Sun Exposure & Sunscreens: What You Need To Know

I started using sunscreens around 2 years ago when I noticed small light moles appearing on my face. Since that time, I’m religiously using it daily whenever I go outside. I even started to use lip balms with SPF and I also have SPF in my primer and foundation.

During our recent trip to Miami, even though I was reapplying SPF 50+ all over my face and body while we’ve been at the beach, I still managed to get a tan. And this got me questioned what I really know about sunscreens.

I did quite a research (that reminds me of my Master’s assignments), as to understand how the sunscreen work I had to learn the nature of the solar exposure and what makes the sunscreens such a huge necessity today if it doesn’t really save you from exposure.

Moreover, if this is something we are using daily, is it even safe?

I’ll lead you through everything you need to know.

Sun Exposure

There is a message we keep receiving from authorities and doctors: there is no such thing as “healthy tan”.

American Academy of Dermatology (AAD) shared the result of the survey, where an overwhelming number of teens believe in the opposite.

And this opinion is still common today with a dramatically increased number of skin cancer nationwide and around the world. The nature of the “pandemic” among young can be explained by several factors. Some can blame the global warming and depletion of the ozone layer (that protects our planet from solar radiation) caused by human’s negligence towards the environment with excessive release of toxic chemicals into the atmosphere.  World Health Organization, on the other hand, suggests that it’s the altered behavior towards the sunbathing habits that is actually at the root of the problem.

Where does the trend come from?

It is believed, it was Coco Chanel, who popularized the idea of tanning, linking the sun to a source of relaxation, pleasure and health.

Starting from late 60s sun-kissed skin has become “a mark of privilege”. Since not everyone had enough money to actually travel to places where they could get a bronzed tan, outdoors activities have gained their popularity. About the same time, a first indoor UV tanning bed was introduced to the market, and a decade later, in the late 70s, it became trending in the US reaching its peak of popularity in 90s.  And now, most of those women who have been spending their youth in solariums contribute to the increased number of melanoma.

How do we tan?

Dermatologists see the tan as a sign of injury, as the ultraviolet rays penetrate into the skin and are absorbed by its layers. Once burnt, the skin responds to the damage by producing special chemicals that change the DNA of pigment cells. Depending on the type of the UV rays and the skin layer that it penetrates into, you either get a tan, sunburn or moles and freckles. In the worse case scenario, these genetic mutations can lead to skin cancer.

Besides the skin cancer, the sun exposure can also contribute to sun sensitivity, significant eye damage as well as considered as an immune system suppressant. It is also linked to premature skin ageing and wrinkles.

Should we abandon the sun exposure then? Not really.

Importance of the Sun Exposure

Even though we are so astonished by the stats published by National Cancer Institute, we cannot fully abandon the sun because it synthesizes vitamin D. Vitamin D, also called the sunshine vitamin, is one of the vital elements that protect against osteoporosis, heart disease, and cancers of the breast, prostate, and colon. Moreover, some studies show that the sunlight also shields against depression, insomnia, and an overactive immune system – completely opposite from what U.S. Environmental Protection Agency (EPA) tells us about the sun exposure. Moreover, Vitamin D is especially important for children.

Indeed, according to the recent statistics, 25% of Americans have a board line level of vitamin D, while 8% is at much greater risk.

Another study that links an increased rate of heart attack to the lack of Vitamin D, supporting the actual importance of sun exposure. In the conclusion, authors agree on the fact that “moderate sun exposure… should be sought rather than avoided“.

In some countries such as Australia for example, the responsible authorities are actually reconsidering their recommendations about the sun exposure, advising people to get vitamin D naturally if the radiation is lower than UV index 3. However, EPA is firm in their views encouraging Americans to get the supplements instead of staying in the sun.

In my childhood, we had a consideration of “good sun exposure” time from sunrise till 11 am and from 4 pm till sunset when we were allowed to play outdoors during the summertime feeling safe from sunburns and sunstrokes. Moreover, we were encouraged to stay outdoors to get the required amount of vitamin D without even thinking of the skin cancer. Today, new research shows the opposite, as noon time (from 11 am to 2 pm) is considered as the most effective time for getting the required amount of vitamin D with a lower chance of skin cancer.

This information might not seem relevant to the use of the sunscreen, however, if you are using sunscreens and avoiding direct sunlight, it is important to keep in mind that there is another side of the coin.

