repellent. The AAD recommends purchasing and using these products separately, as sunscreen needs to be applied generously and often, whereas insect repellent should be used sparingly and much less frequently. 

In addition, keep in mind that while some sunscreens are water resistant, no sunscreen is “waterproof” or “sweatproof.” Sunscreen manufacturers are banned from using these terms, as they would be misleading. Even after using a water-resistant sunscreen, you should reapply it after swimming or sweating.

What is the difference between chemical and physical sunscreens?
Chemical sunscreens work like a sponge, absorbing the sun’s rays. They contain one or more of the following active ingredients: oxybenzone, avobenzone, octisalate, octocrylene, homosalate, and octinoxate. These formulations tend to be easier to rub into the skin without leaving a white “cast.”

Physical (mineral) sunscreens work like a shield. They sit on the surface of your skin and reflect the sun’s rays. Some physical sunscreens also absorb the sun's rays. Physical sunscreens contain the active ingredients zinc oxide and/or titanium dioxide. Opt for this type of sunscreen if you have sensitive skin.

If you are concerned about certain sunscreen ingredients, you can select a formula that contains different active ingredients. As long as your sunscreen is broad-spectrum, water-resistant, and has an SPF 30 or higher, it can effectively protect you from the sun.

Is a high-number SPF better than a low-number one?
Dermatologists recommend using a sunscreen with an SPF of at least 30, which blocks 97% of the sun's UVB rays. Higher-number SPFs block slightly more of the sun's UVB rays, but no sunscreen can block 100% of the sun's UVB rays. 

It is also important to remember that high-number SPFs last the same amount of time as low-number SPFs. A high-number SPF does not allow you to spend additional time outdoors without reapplication. As many individuals only apply about 20–50% of the amount of sunscreen needed to achieve the amount of SPF on the label,10 application of high-SPF sunscreens help to compensate for this under-application. Sunscreens should be reapplied approximately every two hours when outdoors, even on cloudy days, and after swimming or sweating, according to the directions on the bottle.

How can I protect my baby or toddler from the sun?
Ideally, parents should avoid exposing babies younger than 6 months to the sun’s rays.

The best way to protect infants from the sun is to keep them in the shade as much as possible, in addition to dressing them in lightweight and long sleeves, pants, a wide-brimmed hat, and sunglasses. If you can’t find shade, create your own using an umbrella, canopy, or the hood of a stroller. Make sure they do not get overheated and that they drink plenty of fluids. If your baby is fussy, crying excessively, or has redness on any exposed skin, take them indoors.

If possible, sunscreen use should be avoided in babies younger than 6 months.

Parents of infants and toddlers 6 months and older may apply a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher to all skin not covered by clothing, according to the instructions on the product label. When outdoors, sunscreen should be reapplied approximately every two hours, or as often as the label says. Sunscreens that use the ingredients zinc oxide or titanium dioxide, or special sunscreens made for infants or toddlers, may cause less irritation to their sensitive skin.13

Can I use the sunscreen I bought last summer, or do I need to purchase a new bottle each year? Does it lose its strength?
Dermatologists recommend using sunscreen on all skin not covered by clothing every day when you are outside, not just during the summer. If you are using sunscreen every day and in the correct amount, a bottle should not last long. If you find a bottle of sunscreen that you have not used for some time, here are some guidelines you can follow:

• The FDA requires that all sunscreens retain their original strength for at least three years.
• Some sunscreens include an expiration date. If the expiration date has passed, throw out the sunscreen.
• If you buy a sunscreen that does not have an expiration date, write the date you bought the sunscreen on the bottle. That way, you’ll know when to throw it out.
• You also can look for visible signs that the sunscreen may no longer be good. Any obvious changes in the color or consistency of the product mean it’s time to purchase a new bottle.
• Avoid leaving sunscreen containers under direct sunlight, or in a hot environment such as inside of the car, as this will accelerate the degradation of the sunscreen ingredients.

Will using sunscreen limit the amount of vitamin D I get?
Using sunscreen may decrease your skin’s production of vitamin D. However, the AAD recommends that healthy adults should obtain an adequate amount of Vitamin D from a diet that includes foods naturally rich in vitamin D and/or foods/beverages fortified with vitamin D. This approach gives you the vitamin D you need without increasing your risk for skin cancer.

If you are concerned that you are not getting enough vitamin D, you should discuss your options for getting vitamin D with your doctor.

For more information on vitamin D and UV exposure, check out the AAD’s vitamin D fact sheet.

