HCA Midwest Health - June 22, 2020

Here is a startling statistic—just one blistering sunburn during childhood can nearly double the lifetime risk of melanoma! If you’ve had the miserable experience of a sunburn, you know first-hand the importance of wearing sunscreen! For those of us who spent too many hours in tanning beds and slathering ourselves with baby oil, hindsight has shown us that years of sun exposure leads to wrinkles and premature aging. But there is another important reason to protect our skin: skin cancer. Studies show that protecting our skin with sunscreen reduces the risk of skin cancer, including deadly melanomas, by 40-50%. Yet despite the known benefits of sunscreen, a recent study surveyed over 4000 adults and found only 14% of men and 30% of women regularly use sunscreen. More concerning is the low level of sunscreen use among children. In a study of 10,000 children of healthcare providers, only 34% of children were using sunscreen, and 83% had at least one sunburn during the previous summer. Implementing sun-protective measures in early childhood has been shown to promote lifelong sun protection behavior. Our children notice when we make things a priority—it can change how they live their lives!

How do we make sense of all the sunscreen terminology? We can break it down to a few important definitions:

  • SPF (sun protective factor): this measures a sunscreen’s ability to protect against sunburn, which is due primarily to UVB light. SPF does not adequately measure protection against UVA light, which is 95% of the total radiation that reaches the earth.
  • Broad Spectrum: this is the label that indicates protection against both UVB and the harmful UVA rays.
  • Water Resistant: this means the sunscreen maintains its SPF after 40 minutes of swimming or sweating.
  • Very Water Resistant: this indicates 80 minutes of protection with swimming or sweating.

Even with understanding the terminology, it can still be hard to know which one to invest in.

Here are a few tips when you’re in the aisle staring at all those sprays, creams and sticks:

Choose a broad-spectrum sunscreen with an SPF of 30 or higher

Although there is no proven benefit to going higher than SPF 30, people who don’t use the recommended amount (6-9tsp per total body area) or are very light-skinned, may benefit from a higher SPF. Also, the only three ingredients that protect against UVB rays as well as UVA are Avobenzone, Zinc oxide and Titanium dioxide, so these are superior in preventing photoaging and changes leading to skin cancer.

Brand name isn’t better

Don’t feel like you have to break the bank on brand names, as long as it’s broad-spectrum and has an SPF of 30 or higher, it should be adequate.

Opt for sun-protective clothing in infants less than 6 months

The American Academy of Pediatrics recommends avoiding sunscreen products in children less than 6 months old due to their immature skin barrier and increased sensitivity. Sun protective clothing is the preferred approach. However, when this is not adequate, lean towards an inorganic option (titanium dioxide or zinc oxide) due to their minimal irritation and low skin penetration potential.

You may have heard that recent concerns are being raised about the safety of sunscreen. Sunscreens are classified as organic (formerly known as chemical sunscreens) and inorganic (minerals formerly known as physical sunscreens). Organic sunscreens are widely used and are considered easier to apply, but information regarding the degree of their systemic absorption has been limited. The FDA recently sponsored a study testing four organic sunscreens (avobenzone, oxybenzone, octocrylene, and ecamsule). They found these sunscreen chemicals were high enough in people’s blood to warrant further safety studies. However, there are some things to keep in mind: 1.) The trial size was very small and the doses were higher than routinely used. That makes it hard to know if these results are applicable. 2.) We don’t know if these chemicals are harmful at these concentrations. While awaiting further data, we continue to advise patients to use sunscreen, along with other sun-protection measures (eg, seeking shade, wearing sun-protective clothing, hats, and sunglasses). If you are concerned about systemic absorption of organic sunscreen ingredients, sunscreens that contain inorganic ingredients (eg, zinc oxide, titanium dioxide) are good options and are not absorbed into the bloodstream.

So with all the benefits of protecting our skin from sun exposure, why do so many people forgo sunscreen? If your family is like mine, trying to apply sunscreen to myself and my children is like a form of medieval torture (for them and me). So how can we make this process less painful? Consider these tips:

Wear make-up containing sunscreen

If you already wear make-up, you won’t be adding any steps to your routine. They even make powder sunscreens that you can apply to your face like you would your normal finishing powder.

Daily apply a moisturizing lotion with sunscreen to your chest, arms and backs of hands

These are the areas we don’t think about getting chronic daily sun exposure. Moisturizers with sun protection often feel more like everyday lotion and less like sunscreen. Just think of it as part of your daily beauty routine!

Put sunscreen on yourself and your kids before you get dressed

It’s so much easier to apply sunscreen when clothes and swimsuits aren’t in the way and before outdoor activities are screaming for your kid’s attention. Bring a spray sunscreen to reapply quickly if you swim or stay out longer than 2 hours.

Try a sunscreen stick on the back of your hands and fingers

It’s less greasy and helps get sunscreen on an often forgotten sun-exposed part of our body.

Let your kids be part of the process

Once children hit age 4 or 5 you can elicit their help with the application process! Have them apply the lotion to the easier to reach areas (like the arms) while you do legs and face.

Make it a ritual

If sunscreen is an expected part of your family’s preparation for outdoor fun, it will be less of an unexpected surprise.

Talk to your kids about why this is important

As a doctor and a mom, I feel this is critical in many areas besides sunscreen. If our kids know why we do things, they are more likely to comply. Keep it age appropriate. For your toddler say “just like we sit in our car seat to keep us safe on the road, sunscreen keeps our skin safe in the sun." For your teenager say “just one sunburn increases your chance of dying from skin cancer and once skin damage is done it, it can't be undone.”

Like many things my mom used to tell me that I have found to be true, “you only get one skin to live in, take care of it!” Being intentional about the sunscreen you use, when and how much to apply and remembering basic sun-protective measures will help protect this “skin you are in” for years to come!

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