What else do you need to know about the sun exposure?

The way your skin reacts to the sun exposure depends on a number of external factors including season, time of the day, UV index, time of the year, latitude and etc. Besides, the skin pigment, skin care regiment (retinol, skin acids), medications (antibiotics), cosmetic procedures (hair laser removal) and even your diet can increase your sensitivity to the sun. No skin color is protected from the sun damage!

Let’s get in more details about the nature of the UV light.

Types of UV rays

There are three types of UV radiation: UVA, UVB and UVC. They are classified according to their wavelength. The longer the wavelength, the further it can penetrate through the ozone layer and reach human’s skin.

The most dangerous one is UVC with the shortest wavelength. The good news is that it is completely filtered by the atmosphere.

World Health Organization considers the medium-wavelength UVB as the significant promoter of the skin cancer development, while most of the rays are filtered by the atmosphere and it cannot penetrate in deeper skin layers. However, other research suggests that this type of rays is responsible for Vitamin D synthesis.

Finally, UVA, the long-wavelength rays account for 95% of UV radiation that reaches the Earth and can penetrate deeper in the skin layers. It is responsible for immediate tanning effect and recent studies highlight that the UVA rays that are predominantly occurring during the commonly known “good sun exposure” time and are therefore are directly linked to increased rates of skin cancer.

Another important thing to consider is UV index. UV Index shows the forecast of the risk of overexposure to the solar radiation. It was developed by National Weather Service along with EPA and is available to the public. The forecast is provided daily based on your zip code and you can check it here.

Even though there is a controversial opinion about how the sun can really affect our health, it’s better safe than sorry. Regardless of the skin color or age, we need to seek protection from the sun overexposure. The most common ways of protection are seeking shade, wearing hats, sunglasses and clothing that covers your body and using sunscreen. Now we are back to the discussion about the sunscreens.

What do we know about sunscreens?

With thousands of different types, it becomes so hard to decide which is best for use. And, most of the cosmetic brands are actually adding sunscreen filters into their cosmetic formulas.

Sunscreen is an FDA-regulated product that is labelled in accordance with specific regulations. Today, on the labels you can find different numbers that show SPF (Sun Protection Factor) and letters that indicate the spectrum coverage – UVB or Broad Spectrum (UVB/UVA).

What do the labels actually say?

Sun Protection Factor indicates the level of sunscreen protection from UVB rays that are responsible for sunburns and development of skin cancer. Unfortunately, it doesn’t show protection from UVA rays. However, today there are also sunscreens that provide a complete protection from both types of UV radiation.

The optimum ratio for protection from UVA is at least â…“ of that from UVB. This ratio will provide the so-called “Broad Spectrum” protection and you are recommended to use sunscreen with this label only.

The number that follows after these three letters let you stay longer in a sun without burning compared to the time when the skin is bare under the sun. However, the math is a little tricky here.

You may find some sources claiming that for example, if a person normally gets sunburn within 10 minutes, SPF 30 provides protection for 300 minutes (10 times 30). This is only a rough estimate, as according to FDA,  SPF “is not directly related to time of solar exposure but to amount of solar exposure“. Moreover, as mentioned earlier, the effect of sun exposure depends on many other factors.

FDA recommends using Broad Spectrum SPF 15 and higher to protect the skin. However, it is vital to mention, that the higher number of SPF doesn’t provide a significantly better protection.

If you look at the graph, you can see that the increase of protection with higher SPF number is not a linear function.

If you compare the numbers* in the table below, you can see that compared to SPF 30, SPF 50 provides a better protection only by 1%, while the difference between SPF 50 and SPF 70 is only 0.5%.

* data source

While FDA suggests using sunscreen with a higher SPF (up to SPF 50), most dermatologists agree that you don’t really need protection higher than SPF 30. Moreover, there is also an opinion suggesting that SPF 50 +  provides better protection from UVB rays rather than from UVA which actually creates an imbalance in protection ratio, that we’ve covered earlier. Therefore,  sunscreens with the factor higher than 50 give a false sense of protection and FDA considers them as “inherently misleading”. However, specific regulations on this matter are not yet enforced and therefore, products with SPF 50+ are not prohibited for sale on the US market.

