Just as I became really concerned about pesticides when my daughter was born, I also worried a lot about what type of sunscreen to use. I would never have considered not using sunscreen, but wanted to find the safest option. So I took off my mom hat and put on my scientist hat to do some research!
What did I learn?
I learned that sunburns are a really big deal, especially for kids and teenagers. Sunburns early in life increase the risk for all types of skin cancer, especially for melanoma (the deadliest type of skin cancer). Having five sunburns that blister between the ages of 15 and 20 increases the risk of melanoma by 80%. That’s nearly double the risk!
The risk for basal cell carcinoma and squamous cell carcinoma, the other types of skin cancer, also increases by 68%. In contrast, sun exposure later in life mostly increases the risk of basal cell carcinoma and squamous cell carcinoma but not melanoma.
I realized that this risk far outweighed any concern I had about the risk caused by possible toxicity of the ingredients in sunscreen. The most important thing to me now is to buy sunscreen that ensures that all four of us have proper sun protection at all times.
Yet even though sun exposure is so dangerous, and even though sunscreen can help protect us, it’s popular these days on the World Wide Web to see claims that “sunscreen causes cancer.”
But first things first: Let’s walk through the risks associated with sun exposure and how it increases your cancer risk and then discuss factors that go into choosing a sunscreen.
Sun Exposure Increases Cancer Risk
According to the CDC:
Skin cancer is the most common form of cancer in the United States. The two most common types of skin cancer—basal cell and squamous cell carcinomas—are highly curable, but can be disfiguring and costly. Melanoma, the third most common skin cancer, is more dangerous and causes the most deaths. The majority of these three types of skin cancer are caused by exposure to ultraviolet (UV) light.
In 2011, over 65,000 people in the US were diagnosed with melanoma and over 9,000 people died from melanomas of the skin. (2011 is the most recent year with available data). The scariest numbers are those that show that the incidence of melanomas is increasing and the mortality of melanomas is also increasing.
Another risk of sun exposure that we often forget about is eye damage. Sun exposure can cause cancer in the eye and also increases the risk of cataracts.
What are the risk factors for skin cancer?
There are many risk factors that contribute to the risk of getting skin cancer. Some of them we cannot control: skin tone, family history, personal history, eye color, hair color, or skin that burns, freckles, reddens easily, or becomes painful in the sun. But others we can control: exposure to the sun, a history of sunburns and a history of indoor tanning.
All of these things we can control involve exposure to UV light. As Maria recently wrote in regards to tanning, UV exposure is a huge problem.
So let’s talk about what that is and how we can protect ourselves.
What is UV light?
There are three types of UV light: UVA, UVB and UVC.
UVA is the most common because it is not absorbed by the ozone layer. It is also capable of penetrating past the top layer of our skin.
UVB is mostly absorbed by the ozone layer, but some still reaches us here on the surface of the earth. UVB rays don’t penetrate the skin as far as UVA rays. UVB rays are the rays that are critical for the production of vitamin D in the skin.
UVC rays are very dangerous, but you don’t need to worry about them because they are absorbed by the ozone layer.
(This is why ozone depletion – the “ozone hole” – is such a big deal for human health. Without the ozone layer, more dangerous UV rays reach the surface of the earth and us.)
Our primary exposure to UV light comes from sunlight, with other exposure from tanning beds and sunlamps. UV rays are dangerous because they are what is known as ionizing radiation. This type of light can penetrate your skin cells and damage the DNA.
Protecting your skin from UV rays is the best way to prevent skin cancer!
Check the UV Index and watch the clock!
If you are going to be spending the day outside, you can check the UV Index, a measure developed by the EPA and the National Weather Service as a measure of the risk of overexposure to UV rays. The UV Index is measured on a scale of 1-15, with higher numbers representing a greater risk and a greater need for sun protection.
You can use this information to help you decide how long to spend outside and what sun protection to wear to keep your sun exposure low. It’s also important to think about the time of day – your sun exposure will be greater at midday when the sun is directly overhead.
Protect your skin: Slip, Slop, Slap!
I spent some time in Australia after college, where skin cancer has been a huge problem, and learned a valuable lesson from them about sun protection.
Slip on a shirt, slop on the 30+ sunscreen, slap on a hat, seek shade or shelter, slide on some sunnies.
We tend to think only about sunscreen when we think about protecting our skin, but there are other ways to reduce your sun exposure too. It’s important to do all of these things to protect yourself from UV exposure. The Cancer Council website from Australia has some of the best information about sun protection that I have found anywhere and covers many of the topics I’m touching on here in depth.
“Sunscreen causes cancer?” What a dangerous lie.
Sunscreen helps prevent cancer, it doesn’t cause it. Believing the opposite and exposing yourself to the sun without protection can drastically increase your skin cancer risk.
And now that you know all about the risks of sun exposure, and why sunscreen is essential to protect yourself when exposed, here’s…
The 4 Factors To Choose The Right Sunscreen For You
When I choose a sunscreen, I consider a few factors – broad spectrum coverage, the price, how easily can my kids apply it, and (very minorly) the ingredients. Before we get to that, let’s review the basic types of sunscreens.
