Despite the cooler temperatures we are enjoying, the store shelves are stocked with sunscreens and the kids are out of school. Summer must be here. Although one should wear sunprotection year-round, dermatologists know that you probably only think about it this time of year. So a quick review is in order - because it is confusing.
You probably could not set out to design a more confusing system than our country's current method of labeling sunscreen. First of all: Is it "sunscreen" or "sunblock"? The term 'sunscreen' is often used interchangeably. Sunscreens are absorbed into the skin and scatter the UV rays whilw sunblocks sit atop the skin and reflect the rays. Think of sunblock like tiny little mirrors radiating those damaging rays away from your skin.
Sunscreen vs Sunblock
Sunscreens are all chemical based. They remain a popular option and I sometime suse them myself. However, there is growing concern about their potential toxicity. Some of these chemicals can be detected in the blood, urine, and even breast milk months later after a single application. The biological consequences of this are not known and definitive conclusions cannot be made. There is also concern with some of these chemicals around coral reefs and certain watersheds. If this concern you, go to the Good Face Project or Environmental Working Group websites and see which products fit your needs.
Sunblocks are natural elements like zinc and titanium. Formulations are more elgant now and shouldn't leave you with a ghostly face when applied moderately. People with darker skin tones may still have some aesthetic issues with zinc and titanium. Companies have recently started tinting their products with iron oxide, which blends elegantly with darker skin types.
SPF and UV Rays
The SPF raiting of a product is a maddeningly misleading number. There are two types of ultraviolet rays you need to worry about: UVA and UVB. The SPF only refers to blocking UVB which is responsible for sunburns and many skin cancers. The UVA rays case blotchy darkening, wrinkles, photoaging, and likely some cancer as well. An SPF of 100 will not block a single UVA ray! You need a product labeled "broad-spectrum" to block poth types of rays. All sunblocks are naturally broad-spectrum (think of those tiny mirrors).
Sometimes the only way I can get a patient to buy into wearing sunscreen is by appealing to their vanity. When confronted with the potential of skin cancer, some people tune out. When I present it in terms of antiaging, ears perk up. The FDA now allows sunscreens to be labeled as 'antiaging' products.
So what is the most effective sunscreen? The answer is simple: The one you will actually wear. And remember, it works so much better on your skin that sitting around in the bottle! Check the expiration date. It isn't wine and it doesn't get better with age.
Don't forget about the importance of hats, UV rated sunglasses, and seeking shade. And fabrics have evolved to the point where you can actually swim comfortably in a sunshirt.
Patients often ask about vitamins and supplements they can take to further the cause. I recommend either Heliocare or Niacinamide which both can be taken orally. Heliocare is a fern-based supplement that has been shown to decrease sunburn. However it has no data on preventing skin cancer and it runs around $30 a month.
Niacinamide is my favorite recommendation. It is a form of B3 that should not cause hot flashes and flushing like regular niacin is known to do. Niacinamide at 500mg twice daily has been shown to decrease the two most common types of skin cancer by about 20%. That might not sound like much, but it is a cheap and natural product that has no significant side effects.
Our data on niacinamide comes mostly from Australia, where there are too many fair skinned people living at the wrong latitude. Australia is the one country that has a larger skin cancer epidemic than we do and there is a national push to get people on niacinamid.
We live in a fabulous area with so many opportunities to get out and enjoy yourself. With a solid sun protection strategy in place, there is no reason to lead a vampiric existence indoors. Now get out there and have some fun.