Finally, according to Consumer Report, a third of the tested sunscreens provide less protection that shown on the label, especially those with SPF number over 50 which also supports inefficiency of products with higher SPF.

Type of Sunscreens Filters

Mainly, there are two commonly-used types of sunscreen filters: chemical and mineral. These two types differ not only in the active ingredients but also in the way they protect the skin from solar radiation.

Chemical filters protect your skin by absorbing the UV rays, while mineral ones are reflecting them. Let’s take a deeper dive into ingredient’s interaction with our health.

Ingredients

This is probably the most important topic when we talk about the sunscreens.

Back in 1978, FDA presented a list of acceptable active ingredients for sunscreens. And it hasn’t been modified or changed afterwards.

• Aminobenzoic acid
• Avobenzone
• Cinoxate
• Dioxybenzone
• Homosalate
• Menthyl anthranilate
• Octocrylene
• Octyl methoxycinnamate
• Octyl salicylate
• Oxybenzone
• Padimate O
• Phenylbenzimidazole sulfonic acid
• Sulisobenzone
• Titanium dioxide
• Trolamine salicylate
• Zinc oxide

There has been a huge dispute around several ingredients on this list because of their toxicity. Even though they still fall under category Generally Recognized As Safe (GRAS), FDA has now added below comment under the list:

Although the protective action of sunscreen products takes place on the surface of the skin, there is evidence that at least some sunscreen active ingredients may be absorbed through the skin and enter the body. This makes it important to perform studies to determine whether, and to what extent, use of sunscreen products as directed may result in unintended, chronic, systemic exposure to sunscreen active ingredients. – FDA

Nevertheless, FDA still considers that sunscreens are safe. But the same department labelled  BPA as GRAS as well until the later research has proved the opposite. Therefore, even though it’s the governing body, we cannot fully rely on this information.

Fortunately, there is a number of individual researchers as well as independent Environmental Working Group (EWG) that evaluates the sunscreens on the safety and effectiveness.

Every year, EWG publishes a report where the updated data on this matter is presented to the public. They also share a table that compiles all the research that has been done until present day on each of active ingredient, their level of toxicity and impact on our health.

Top Toxic Ingredients

According to EWG, the most troublesome ingredient is Oxybenzone (also known as benzophenone-3) – a widespread chemical found in 65% of all sunscreens. There was evidence when it not only penetrates into human’s body but also can disrupt hormones and cause allergies. It is also found in mother’s milk and some research link it to altered birth weight in human studies. Moreover, there is another research showing the deadly impact of oxybenzone on coral reefs and altered reproductive organs in sea life. Hawaii is even passing a bill to ban the sale and use of sunscreens with this chemical to save the reefs.

Interestingly, but there is also a separate study that critically reviewed the literature available by 2011 that outweighs the benefits of oxybenzone as a stable and strong sunscreen protecting from skin cancer. Meanwhile, in another study, there is no obvious hormone disruption found in people. However, we need to consider bias in the mentioned research as it followed only young men and postmenopausal women, while the studies on animals that confirmed the hazardous level of toxicity are particularly focused on female reproductive organs and their sensitivity to oxybenzone.

While there is not any complete and comprehensive research on the real effect of oxybenzone, it is still recommended to avoid the use of this chemical, especially for young children. Even FDA recommends avoiding the use of sunscreen on infants.

Another chemical that comes next in the EWG’s table is Octinoxate (also known as Octylmethoxycinnamate). Even though it has a lower index (moderate hazard), it is also linked to hormone disruption and there is an evidence of penetration into body and mother’s milk. Similar to the oxybenzone, there is not enough information for FDA to ban the sale of cosmetics with this chemical.

Less Toxic Ingredients

Besides these widespread chemicals, there are several ingredients that are mostly found in “natural” and “organic” labelled products. These are two minerals ( zinc oxide and titanium dioxide) as well as Avobenzone (less toxic but less stable chemical) and Mexoryl SX (commonly used in EU, currently pending FDA approval). According to EWG, these ingredients have no evidence of hormonal disruption and have a very small percentage of skin penetration.

Mineral sunscreens provide excellent protection from UVA rays. Most of them are usually presented in a form of nanoparticles. The smaller the particle the better the SPF protection. Moreover, Nano-size particles leave less white residues when you apply the sunscreen to your skin.