Are sunscreens safe?
Skin cancer is the most common cancer in the U.S., and unprotected exposure to the sun’s harmful ultraviolet rays is a major risk factor for skin cancer. Scientific evidence supports the benefits of using sunscreen to minimize short-term and long-term damage to the skin from UV.

AAD dermatologists see first-hand the impact that skin cancer has on patients and their families. Sunscreen is an effective way to reduce skin cancer risk and the FDA has regulations on sunscreen.

Reviewing the safety, effectiveness and quality of sunscreens is one of the FDA’s responsibilities. The FDA’s standards for OTC sunscreen products are very high to ensure patient safety. The FDA’s current recommendations are based on current scientific evidence, and the science doesn’t show that any sunscreen ingredients currently available in the U.S. are harmful to human health.

The FDA is required to monitor over-the-counter (OTC) drugs. Part of this responsibility requires the FDA to determine which ingredients are GRASE, which means generally safe and effective.

If the FDA considers ingredients in a sunscreen as GRASE, then the product can be manufactured without going through an FDA approval process.
The FDA is calling for more data on the following 12 ingredients before determining whether these ingredients can continue to be classified as GRASE:

• Ingredients commonly used in the U.S.: Ensulizole, octisalate, homosalate, octocrylene, octinoxate, oxybenzone, avobenzone.
• Ingredients not frequently used in the U.S.: Cinoxate, dioxybenzone, meradimate, padimate O, sulisobenzone.

While the FDA is asking for more data, it does not say that the ingredients are unsafe. It does not ask the public to stop using sunscreens that contain any of these ingredients.

A recent study by the FDA looked at four sunscreen ingredients and concluded that absorption of these ingredients into the body supported the need for additional research to determine if the absorption has any effects on a person’s health. As the researchers pointed out, just because an ingredient is absorbed into the bloodstream does not mean that it is harmful or unsafe.

The AAD remains committed to supporting and enhancing patient care. If you are concerned about the safety of the ingredients in your sunscreen, speak with a board-certified dermatologist to develop a sun-protection plan that works for you.

How do I treat a sunburn?
Your skin can burn if it gets too much sun without proper protection from sunscreen and clothes. To help heal and soothe stinging skin, it is important to begin treating sunburn as soon as you notice it. The first thing you should do is get out of the sun—and preferably indoors. In addition to stopping further UV exposure, dermatologists recommend treating a sunburn with:
Once indoors, these dermatologists’ tips can help relieve the discomfort:

1. Take frequent cool baths or showers to help relieve the pain. As soon as you get out of the bathtub or shower, gently pat yourself dry, but leave a little water on your skin. Then, apply a moisturizer to help trap the water in your skin. This can help ease the dryness.
2. Use a moisturizer that contains aloe vera or soy to help soothe sunburned skin. If a particular area feels especially uncomfortable, you may want to apply a hydrocortisone cream that you can buy without a prescription. Do not treat sunburn with “-caine” products (such as benzocaine), as these may irritate the skin or cause an allergic reaction.
3. Consider taking aspirin or ibuprofen to help reduce any swelling, redness and discomfort.
4. Drink extra water. A sunburn draws fluid to the skin’s surface and away from the rest of the body. Drinking extra water when you are sunburned helps prevent dehydration.
5. If your skin blisters, allow the blisters to heal. Blistering skin means you have a second-degree sunburn. You should not pop the blisters, as blisters form to help your skin heal and protect you from infection.
6. Take extra care to protect sunburned skin while it heals. Wear clothing that covers your skin when outdoors. Tightly-woven fabrics work best. When you hold the fabric up to a bright light, you shouldn’t see any light coming through.
7. With any sunburn, you should avoid the sun while your skin heals. Be sure to cover the sunburn every time you head outdoors.

Does the Academy have a position on the environmental impact of sunscreens?
The American Academy of Dermatology supports the National Academies of Sciences, Engineering, and Medicine’s recommendation that the U.S. EPA conducts an ecological risk assessment of UV filters to characterize possible risks to aquatic ecosystems and the species that live in them. As the report released today makes clear, the science in this area is limited and inconclusive. In addition, the Academy supports the recommendation that studies be conducted to determine how any changes to the availability of UV filters would impact human health.

It is well established that unprotected exposure to ultraviolet rays is a major risk factor for skin cancer. Since exposure to the sun’s harmful UV rays is the most preventable risk factor for skin cancer, it’s important that everyone protect their skin from the sun.

The use of sunscreen is one way to minimize short-term and long-term damage to the skin from the sun and to reduce the risk of skin cancer. In addition to applying a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher, the AAD also recommends that people seek shade and wear sun-protective clothing, including a lightweight and long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses.Source: https://www.aad.org/media/stats-sunscreen