Written by Sara Peach for UNC Health Care
CHAPEL HILL — Applying sunscreen is a summer ritual for Americans hoping to protect their skin from burns, wrinkles and cancers. But researchers have raised questions about the safety of some sunscreens. Read below for answers to your skin questions from Craig Burkhart, MD, an assistant professor of dermatology at the University of North Carolina School of Medicine who works in the multispecialty melanoma program.
Why do I need skin protection?
Sunlight contains two rays harmful rays, Ultraviolet A and B, that cause wrinkles, age spots and burns. Both forms of ultraviolet light play a role in the development of skin cancers.
More than one million skin-cancer cases are diagnosed each year in the United States, according to the American Academy of Dermatology. Most are basal cell and squamous cell cancers, which are rarely fatal.
A third type of skin cancer, melanoma, is more dangerous. More than 50,000 Americans are diagnosed with melanomas annually, and about 8,000 die of the disease each year.
But I wear sunscreen, so I'm protected, right?
Actually, applying sunscreen is only the first step to skin protection, Burkhart said.
“People think sunscreen is the whole thing,” he said. “A sun-avoidance regimen is much more important.”
In addition to wearing sunscreen, you should wear sun-protective clothing, such as long-sleeved shirts, pants, wide-brimmed hats and wrap-around sunglasses. Several companies offer lightweight clothing with ultraviolet protection that can be worn even in hot weather.
It's also important to avoid the outdoors when the sun is brightest, Burkhart said, which means seeking shade between 10 a.m. and 4 p.m.
Are sunscreens safe?
Some studies indicate that sunscreen could interfere with hormones in the body. Two common sunscreen agents, 4-MBC and oxybenzone, also known as benzophenone-3, have been shown to mimic estrogen in some animals.
Meanwhile, preliminary data from a Food and Drug Administration study suggests that one form of Vitamin A often added to sunscreens may accelerate the development of cancer in rats. The vitamin usually appears on the label as retinyl palmitate.
Because of those concerns, Burkhart recommends that his patients use “physical” sunscreens, such as zinc oxide or titanium dioxide, rather than chemical sunscreens, which are absorbed by the skin. Unlike chemical sunscreens, physical sunscreens don't penetrate the skin, and they don't degrade over time. In general, they also provide better Ultraviolet A protection than chemical sunscreens.
In addition, infants younger than six months should wear sunscreen only on small areas, such as the face and hands, Burkhart said.
I have skin of color. How should I protect myself?
No matter your skin color or ethnicity, you can develop skin cancer. Everyone should practice a sun-avoidance regimen and wear sunscreen, Burkhart said.
It can be more difficult to detect melanoma in darker skin, so the American Academy of Dermatology recommends that like everyone, people with skin of color should regularly examine their skin and learn to identify abnormalities.
But if I avoid the sun, will I get enough Vitamin D?
Your body forms Vitamin D when you are exposed to sunlight. The vitamin helps you to build and maintain strong bones and may protect you against osteoporosis, cancer and other diseases.
To make sure you get enough Vitamin D, you should take a vitamin pill, Burkhart said.
“Take the supplement, and then you don't need the sun exposure,” he said.
You can also obtain Vitamin D by eating fish, eggs, cod liver oil and fortified milk.
What else should I do to protect my skin?
Use sunscreen with SPF 30 or higher and both UVA and UVB protection.
Apply sunscreen to dry skin 15-30 minutes before you go outdoors. Reapply it frequently, following the label instructions.
Avoid tanning beds. In 2000, the U.S. Department of Health and Human Services declared exposure to sunlamps and sunbeds to be a known cause of skin cancer. People who use tanning beds before age 30 are at particular risk.
Don't buy combination products, such as those that contain both suncreen and insect repellant. In general, insect repellent needs to be used only once a day, but sunscreen should be applied every few hours. “When you combine the two, you're applying one of them wrong,” Burkhart said.
Because ultraviolet rays penetrate the clouds, use sun protection even on cloudy days.
Remember that even in a tropical paradise, you can still get burned. “Most people forget to practice sun avoidance during vacations,” Burkhart said.
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