However, there is a “problem” with mineral filters that we need to mention here. According to EWG, mineral sunscreens are providing a significantly better protection with fewer health concerns and don’t break in the sun. Nevertheless, smaller particles (nano-sized) are not that effective when it comes to UVA protection. Besides, there is a controversy about if nano-particles of zinc oxide into the bloodstream, however other studies conducted by FDA and EU confirmed there is no penetration of nanoparticles into the body.

Apart from this, nanoparticles (especially titanium dioxide) tend to be more sun-sensitive (photocatalysts) and can possibly form free radicals that can damage the cells. Some studies suggest that it can be prevented if the minerals have a special coating, while another research concluded that these free radicals are neutralized naturally by skin’s antioxidant protection. Nevertheless, European Union has special regulation in terms of the types of minerals and their coating used in cosmetic industry. Unfortunately, there is no similar enforcement in the US.

What is more important to mention, nano-particles (particle size less than 100nm) of both zinc oxide and titanium dioxide are dangerous for inhalation and can cause lung damage. EWG encourage to avoid using of any mineral sunscreen in a form or powder or spray regardless of the particle size.

While this information might seem sufficient not to consider sunscreens with nanoparticles, it would be really hard to get “real” sunscreens with bigger particle size as there are no special regulations from FDA on this matter. Therefore, not everything that is marketed as “non-nano” indeed corresponds to reality.

Finally, the latest test conducted by Consumer Report suggests mineral filters to be less effective compared to such active chemical ingredients as Avobenzone, However, the latest EWG report still considers zinc oxide and titanium dioxide as the least hazardous ingredients for sunscreen protection.

Another ingredient to be aware of

Vitamin A – (also knows as retinyl palmitate, retinyl acetate, retinyl linoleate and retinol) is an antioxidant used in anti-ageing skin care products. According to EWG, some studies report that under solar radiation this vitamin in skin care products may cause skin tumor and lesions. Interestingly, even though the usage of this additive decreased for the past 8 years, today at least 15% of skin moisturizers with SPF contain this ingredient. Some governments even recommend against the use of vitamin A in general.

From research to action

Taking into consideration everything we know right now about the sun exposure and sunscreens, one thing remains unclear: is it even safe to live?

Obviously, the study about the effect of the sun exposure on human’s body and health as well as the safety of the sunscreens that everyone tells us to use remain under-researched. Nevertheless, taking into consideration that 50% of skin cancer can be prevented by just wearing sunscreen indeed makes us think again about the protection from the sun.

I’ve never been as cautious of the ingredients in my cream as I am now after this research. I’d even say it impressed me to the extent that half of my vanity goes straight to trash. But I’m not even sure, if this action will even protect me from other chemicals that I use in other skin care products, makeup or whether I’m even safe by drinking the water or breathing in the air. We can’t live in isolation from everything. Moreover, some of the man-made chemicals saved millions of lives by producing medicine that we still use today.

Maybe our bodies are stronger than we think in breaking down the chemicals and they are not stored forever in our organs. And maybe were are just becoming paranoid by various scientific papers published every year? No one knows for sure. The science is yet lacking a full picture on how our body functions in reaction with the chemicals.

The Safest and The Most Effective Sunscreens of 2018

Like it or not, all the ingredients listed in any sunscreen product are still chemicals. But to get the required protection, we can at least choose something that seems less toxic. Moreover, since there isn’t much difference in protection percentage between SPF 30 and SPF 50, it is better to stick to the lower number with less concentration of the minerals. Besides, FDA doesn’t “authorized the marketing of nonprescription sunscreen products in the form of wipes, towelettes, powders, body washes, or shampoos” and even so-called sunscreen pills. To keep it simple, I suggest narrowing our search for ideal sunscreen to creams, lotions and sticks.

Thanks to EWG and Consumer Report, who analyze sunscreens available on the market each year and coming up with shortlist of safest sunscreens.

Since I barely can recommend anything from my vanity, I’d share some of the creams that I’m willing to try instead:

Drunk Elephant Umbra Tinte Physical Daily Defense, SPF 30 ($36, Buy Now)

Score: 1

UVA Protection: EXCELLENT

Balance of UVA to the SPF: GOOD

Health Concern: MODERATE

Active Ingredients: 20% ZINC OXIDE (sunscreen grade > 100nm)

Drunk Elephant Umbra Sheer Physical Daily Defense, SPF 30 a regular sunscreen without a tint has also scored 1 in EWG rating.