Types of sunscreen: chemical interactive vs. barrier
Barrier sunscreens literally form a physical barrier that does not allow UV light through to your skin. These are sunscreens made from zinc oxide or titanium dioxide.
Chemical interactive sunscreens use chemicals that interact with the UV light, reducing its penetration and effects on the skin. These are all the other sunscreens on the market.
Now let’s get into the factors.
#1: Broad spectrum coverage
The most important factor in choosing a sunscreen is to ensure that you have broad spectrum coverage that protects against both UVA and UVB. In 2011, the FDA issued new regulations about sunscreen labeling that established requirements for the testing and labeling of sunscreen based on whether they are broad spectrum. The words “broad spectrum” on your sunscreen now actually mean that the sunscreen provides broad spectrum coverage.
If your sunscreen carries a “Broad Spectrum” label and is SPF 15 or higher, it protects against all types of sun-induced skin damage. Without those labels, it only prevents sunburn.
This chart shows examples of chemicals used in sunscreen in the US. Barrier sunscreens, specifically zinc oxide, provide the broadest coverage of the common sunscreens available in the US. Find a full list of what types of UV radiation each FDA-approved active ingredient blocks here.
Unfortunately, cost is a consideration for many people, especially if you spend a lot of time outside and go through a lot of sunscreen. Our kids are outside at camp everyday with 2 or 3 applications of sunscreen a day. You can imagine how many bottles of sunscreen we go through!
So, while zinc oxide provides the broadest spectrum coverage, barrier sunscreens (zinc oxide and titanium oxide) are often quite expensive and hard to find. They tend to be made by specialty “all-natural” brands. I have yet to find a generic brand of zinc oxide sunscreen.
On the other hand, chemical interacting sunscreens are the least expensive and easiest to find. Every drug store chain sells their own generic version of these sunscreens.
This year, for the first time, I saw a non-specialty brand of sunscreen that had a zinc oxide/titanium dioxide formula (and it had a coupon attached!). I hope that this changes and barrier based sunscreens become cheaper and more affordable so everyone with every size budget has options.
#3: Ease of application
Many barrier sunscreens are thick, sticky and difficult to apply with good coverage. They also leave a visible residue on your skin. These factors make it unlikely that consumers will consistently use these products properly. Companies do seem to be improving their formulas though and some of the newer formulations are easier to apply. This is not such an issue for me, but it’s a huge issue for my kids!
Kids are squirmy and don’t want to wait to go out and play while you apply sunscreen. For our family, this is actually one of the biggest factors in choosing a sunscreen. The barrier sunscreens, while my top choice in general, are just more difficult to apply well. The bottom line is that we need to make sure they have sunscreen on every piece of exposed skin, regardless of the type of sunscreen.
When I or my husband is applying the kids’ sunscreen, we try to use the zinc oxide based lotions to ensure the broadest coverage. However, both kids go to camp during the summer. Our son is almost 2 and the counselors have to get sunscreen on a room full of toddlers multiple times a day. Our daughter is 7 and at summer camp, where the kids apply sunscreen themselves with some help from counselors.
For camp, they each get a face stick, a lotion and a spray that are waterproof, sweat-proof, and 50+ SPF. This makes is easy for our son’s counselors and for our daughter to use whatever is best for them. This ensures that the kids are fully protected whenever they go out in the sun.
#4: Possible toxicity and the dangerous “sunscreen causes cancer” claim
There are many articles out there about the “dangers” of sunscreen. These come in two flavors.
First, some articles claim that using sunscreen actually increases your risk of skin cancer (the popular “sunscreen causes cancer” fad). There was an article shared on social media recently misrepresenting a 2014 epidemiological study. The article claimed that this study showed that there is no evidence that sunburns and sun exposure increase the risk of skin cancer or that sunscreens protect against melanoma However, this is a misrepresentation of the study’s findings.
The authors’ conclusions as stated in the abstract:
Following sun exposure advice that is very restrictive in countries with low solar intensity might in fact be harmful to women’s health.
In other words, light-skinned women who live in parts of the world with a low UV index (like Sweden, where the study was carried out) would benefit from a small amount of sun exposure rather than following guidelines for sun exposure developed for places with a high UV index (like Australia). This is because we need a small amount of sunlight to produce vitamin D.
To reiterate, the scientific consensus is that sun exposure and UV light increase the risk of skin cancer and that lowering this exposure by using sunscreen and other methods can prevent this increased risk.
The second, and probably the more common, claim is that the toxicity of the ingredients used in sunscreens carry such a high risk that you should avoid sunscreen.
There are two main problems with this narrative. First, few, if any, of these articles consider the relative risk.
What is relative risk? Every decision we make, on some level, comes down to a comparison of risk. In this situation, you have to compare the risks and benefits of each type of sunscreen as well as the risks and benefits of NOT wearing sunscreen. This is the relative risk.
