Summer is almost over, but that doesn't mean it's time to pack away the sunscreen. Sunshine will continue to reflect off the water all fall, and when winter comes, it will reflect off the snow.
Choosing a good sunscreen can be a daunting task. Among the labels: SPF 15, SPF 30, SPF 50, UVA/UVB protection, sport, waterproof and tear-free, just to name a few. With so many labels and brands, how does a consumer make the right choice?
Most dermatologists agree that sunscreen is a necessary factor in the equation for skin protection. The American Cancer Society's "Cancer Facts and Figures 2008" report includes a section on how to protect your skin: limit exposure to the sun between 10 a.m. and 4 p.m.; wear protective clothing, including hats and sunglasses; and use sunscreen.
The organization is one of many with the same guidelines, but its report compiles these tips with estimates of skin cancer diagnoses for the year. It predicts that more than one million people will be diagnosed with skin cancer this year and 62,480 new cases of melanoma, the most serious form of skin cancer, will be diagnosed in 2008. The report also estimates 8,420 people will die this year because of melanoma.
Dermatologist John DeSpain from DeSpain Dermatology Center in Columbia said he thinks the risk of skin cancer, including melanoma, increases with sun exposure, but acknowledged there were other opinions among dermatologists.
"The minority opinion would say sunscreens are dangerous," DeSpain said. "Some dermatologists do claim that melanoma has no relationship to damage from the sun."
DeSpain said he likes to go to the lake and play golf - outside activities he wouldn't do without protection from the sun.
"The other option is not to go outside," DeSpain said. "But I think the best option is to do so in moderation."
In early July, the Environmental Working Group, a nonprofit organization based in Washington, D.C., released a report that said four out of five sunscreen products offered inadequate protection from the sun or contained ingredients with significant safety concerns.
"Everyone who spends time outdoors this summer ought to have reliable information on how to protect themselves from the sun," Jane Houlihan, vice president for research at Environmental Working Group, said in a news release. "We've been waiting 30 years for the FDA to come up with adequate safety standards, and we're still waiting."
DeSpain said reports like that upset the public because it only sees bits and pieces of information. After reading the report, he said he agreed with many of the points but the information in the news might alarm people because they are not exposed to the entire picture.
Michelle Wanna, a dermatology resident with MU's Department of Dermatology, agreed. She said she had to dig through the report to find the methods for the study.
Researchers with the Environmental Working Group evaluated sunscreen ingredients based on technical sunscreen literature, including nearly 400 industry- and peer-reviewed studies, and compiled a searchable, online database of 952 sunscreens. Consumers can search the database by brand name, water-resistant sunscreens, sunscreens for children and babies, sunscreens with good UVA protection and sunscreens with no nanoparticles - microscopic particles that the Environmental Working Group says may be toxic when absorbed by skin.
The report stressed that consumers have no way to know if the claims on the sunscreen bottle are true until the Food and Drug Administration finalizes sunscreen regulations. Current regulations only require sunscreen manufacturers to list the SPF, or amount of UVB protection a sunscreen offers. The FDA proposed rules in August 2007 that would require sunscreen manufacturers to list the level of UVA protection on the sunscreen bottle along with the SPF. UVA rays pass deeper than UVB rays under the skin and add to skin damage that can lead to premature aging and skin cancer, according to the National Cancer Institute.
The FDA has not finalized the proposed rules from 2007 yet. Sen. Christopher Dodd, D-Conn., introduced the Sunscreen Labeling Protection Act of 2008, or the SUN Act, on Aug. 1 in the Senate. If passed, the legislation would require the FDA to finalize its proposed rule in 180 days.
"Until (the FDA finalizes its rules), our database is a tool consumers can use to find out which brands are best for their families," Houlihan said.
The sunscreens that scored the best in the Environmental Working Group database are physical sunscreens. They contain few chemicals and block the sun's rays physically, without chemical reactions. The No. 1 sunscreen in the database, Keys Soap Solar RX Therapeutic Sunblock, sells for $32 on Amazon.com. Common brands like Coppertone, Neutrogena and Banana Boat rank poorly in the database. Many of them scored lower because of high chemical content.
"It is pretty common for patients to ask about the chemical ingredients of sunscreens," DeSpain said. "And realistically, some people do have allergic reactions to the ingredients."
At his office, he recommends physical sunscreens because they don't irritate skin as much and they work right away, offering full spectrum protection. These sunscreens contain zinc oxide and titanium dioxide, which are chemical compounds that are safe for babies, pregnant women and anyone who has sensitive skin or is concerned about chemicals, he said.
DeSpain also recommends new chemical sunscreens with Helioplex, a chemical compound used in several Neutrogena sunscreens. These sunscreens last longer on the skin because they are photo-stabilized, meaning chemicals won't break down in the sun.
Some people, especially children younger than 6 months, should avoid any contact with the sun and sunscreen if possible because their skin is more sensitive, Wanna said. She said everyone should look for the term "broad-spectrum" protection on the label, even though there is no current rating system for UVA protection.
"The key is to find a sunscreen you like and you will use consistently, she said. "It's better to try them than worrying about having an allergic reaction to an ingredient."
Wanna recommends people wear a light lotion with SPF 15 every day, higher if they are going to be outside.
"If you know you're going to spend a lot of time at a baseball game or the pool, wear at least SPF 30," Wanna said.
However, people should keep in mind that sunscreen will never shield them 100 percent from UV rays, she said.
DeSpain said people should continue to use sunscreens, despite the ongoing chemical debate.
"One of the most dangerous problems is for people to be afraid to use sunscreens," he said.