These two products are also marked with “Clean at Sephora” sticker.

Biossance Squalane + Mineral, SPF 45 ($39, Buy Now)

Score: 2

UVA Protection: MODERATE

Balance of UVA to the SPF: MODERATE

Health Concern: LOW

Active Ingredients:

4.1% TITANIUM DIOXIDE (sunscreen grade)

7% ZINC OXIDE (sunscreen grade > 100nm)

Juice Beauty Mineral Moisturizer, Sheer, SPF 30 ($29, Buy Now)

Score: 1

UVA Protection: EXCELLENT

Balance of UVA to the SPF: GOOD

health concern: LOW

Active Ingredient: 20% ZINC OXIDE (sunscreen grade > 100nm)

Neutrogena Sheer Zinc Dry-Touch Sunscreen, SPF 30 ($5.99, Buy Now)

Score: 1

UVA Protection: MODERATE

Balance of UVA to the SPF: GOOD

Health Concern: LOW

Active Ingredient: 8% ZINC OXIDE (sunscreen grade > 100nm)

COOLA Suncare Sport Mineral Sunscreen Stick, SPF 50 ($26, Buy Now)

Score: 1

UVA Protection: EXCELLENT

Balance of UVA to the SPF: GOOD

Health Concern: MODERATE

Active Ingredient: 20% ZINC OXIDE (sunscreen grade > 100nm)

Supergoop! Play 100% Mineral Sunscreen Stick, SPF 45 ($24, Buy Now)

Score: 1

UVA Protection: GOOD

Balance of UVA to the SPF: GOOD

Health Concern: LOW

Active Ingredient: 17% ZINC OXIDE (sunscreen grade > 100nm)

Burt’s Bees All Weather Moisturizing Lip Balm, SPF 15 ($6.64, 2 pc, Buy Now)

Score: 1

UVA Protection: MODERATE

Balance of UVA to the SPF: EXCELLENT

Health Concern: LOW

Active Ingredient: 11% ZINC OXIDE (sunscreen grade > 100nm)

My choice of products is based on EWG’s recently published report (May 2018).

How-to Sunscreen

Applying

FDA recommends applying the sunscreen at least 30 minutes before the exposure. Since the authority also considers the chemical filters, with minerals filters you need far less time.

It is important to highlight the correct amount of sunscreen used per application, as in general people are underusing the sunscreen which decreases the factor of protection: using half of the dosage will provide the square root of the SPF. In other words, if you under-apply SPF 30, you are actually getting the same protection as in SPF 5.5 (BadgerBalm, 2018).

Following the recommendation from the governing authorities, use at least 1 oz (a shot glass) per application to fully cover your body and reapply at least every 2 hours or more frequently after swimming or sweating. Shake well before use.

If you apply to face alone, the appropriate amount is a nickel-sized dollop.

When it comes to children and infants protection, FDA considers keeping the infants out of the sun entirely as the best protection and avoiding the use of sunscreen since baby’s skin is more prone to sunscreen’s side effects.

Storing

Store your sunscreen in cold dry place away from direct sun exposure. According to FDA, sunscreens have a shelf life of three years unless the manufacturer shows a different expiration date on the package. If it smells bad or you notice a change in color and consistency, discard immediately.

Bottom line

After going through all these papers and articles, it is still unclear to me whether the sun is still that bad for us or there is even more jeopardy from the use of sunscreens.

I live in sunny Houston, so while now I’m more cautious about the ingredients in my cream, I’ll keep using sunscreens on the days, when it’s impossible to avoid the strong sun exposure. But in a nice weather, I’ll let myself enjoy the sunlight to get a bit of sunshine vitamin. Finally, I’m definitely investing more money in my wardrobe to get more hats and long-sleeved shirts to protect myself from head to toes during the sunny hot days. And whenever I’m in Europe, I’m more likely to shop there for sunscreens.

What is your attitude to sunscreens?

