by Dr. Madeleine Morrison ND
First things first:
Check Your Sunscreen Ingredients, Reapply and Cover Up
Check your skin regularly for new moles or growth or changes in an existing mole. Ask your primary health care provider how often you should see a dermatologist. Here in California, annual visits depending on age and skin type are the norm. Fair-skinned people may start visits early, depending on history of sun exposure.
The best defense against too much harmful ultraviolet radiation is a combination of protective clothing, shade and good timing (before 10am and after 4pm). Stanford University dermatologists who reviewed data from a national CDC survey found that people who relied solely on sunscreen for sun protection got more sunburns than people who reported infrequent sunscreen use but wore hats and clothing to shield themselves from the sun. They also found that people rarely use a combination of strategies, such as protective (wearing sunglasses and sunscreen), avoidant (seeking shade, avoiding the outdoors), and covering-up (wearing a shirt, hat, or pants).
Cancer and the Sun
Basal cell carcinoma (BCC) – most common type. Looks flesh colored, pearl like bump, or pinkish patch of skin. BCC usually develops after years of sun exposure or indoor tanning. Catch it early as its growth can penetrate other local tissues such as nerves and bones.
Squamous cell carcinoma (SCC) – second most common type. Often looks like a firm red bump, scaly patch, or a sore that heals and reopens. Common in light-skinned people. Tends to form on skin that gets frequent sun exposure, rim of ear, face, neck, arms, chest, or back. Can spread so catch it early.
Actinic keratosis – not cancer but considered pre-SCC. Red, dry, scaly patch. Get checked to prevent SCC.
Melanoma – will spread and can be fatal. Often develops in a mole or suddenly appears as a dark spot on the skin. A – asymmetry, B – border irregular, C – color (darker areas but other shades as well), D – diameter larger than a pencil eraser, E – evolving spot is changeable size, shape and color. Can develop in areas that get less sun exposure, but more common in sun exposed areas.
American Academy of Dermatology Association aad.org
SUN USE ADVICE
Don’t get burned. Sounds easy, but avoiding extra measures and misplaced trust in sunscreens can lead to sore, blistered or peeling skin and raises your skin cancer risk.
Extra Measures
- Cover up. Shirts, hats, shorts and pants provide the best protection from UV rays.
- Find shade – or make it. Picnic under a tree, read beneath an umbrella or take a canopy to the beach. Keep infants in the shade – they are still developing the tanning pigments, known as melanin, that protect skin.
- Plan around the sun. Go outdoors in early morning or late afternoon, when the sun is lower. UV radiation peaks at midday.
- Sunglasses aren’t just a fashion accessory. Good shades protect your eyes from UV radiation, which may cause cataracts.
A Moment on Solar Ultraviolet Radiation
Solar ultraviolet radiation is divided into three categories by wavelength, UVA, UVB and UVC. The shortest UVC is dispersed through the ozone-oxygen cycle. The UVA and part of the UVB reach the planet’s surface.
The Good: Exposure to sunlight is vital in 7-dehydrocholesterol’s conversion to pre-vitamin D3 in human skin. Low vitamin D3 yield is attributed to the efficiency of UVB radiation. Which is affected by; skin pigmentation (more melanin, more blockage, lower vitamin D), sunscreen application, time of day, season, latitude, altitude and air pollution.
The Bad: Chronic exposure to UV irradiation brings immunosuppression, photoaging and carcinogenesis. The exposure involves immune system modulation, accumulation of genetic changes, and can lead to skin tumors.
Ironically the tanning is a defense in itself by creating pigmentation of the skin. As well, increasing vitamin D aids in the modulation of the immune system.
The Bad: The UV filters (chemicals in sunscreens to filter out UV rays) are not fully broken down by ordinary wastewater treatment methods, aquatic ill effects are being documented. Additionally, oxybenzone probably leads to reef bleaching and other UV chemical filters have been found in fish species and may prove toxic. (Hence; “Reef Safe Sunscreens”).
He et al. Natural components in sunscreens: Topical formulations with sun protection factor (SPF)
Biomedicine & Pharmacology 134 (2021)111161
Wear Sunscreen
Picking a good sunscreen
Some sunscreens prevent sunburn but are less effective at reducing all UV rays, such as UVA rays that cause other types of skin damage. Make sure your sunscreen offers broad spectrum protection.
*SPF values are an unreliable measure of a sunscreen’s all-around effectiveness. A good sunscreen should provide equal broad-spectrum protection, protecting against both UVA and UVB rays. But the SPF value reflects only how well a product will protect from UVB rays, the main cause of sunburn and some skin cancers such as squamous cell carcinoma. UVA rays are possibly just as dangerous but are not tested in America as part of the SPF ratings. Our FDA has not changed regulations as they have in Europe to reflect full protection.
Don’t fall for high SPF labels. Pick a sunscreen with an SPF between 15 and 50+. Studies show higher SPF numbers can tempt you to stay in the sun too long– and even if you don’t burn, your skin may suffer from long-term damage. Consider a more protective product if you are near water or at high elevation and make sure to reapply often. Sunscreens only work when they sit on the skin, as time passes and the UVB rays hit the skin, penetration into the skin is enhanced, leaving you vulnerable.
