Although experts disagree on which products are safe, they all agree that we should be slathering on some type of product when you can’t avoid the sun.
But it gets tricky when it comes to figuring out which to pick. With ever more products available, and with contradictory reports on safety, navigating the sunscreen aisle can be tricky. New label regulations from the FDA were supposed to make things simpler by rolling out stricter rules on labels in time for summer, but pressure from the industry that manufacturers needed more time to change the labels led the agency to delay the deadline until December 2012.
Recently, the Environmental Working Group published its annual analysis of sunscreens. The environmental public health nonprofit started evaluating sunscreens six years ago in an effort to raise awareness of potentially dangerous ingredients in products. It bases its ratings for safety and sun protection on ingredients, UVA (ultraviolet A, long-wave rays) and UVB (ultraviolet B, short-wave rays) protection and the ratio between the two, and how long the product remains effective.
"EWG works from a precautionary principal, senior analyst Nneka Leiba said. “We read evidence, and we err on the side of public health safety. There are studies that say that oxybenzone pentrates the skin and has the potential to disrupt hormones. That’s enough of a red flag to us to say avoid it.”
Despite its cautious approach, more and more products are getting the green light since the EWG has been analyzing sunscreens.
“This year we can recommend one in four products,” Leiba said. Just a couple of years ago, the group recommended one in 12. “Still, it’s far from our ultimate goal of every single product being effective and safe,” she added.
UIVA vs. UVB
There are two concerns about current SPF labels: First, SPF only measures UVB rays. Because UVB are the rays that cause sunburn. Sunscreen manufacturers originally assumed that deflecting those rays would also prevent conditions such as skin cancer. But experts now believe that both rays are harmful. UVA rays are always present, and previously thought to be mostly harmless. Also, there is some evidence that SPF over 50 doesn't offer additional protection, possibly because people place too much trust in the product and stay in the sun longer than they otherwise would.
Hidden Sunscreen Additives
Advocates are concerned about a form of vitamin A, retinyl palmitate, that's often added to sunscreen, referring to a study that suggested that it can speed the development of skin tumors and lesions in the presence of sunlight.
Others worry about vitamin D deficiency if you're always wearing sunscreen.
"This is a scenario where you can have your cake and eat it, too," said dermatological surgeon Jerry Brewer of the Mayo Clinic. "You can get vitamin D from the sun and your diet, and you can take a supplement if you're not getting enough from the sun." About 10-15 minutes of sun exposure is good for your daily vitamin D dose, depending on your skin tone.
Mineral vs. Non-Mineral
The debate between mineral (or physical) vs. non-mineral (or chemical) sunscreens seems to provoke the most passion between the "play-it-safe" camp and those who believe concerns have been overly hyped, and that the benefits of using any sunscreen far outweigh the risk.
Mineral sunscreens, which the EWG favors, use zinc oxide or titanium dioxide to help shield your skin from the sun. The nano- and micro-sized particles are not believed to penetrate the skin. More traditional products rely on octisalate (found in 59 percent of products, according to the EWG), oxybenzone (found in 52 percent) and avobenzone (found in 49 percent). Oxybenzone presents the most concerns; it can trigger allergic reactions, is a potential hormone disrupter, and penetrates the skin in relatively large amounts, according to the EWG.
"There has been a lot of hype about [ingredients] possibly causing endometriosis or increasing skin cancer," Brewer said. "The bottom line is, sunscreen continues to be one of the most effective methods of sun protection available." Oxybenzone has been approved by the FDA since 1978.
“Available peer-reviewed scientific literature and regulatory assessments from national and international bodies do not support a link between oxybenzone in sunscreen and hormonal alterations, or other significant health issues in humans,” said Dr. Daniel M. Siegel, president of the AAD, in a statement. “The FDA has approved oxybenzone in sunscreen for use on children older than six months, and dermatologists continue to encourage protecting children by playing in the shade, wearing protective clothing and applying broad-spectrum sunscreen.”
Lotion or Spay?
The EWG recommends lotions and creams over sprays to avoid nano-particles finding their way into lungs.
Should You Tan At All?
Brewer often gets asked, What’s the right amount of tan I can get?
“The strict medical answer is that the sun is a proven carcinogen," he said. "It’s probably the most common carcinogen known to man. It’s like asking how much arsenic is a safe amount? There isn’t a safe amount. Any amount of tan increases your skin cancer risk...and if you’re wearing sunscreen and still getting tan, then you’re not putting it on often enough or thick enough.”
The EWG recommends reapplying sunscreen every 30 minutes especially after swimming or sweating. As for specific products?
“I know that some people get overwhelmed when they can’t find a safe sunscreen, but the truth is is that they are not there. It’s not a throw-your-hands-up-in-the-air kind of situation,” Leiba said.
Your safest bet is to wear naturally sun-resistant clothing (hold it up to the sun to see how much light gets through), hats, and sunglasses, in combination with a sunscreen that offers UVA and UVB protection and makes the EWG's list.
“If I were giving recommendations, I’d say to find something you’ll use,” Brewer said. “I get asked all the time, what’s the right sunscreen for me? I can explain what SPF means, but the bottom line is, if you going to use the SPF 15 every day because it’s easy to put on,” that’s probably the best choice.
Of course, avoiding the sun, especially during peak hours, and wearing tightly-woven clothing and sunhats, are solutions everyone can agree on.