References:

American Academy of Dermatology (2012).  Sunscreen remains a safe, effective form of sun protection

American Skin Association (2012). Sun Safety

Badgerbalm.com. (2018). What Is SPF Sunscreen? – Sun Protection Factor explained by Badger

Baggerly, C., Cuomo, R., French, C., Garland, C., Gorham, E., Grant, W., Heaney, R., Holick, M., Hollis, B., McDonnell, S., Pittaway, M., Seaton, P., Wagner, C. and Wunsch, A. (2015). Sunlight and Vitamin D: Necessary for Public Health. Journal of the American College of Nutrition, [online] 34(4), pp.359-365

Burnett, M. and Wang, S. (2011). Current sunscreen controversies: a critical review. Photodermatology, Photoimmunology & Photomedicine, [online] 27(2), pp.58-67

Chodosh, S. (2018). You have questions about sunscreen. We have answers. [online] Popular Science

Consumer Reports. (2018). Sunscreen Buying Guide.

Cynthia Bailey, M. (2018). How High of an SPF Does Your Sunscreen Need To Have?. [online] Dr. Bailey’s Skin Health & Wellness Blog.

Dellorto, D. (2012). Avoid sunscreens with potentially harmful ingredients, group warns – CNN.

Downs, C., Kramarsky-Winter, E., Segal, R., Fauth, J., Knutson, S., Bronstein, O., Ciner, F., Jeger, R., Lichtenfeld, Y., Woodley, C., Pennington, P., Cadenas, K., Kushmaro, A. and Loya, Y. (2015). Toxicopathological Effects of the Sunscreen UV Filter, Oxybenzone (Benzophenone-3), on Coral Planulae and Cultured Primary Cells and Its Environmental Contamination in Hawaii and the U.S. Virgin Islands. Archives of Environmental Contamination and Toxicology, [online] 70(2), pp.265-288

Environmental Protection Agency (2004). A guide to the UV index

Environmental Protection Agency  (2018). Sun Safety | US EPA

Environmental Protection Agency  (2018). What is the UV Index

Environmental Working Group (2018). EWG’s 2018 Guide to Safer Sunscreens

Environmental Working Group (2018). Nanoparticles in Sunscreens

Environmental Working Group. (2018). 8 Little-Known Facts About Sunscreens

Environmental Working Group (2018). The Trouble With Ingredients in Sunscreens

Environmental Working Group (2018). What”™s Wrong With High SPF?

Food and Drug Administration (2018). Should You Put Sunscreen on Infants? Not Usually.

Food and Drug Administration (2018). Sunscreen: How to Help Protect Your Skin from the Sun.

Food and Drug Administration (2018). Ultraviolet (UV) Radiation.

Green, A., Williams, G., Logan, V. and Strutton, G. (2011). Reduced Melanoma After Regular Sunscreen Use: Randomized Trial Follow-Up. Journal of Clinical Oncology, [online] 29(3), pp.257-263.

Hale, E. (2010). ASK THE EXPERT: How much sunscreen should I be using on my face and body? – SkinCancer.org

Janjua, N., Mogensen, B., Andersson, A., Petersen, J., Henriksen, M., Skakkebæk, N. and Wulf, H. (2004). Systemic Absorption of the Sunscreens Benzophenone-3, Octyl-Methoxycinnamate, and 3-(4-Methyl-Benzylidene) Camphor After Whole-Body Topical Application and Reproductive Hormone Levels in Humans. Journal of Investigative Dermatology, [online] 123(1), pp.57-61

Kotz, D. (2008). Time in the Sun: How Much Is Needed for Vitamin D?. [online] health.usnews.com

Looker, A., Johnson,C., Lacher, D., Pfeiffer, C., Schleicher, R, and Sempos, C. (2011). Vitamin D Status: United States, 2001”“2006.

Moan J., Dahlback A., Porojnicu A.C. (2008) At What Time Should One Go Out in the Sun?. In: Reichrath J. (eds) Sunlight, Vitamin D and Skin Cancer. Advances in Experimental Medicine and Biology, vol 624. Springer, New York, NY

Pierre-Louis, K. (2017). Why some people worry that sunscreen might be bad for you. [online] Popular Science.

Sarnoff, D. (2010). The Tale of Tanning. [online] Skincancer.org

Seer.cancer.gov. (2018). Melanoma of the Skin – Cancer Stat Facts.

Siegel, E. (2018). Why It’s So Shocking That Skin Cancer Is on the Rise

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World Health Organization. (2018). Sun protection.

World Health Organization. (2018). UV radiation.

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