Sunscreen is as ubiquitous as bottled water these days; it's in clothing, make-up and a dizzying selection of creams, lotions, sprays and sticks. But is it all equal? And how does one choose among all the options?
With the recent FDA regulations for sunscreen going into effect in the coming year, terms like “waterproof” and SPFs of 100 will be obsolete, and the safety and efficacy of spray sunscreen is also under question. But even as the FDA attempts to regulate and streamline sunscreen labeling, for now it can still be confusing.
I am a mom of two and understand how skin cancer and wrinkles can occur without sunscreen, so I religiously use it. I am, however, admittedly lax about re-applying, am guilty of quickly slathering up my kids minutes before they jump in the pool and frankly don’t know what to make of words like Helioplex.
To help set me straight on sunscreen protocol, I employed the help of Kimberly Ruhl, a mom of two and, most importantly for this article, a dermatologist. Ruhl graciously submitted to a quick Q&A on how to stay safe and protected in the sun.
Q) What should people look for on a sunscreen product label?
A) The labeling guidelines will be modified next year but for now we suggest SPF 30. Higher numbers give an erroneous idea about greater levels of protection. For example SPF 30 blocks 96.67% of UVB rays and SPF 70 blocks 98.57% of UVB. This is less than a 2% increase in protection, not the two fold increasing that most people believe.
Also remember that sunscreen and SPF are not additive; for example, if your makeup has SPF 15 and your moisturizer has SPF 20, your level of protection is only as high as the highest number e.g. SPF 20. SPF also only refers to protection from UVB (sun burning) rays and make no claims about UVA protection (skin aging and DNA damage). Make sure the label indicates that the product has broad-spectrum UVA and UVB coverage as both are dangerous.
Q) How soon before sun exposure should we apply sunscreen, and when should it be reapplied?
A) Given the variability in the absorption rate of different chemicals, we usually suggest 30 minutes prior to going outside. Sunscreens should generally be applied to dry skin. Also, even though products advertise them as being water resistant, most of their efficacy is removed after about 40 minutes in the water and essentially the vast majority is gone by 80-90 minutes. Given that time frame, we suggest that block be applied every 90 minutes. Even if you are not swimming or sweating, the skin breaks down some sunscreen.
Remember to apply enough to liberally cover the body. Do not economize here. A full shot glass size of lotion should be used. Even on a cloudy day, up to 70% of the sun's ultraviolet rays can pass through the clouds so sunscreen still must be used. Sun and sand also worsen the effect of the sun by reflecting back 25% and 80% of the sun’s rays, respectively.
Q) What is the difference between sunscreens with Titanium Dioxide and those without?
A) Sunscreens are basically categorized as either chemical or physical blocks. Sunscreens that use only chemical blocks like avobenzone, homosalate, oxybenzone etc., need to be combined in order to provide full spectrum coverage. Some of the UVA blockers are very chemically unstable and need stabilizers like Helioplex, which is found in many Neutrogena formulations. A chemical sunscreen called mexoryl is made in products by La Roch-Posay and is very stable and can be used alone without additional stabilizers.
According to the American Association of Dermatology, there has been some concern that chemical sunscreens work by absorbing the energy from the UV rays is then dispersed into surrounding skin cells. Dermatologists say the by-products of the dispersal may cause later problems.
With all this in mind, The best, safest sun protection products contain physical blocks like zinc oxide or titanium dioxide. These are not absorbed and work by reflecting light from the surface of the skin. They used to be thick white pastes that lifeguards used but have now been micronized into very cosmetically elegant formulations that do not leave a white sheen on the body. (Author note: kids may also dig the new colored zinc oxides like the ones from Zinka)
Q) Do you have any favorite brands you can recommend?
A) I prefer the physical blocks. Aveeno has a product line called Natural Protection and comes in face and body formulations for kids and adults. They also contain some natural antioxidants to help with sun damage. Neutrogena has a cream sunscreen for sensitive skin that has a nice high level of titanium. Coppertone has a nice product called Sensitive Skin Gentle Formula with Zinc Oxide. If you shop online you may also order products under the COTZ label. This stands for contains only titanium and zinc.
Q) How is your own children’s attitude towards sunscreen?
A) My kids have grown up with vigilance about sunscreen use and now at age 11 and 14 ask for it on their own. In their minds now, sun and sunscreen go together.
Q) What, besides applying sunscreen, can we do for sun protection?
A) Many companies make very cute and stylish surf shirts (rash guards) that can be gotten with long sleeves. That way, you only need to worry about face and legs when at the beach. Brimmed hats are an easy way to provide extra help too. Lastly, encourage your kids to wear sunglasses routinely starting at a young age. UV radiation will lead to cataracts and squint lines later. If younger ones balk, let them pick out goofy ones or styles that will encourage the glasses to say on.
(Author note: For sunglasses, try Tweak'ms. Invented by Montclair mom Tracey Diamond, Tweak'ms have a patened design to stay put and stand up to kids' wear and tear. They can be worn by newborns through school-age kids and come in a wide variety of fun styles)
Kimberly Ruhl, M.D. is a practicing dermatologist at Advanced Dermatology Skin Care, located at 101 Old Short Hills Road, West Orange NJ. (973) 731-9600. Her practice serves patients of all ages, starting in infancy.