So, while there MAY be a small risk caused by the chemicals used in sunscreen, you have to compare that risk to the risk of not wearing sunscreen to arrive at a true assessment of the real life risk.
The second problem with this argument is that the actual toxicity data on these compounds that are cited by groups like the Environmental Working Group does not support their claims. When I first started exploring this issue a few years ago, I relied on EWG. But actually working in the field of toxicology showed me that they are not a reliable source.
There was an article published last week citing EWG that claimed that a certain high-end brand of sunscreen contains harmful chemicals that do more harm than good. EWG is known to use questionable methods for many of their rating systems, including the Dirty Dozen list and their cosmetics database.
Many others have already dissected their misrepresentation of the science in regard to their sunscreen recommendations and provided analysis of exactly where the science is on the toxicity of the active ingredients in sunscreen, including EWG’s favorite active ingredients to demonize: oxybenzone, avobenzone, Meroxyl, nanoparticles and retinyl palmitate. I don’t have space to get into specifics in this article, so I recommend the linked articles if you are interested in specific info.
As mentioned above, sunscreens are regulated by the FDA as drugs. To be sold in sunscreens in the US, ingredients must be tested for both safety and efficacy, just as pharmaceutical products are. Current data does not suggest that we should be worried about the safety of currently available sunscreens.
The most compelling fact for me is that through many years of people using these chemicals in their sunscreen, not only is the “sunscreen causes cancer” allegation unsupported, there is actually no evidence of human health problems caused by these chemicals, as discussed in this article from the Skin Cancer Foundation. While the toxicity of these chemicals is an ongoing area of research, this means that if there is an effect, it is very small. And again, you have to compare that small, hypothetical risk to a large, very real risk.
If you are interested, you can find information about the ingredients in sunscreen (and other household products) in the NIH Household Products Database and more technical information on the NIH Toxicology Data Network.
To summarize, the risk of not protecting your skin far outweighs any risk of toxicity from sunscreen. Put another way, the benefit of sun protection is so high that is far outweighs that the small (and unproven) risk of exposure to the chemicals in sunscreen.
What else to consider: Sunscreen sprays, allergies, and sensitive skin.
What about sunscreen sprays?
There are some concerns about spray sunscreens. The FDA is exploring the efficacy of these sprays because there is concern that people don’t spray enough to get the full protection (one of the provisions of the Sunscreen Innovation Act of 2014). There are also concerns that inhaling sunscreen may produce a different toxicological effect that applying it to your skin (not an unreasonable hypothesis as mode of exposure is a very important factor in understanding the effects of chemicals on our bodies).
So the jury is still kind of out on sprays. I’ll admit that we use them for reapplying sunscreen quickly when we are at the pool with the kids and between sets of my tennis matches. We only use them outside and never spray near the face. If we need to use a spray on our faces, we spray into our hands and rub it on our faces.
A really important thing to remember about sprays in never to use them near a flame. They often contain flammable ingredients and this can be very dangerous.
What about allergies and sensitive skin?
I hope that what this article drives home is that the products on the market are safe and effective and that the risk of not wearing sunscreen is too high to avoid using proper sun protection. If you or you children have allergies or sensitive skin, don’t let the active ingredients in sunscreen limit your search for a sunscreen that doesn’t cause a reaction. Remember that most reactions to sunscreen are not due to the active ingredient, but to fragrances and other ingredients.
Finally: A quick note about vitamin D
Maria covered this really well a couple of weeks ago in her post about the health risks of tanning. Basically, UV light is required for your body to produce vitamin D and having sufficient vitamin D levels is really important for your health. So if you avoid the sun completely, you don’t have enough vitamin D. But how much time in the sun do you need to produce enough vitamin D? As Maria wrote in her post about the elusive benefits of tanning:
- In the summer, 2-14 minutes at 12 pm 3-4x a week are enough. So a total of say 10 minutes a week at 12 pm is fine as far as vitamin D is concerned.
- In spring or fall, 10-15 min 3-4x a week at 10 am or 3 pm are also enough to produce Vitamin D. So a total of 30 min a week, when the sun is not at its peak, are fine for vitamin D production.
- In the winter, the study suggests we need longer exposure time. Makes sense if it’s rainy or cloudy most of the time!
The way I figure this is that if we apply sunscreen when we get to the pool, by they time we get everyone slathered up, we’ve all had enough sun exposure to take care of our vitamin D production.
Sunscreen is an important part of sun protection, but not the only part!
When you go out in the sun, please make sure you wear sun protection. Skin cancer is common and serious. A nice tan is not worth melanoma. Listen to the Australians and “Slip, slop, slap”!
- Use sunscreen as directed and make sure to use enough. Reapply sunscreen often.
- Wear a rash guard or other shirt with SPF when outside in the sun. I just bought a really cute swim shirt for this summer! I’ve seen more of these in stores this year than I ever have before.
- Buy a fun hat.
- Wear awesome sunnies.
Leave a comment and let us know: Have you also heard of the dangerous “sunscreen causes cancer” claim? Also: What kind of sunscreen do you use?