In the last few weeks, there has been a tremendous spotlight focused on the importance and efficacy of sunscreens.
Consumer Reports released a scathing report stating most sunscreens do not live up to their labeling, and instead have lower SPF than what is advertised. They stated that physical sunscreens (also called mineral sunscreens) were poor performers in particular. A report by the EWG similarly cast doubts on the efficacy and safety of sunscreens currently available and the harm they can cause.
But what do dermatologists think? While I can't speak for all, the majority of dermatologists I spoke with were skeptical of the reports. While there is a tremendous amount of respect for both Consumer Reports and the EWG, the FDA is considered the gold standard to which all medicines and product efficacies and safety profiles are measured.
We believe the FDA does an excellent job screening products to ensure that patients and consumers only get the best and safest products developed. The methodology of both reports differ from the typical standard needed for FDA approval and as such, should be interpreted as so.
Why is this a concern?
Even in the last week, we've already had patients asking if they should use any sunscreen at all. This is worrisome for a host of reasons, primarily the idea that harmful UV ray exposure could increase, as could the potential for skin cancers in the future.
The bottom line is, while some sunscreens are better than others, the vast majority of sunscreen products are both safe and effective. The single most important mistake people make is how much they apply.
Scary fact: Recent studies have shown pretty much everyone skimps on the amount of sunscreen applied. You should apply 20-30 minutes before exposure, and then about every two hours, depending on the product. You should also reapply after going swimming or playing sports that work up a sweat. There are a host of apps out there that have built-in timers to help you remember (I know I sometimes I need it). And when applying, remember that, in order to get the full SPF of a sunscreen, you need to use about 1 ounce (about a shot glass full) each time you apply. But how do you choose the right one?
Chemical vs. Physical
Chemical sunscreens offer broad protection against UVA and UVB (types of ultraviolet radiation), and tend to be lighter than the physical counterpart. Given the need for absorption, you should apply these about 30 minutes before you expect to be exposed to the sun. I'm a big fan of the Helioplex Line by Neutrogena for when you are outside for extended periods of time (like the beach), and Positively Radiant by Aveeno (with SPF 30) as a daily moisturizer with sun protection. Dermatology hack: The soy in the Aveeno cream helps even out pigmentation changes/dark spots. Chemical sunscreens also tend to be beneficial to those who are in the water often or are playing sports that can leave them sweaty.
Physical sunscreens tend to be thicker and contain physical blockers, such as titanium dioxide or zinc oxide. They work by reflecting off the UV rays of the light, as opposed to the chemical sunscreens that absorb or scatter the rays. They often leave the characteristic “white streak,” but are great at blocking the harmful rays from the sun, especially in those who need the added protection like patients with melasma, a history of skin cancers, etc.
Patients with sensitive skin also tend to do better with these products compared to chemical sunscreens. Some of my favorite recommendations include SkinCeuticals Physical Matte UV Defense, which is great for people who still want the makeup/ foundation look without applying any, as well as Elta MD products.
Despite what media outlets and various sites say, using a daily SPF is incredibly important. The vast majority of cancers are preventable, and skin cancer is no exception. In my private practice, I've seen people diagnosed with both melanoma and non-melanoma skin cancers as early as 20 years-old, and even one bad sunburn increases your chance of having a skin cancer later in life (not to mention the effects on early wrinkling). I'm confident enough in the products on the market to use them both on myself and on my family. You should be, too.