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continued:

Best sunscreen: Understand sunscreen options

What about mineral-based sunscreens?

If you'd rather avoid benzone products or any of the other substances approved by the AAD, try a mineral-based sunscreen. Look for zinc oxide or titanium dioxide. Neither of these seems to penetrate the skin, and sunscreens based on these ingredients appear to be safe as well as effective.

Are some brands of sunscreen better than others?

Try several different brands to see which works best for you. Brand matters less than how you use the product. In general, look for water-resistant, broad-spectrum coverage with an appropriate SPF — at least 15. Check the expiration date, and follow the directions on the label.

Also, keep in mind that labeling guidelines for sunscreen in the United States are changing. Under new Food and Drug Administration guidelines:

  • Only sunscreens that offer protection from both UVA and UVB rays can advertise broad-spectrum coverage on the label
  • Only broad-spectrum sunscreens with an SPF of 15 or higher can claim to reduce the risk of skin cancer or prevent early skin aging
  • Any claims about reducing the risk of skin cancer or early skin aging must be accompanied by other sun-safe measures, such as wearing protective clothing and avoiding midday sun
  • Sunscreens with an SPF of at least 2 but less than 15 can advertise protection from sunburn only — not protection from skin cancer or early skin aging
  • Sunscreens can't be advertised as sweatproof or waterproof
  • Sunscreens that pass a water resistance test can be labeled "water resistant" for either 40 or 80 minutes, as long as they also include instructions to reapply after 40 or 80 minutes of swimming or sweating, immediately after towel drying and at least every two hours

Ultimately, it's important to find a sunscreen you like. If you don't care for the sunscreen, you're not as likely to use it consistently.

What about claims that sunscreen is ineffective?

Even the best sunscreen isn't perfect. Many sunscreens especially fall down when it comes to UVA protection. In addition, sunscreen use alone isn't thought to prevent all skin cancers. Yet sunscreens are getting better, and using them is certainly better than using nothing at all.

Is there any truth to the claim that sunscreen use can actually increase the risk of melanoma?

Researchers don't understand why people develop melanoma — a serious form of skin cancer. There are several different types of melanoma, and not all types are equally linked to sun damage. Genetics plays a key role as well. Many factors are involved, which makes it hard to link sunscreen use with skin cancer.

If you have any risk factors for skin cancer — especially a family history of the disease — be sure to consult a dermatologist. Also remember this advice from the AAD: "Check your birthday suit on your birthday." If you notice any changes in your skin, such as growths or bleeding, consult a dermatologist right away. When detected early, most forms of skin cancer are quite treatable.

What else is it important to remember about using sunscreen?

When you use sunscreen:

  • Apply generous amounts of sunscreen to dry skin 30 minutes before you go outdoors.
  • Use sunscreen on all skin surfaces that will be exposed to sun — especially your face, ears, hands, arms and lips. If you don't have much hair on your head, apply sunscreen to the top of your head or wear a hat.
  • Coat your skin well and rub sunscreen in thoroughly.
  • Reapply sunscreen every two hours — more often if you're perspiring.
  • Reapply sunscreen immediately after swimming.
  • Remember that sand, water and snow reflect sunlight and make it even more important to use sunscreen.
  • Since UVA rays penetrate glass and clouds, use sunscreen even when it's cloudy or you're indoors but in rooms with lots of windows.

You can apply sunscreen to children as young as age 6 months. Keep younger children in the shade as much as possible.

What's the bottom line on sunscreen?

Use sunscreen year-round, but don't let any product lull you into a false sense of security about exposure to the sun. A combination of shade, clothing, sunscreen and common sense is your best bet.

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References
  1. Agin PP, et al. Rates of allergic sensitization and irritation to oxybenzone-containing sunscreen products: A quantitative meta-analysis of 64 exaggerated use studies. Photodermatology, Photoimmunology & Photomedicine. 2008;24:211.
  2. Diffey BL. Sunscreens as a preventative measure in melanoma: An evidence-based approach or the precautionary principle? British Journal of Dermatology. 2009;161(suppl):25.
  3. Facts about sunscreens. American Academy of Dermatology. http://www.aad.org/media/background/factsheets/fact_sunscreen.htm. Accessed June 28, 2010.
  4. Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. June 23, 2010.
  5. Newman MD, et al. The safety of nanosized particles in titanium dioxide- and zinc oxide-based sunscreens. Journal of the American Academy of Dermatology. 2009;61:685.
  6. Sun safety: Save your skin! U.S. Food and Drug Administration. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049090.htm. Accessed June 28, 2010.
  7. Sciallis GF. Mayo Clinic statement: Sunscreens and recent questions of health concerns. Mayo Pharmaceutical Formulary Committee. June 2011.
  8. Wang SQ, et al. In vitro assessments of UVA protection by popular sunscreens available in the United States. Journal of the American Academy of Dermatology. 2008;59:934.
  9. Burnett ME, et al. Current sunscreen controversies: A critical review. Photodermatology, Photoimmunology & Photomedicine. 2011;27:58.
  10. Questions and answers: FDA announces new requirements for over-the-counter (OTC) sunscreen products marketed in the U.S. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingOver-the-CounterMedicines/ucm258468.htm. Accessed July 28, 2011.
  11. Over-the-counter sunscreen drug products; required labeling based on effectiveness testing. Electronic Code of Federal Regulations. http://www.gpoaccess.gov/ecfr. Accessed June 21, 2012.
MY01350 July 17, 2012

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