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How To Stay Truly Safe In The Sun

Discussion in 'Dermatology' started by Mahmoud Abudeif, May 31, 2021.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Golden Member

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    Summer is around the corner, and with the pandemic waning for many, the CDC encourages people to spend more time unmasked outdoors. But protecting yourself from the sun is more important than ever, and questions about sunscreen safety may make you wonder how to do it.

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    Carcinogen Detected in Sun Care Products

    Valisure, an online pharmacy known for testing every batch of medication they sell, announced this week that they petitioned the FDA to recall 40 batches of sunscreens and after-sun products they say tested for high levels of the chemical benzene. The company tested 294 batches from 69 companies and found benzene in 27% -- many in major national brands like Neutrogena and Banana Boat. Some batches contained as much as three times the emergency FDA limit of 2 parts per million (ppm).

    Long-term exposure to benzene is known to cause cancer in humans.

    “This is especially concerning with sunscreen because multiple FDA studies have shown that sunscreen ingredients absorb through the skin and end up in the blood at high levels,” says David Light, CEO of Valisure.

    The FDA is seeking more information about the potential risks from common sunscreen ingredients.

    “There is not a safe level of benzene that can exist in sunscreen products,” Christopher Bunick, MD, PhD, associate professor of dermatology at Yale University, said in Valisure’s FDA petition. “The total mass of sunscreen required to cover and protect the human body, in single daily application or repeated applications daily, means that even benzene at 0.1 ppm in a sunscreen could expose people to excessively high nanogram amounts of benzene.”

    Valisure’s testing previously led to FDA recalls of heartburn medications and hand sanitizers.

    Examining Sunscreen’s Environmental Impact

    Chemicals in sunscreen may be harmful to other forms of life, too. For years, scientists have been examining whether certain chemicals in sunscreen could be causing damage to marine life, in particular the world’s coral reefs. Specific ingredients, including oxybenzone, benzophenone-1, benzophenone-8, OD-PABA, 4-methylbenzylidene camphor, 3-benzylidene camphor, nano-titanium dioxide, nano-zinc oxide, octinoxate, and octocrylene, have been identified as potential risks.

    Earlier this year, the National Academies of Sciences, Engineering, and Medicine created a committee to review the existing science about the potential environmental hazards. Over the next 2 years, they’ll also consider the public health implications if people stopped using sunscreen.

    Sun Protection Is Still Necessary

    If you’re nervous about using sunscreen, it isn’t the only way to stay safe. But a recent survey suggests that many of us don’t do enough to protect ourselves from skin cancer. The American Academy of Dermatology surveyed 1,000 people and found that one-third of them didn’t know about basic steps, even ones as simple as seeking shade, that can reduce the risk.

    The younger the respondent, the less likely they were to understand the connection between sun exposure and skin cancer. More than half of those in Generation Z, born after 1996, and millennials, born between 1981 and 1996, believe that a base tan will prevent sunburns. And 71% of Gen Z respondents believe a base tan will protect them from skin cancer, when in fact the majority of melanoma cases can be attributed to sun exposure.

    The survey did find that people know they need to protect themselves from the sun -- 97% said they feel it’s important. And 85% understand that too much sun can damage their skin, with 66% saying they wish they’d done more to protect their skin when they were younger. But awareness plummets when it comes to the link between sun exposure and skin cancer. Among Gen Z respondents, 42% didn’t understand the connection. Millennials were only slightly better, with 37% unaware. Just five blistering sunburns between the ages of 15 and 20 increases melanoma risk by 80%.

    “Think about the pushback against vaccines. Why haven’t people gotten that message?” says Larisa Geskin, MD, director of the Comprehensive Skin Cancer Center at Columbia University Medical Center. “They believe what they want to believe. People enjoy being in the sun, and if they’re not in imminent danger, they tend to neglect the danger.”

    How to Stay Sun-Safe

    While the link between sun exposure and skin cancer is clear -- and the news about sunscreen is potentially alarming -- that doesn’t mean you can’t have fun outdoors safely. A few simple precautions can lower your risk of developing skin cancer while using as little sunscreen as possible:

    • Shade. The sun’s rays are strongest between 10 a.m. and 2 p.m., so you’d be wise to stay out of the sun completely during those hours. If you must be outside, shade offers some protection. At the beach, be aware that while an umbrella casts shade, the sun’s UV rays are still bouncing off the sand all around you. Shade alone won’t shield you.
    • Sun-protective clothing. Wear a broad-brimmed hat and sunglasses, ideally with UV protection, and a lightweight, long-sleeved shirt and pants. The more of your skin you can cover, the less sunscreen you’ll need to use. “Look for clothing that has a UPF [ultraviolet protection factor],” says Seemal R. Desai, MD, a dermatologist in Plano, TX. “You can find very nicely designed long sleeve shirts, hats, pants, cool-looking fitness gear, all kinds of outdoor gear that can protect you.”
    • Sunscreen. Yes, there are concerns. But that doesn’t mean you should skip this important layer of protection. “Given the recognized public health benefits of sunscreen use, the FDA strongly advises all Americans to continue to use sunscreens in conjunction with other sun protective measures (such as protective clothing) as this important rulemaking effort moves forward,” says the FDA’s discussion of sunscreen absorption.
    And in Valisure’s announcement about their findings, they included this message: “It is important to note that not all sunscreen products contain benzene and that uncontaminated products are available, should continue to be used, and are important for protecting against potentially harmful solar radiation.”

    Using sunscreen with SPF 15 every day can lower your risk of squamous cell carcinoma by around 40% and melanoma by 50%. The American Academy of Dermatology recommends a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher. Apply it to all skin that clothing doesn’t cover, and reapply every 2 hours or after swimming or sweating.

    “We’re not talking about slapping on some kind of sunscreen in the morning and heading to the beach,” Geskin says. “It’s an ongoing, active way of thinking about your skin and skin protection.”

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