Avoid sunscreen with vitamin A. Government data shows that tumors and lesions develop sooner on skin coated with creams containing vitamin A, also called retinyl palmitate or retinol. Avoid any sunscreen whose label includes retinyl palmitate, retinol or vitamin A.
Avoid oxybenzone, homosalate, avobenzone ingredients that readily penetrate the skin and have been shown to disrupt the hormone system. Instead look for sunscreen lotions with zinc oxide and titanium dioxide, the only two sunscreen ingredients categorized as safe and effective by the Food and Drug Administration.
On the Horizon in Research
Research is expanding into looking for natural substances that show promise in blocking UV rays, they can be added to the mineral based safe sunscreens. Additionally, some of the natural substances are antioxidants that may help diminish the damage to the skin cells and DNA that occurs from exposure. These include lignin, silymarin, and some marine algal species. Considering the toxicity of chemical sunscreens, using natural antioxidants for UV filtration may provide a reliable alternative with added benefits.
He et al. Natural components in sunscreens: Topical formulations with sun protection factor (SPF)
Biomedicine & Pharmacology 134 (2021)111161
Don’t combine sunscreen with bug repellent. If you need bug repellent, buy it separately and apply it first.
Don’t spray. Sprays cloud the air with tiny particles that may not be safe to breathe. It is also difficult to apply an even layer of mineral sunscreen that is thick and uniform enough to ensure proper UV protection.
Reapply often. Sunscreen chemicals sometimes degrade in the sun, wash off or rub off on towels and clothing. Sunscreen should be reapplied at least every two hours – more often if you have been swimming or sweating. So remember when hiking or biking that you need to stop and reapply.
Men Need a Kick in the Sunscreen. In 2021, the American Cancer Society estimated about twice as many American men are expected to die from melanoma as women and surveys show that only 48 percent of men report routine sun avoidance, compared to 68 percent of women.
**Got your vitamin D? Many people don’t get enough vitamin D, a hormone manufactured by the skin in the presence of sunlight. Your health care provider can test your vitamin D levels and recommend supplements if they’re low.
Next Blog will be about the Vitamin D Conundrum.
Sun safety tips for kids
A few blistering sunburns in childhood can double a person’s lifetime chances of developing serious forms of skin cancer. The best form of sun protection is a hat, shirt and shade. After that, protect kids with a sunscreen product that’s effective and safe.
Special precautions to take with infants and children
Infants
Infants under 6 months should be kept out of direct sun as much as possible. Their skin is not yet protected by melanin. When you take your baby outside:
Cover them up with protective clothing that’s tightly woven but loose fitting, and a sun hat. Mom or dad’s UV protective shirts can work as a baby cover up.
Make shade. Use the stroller’s canopy or hood. If you can’t sit in a shady spot, use an umbrella.
Avoid midday sun. Take walks in the early morning or late afternoon.
Follow product warnings for sunscreens on infants younger than 6 months. Most manufacturers advise against using sunscreens on infants or advise parents and caregivers to consult a doctor first. The American Academy of Pediatrics says that amounts of sunscreen can be used on infants to avoid sunburns when it isn’t possible to find shade.
Toddlers and children
Sunscreens are an essential part of a day in the sun. But young children’s skin is especially sensitive to chemical allergens, as well as the sun’s UV rays.
Test sunscreen by applying a small amount on the inside of your child’s wrist the day before you plan to use it. If an irritation or rash develops, try another product. Ask your child’s doctor to suggest a product less likely to irritate your child’s skin.
Slop on sunscreen (remember it works by covering the skin, not as well when it sinks in) and reapply it often, especially if your child is playing in the water or sweating a lot.
Sun safety at school
Send sunscreen to daycare and school. Some childcare facilities provide sunscreen, but you can buy your own to make sure it’s safe and effective. You can share EWG’s safe sunscreen tips and product suggestions with your child’s school and caregiver.
*For pale children, find out your child’s school’s sun safety policy.
Teens
Teenagers (I was one of these with baby oil), who covet bronzed skin are likely to sunbathe or visit tanning salons, both of which are a bad idea. Researchers believe that increasing UV exposure may have caused the marked increase in melanoma incidence in women born after 1965.
*Tanning salons expose the skin to as much as 15 times more UV radiation than the sun, and tanning bed use has been directly linked to increased rates of melanoma in women.
Be a good role model for your teens – let them see that you protect yourself from the sun.
Let me leave you with 2 head scratchers
Vitamin D activation requires sun, but sun can really damage skin
Melanin protects our skin yet sun exposure helps create melanin
**EWG’s sunscreen database evaluates the safety and efficacy of SPF-rated products, including sunscreens for recreational use and SPF-rated daily-use moisturizers and lip products. They give the best ratings to products that provide broad spectrum protection – that is, protection from both UVA and UVB rays – with ingredients that pose fewer health concerns when absorbed by the body. Consumers can shop for EWG VERIFIED® sunscreens, making it easier to choose products that are safe and effective.
SOURCES: EWG.org