Reapply your sunscreen.
If there’s one edit worth making to the infamous Mary Schmich commencement-speech column in the Chicago Tribune about how wearing sunscreen was her only tip with scientifically proven benefits, that would be it.
Although a study in the Journal of Clinical Oncology last year found that the risk of developing melanoma was reduced by half when participants used sunscreen every day, dermatologists say the fine print is that you need to reapply the stuff to reap its benefits.
“Your sunscreen could say it has a sun protection factor of 50”—meaning you should be able to stay in the sun 50 times longer than usual without burning—“but you could barely be getting 10 if you’re not applying it properly,” says Elizabeth Tanzi, a DC dermatologist and assistant professor at Johns Hopkins School of Medicine. “And there are a lot of people who don’t apply it properly.”
Make that about 80 percent of people, according to dermatologists.
How could a city of people with an alphabet of advanced degrees after their names mess up something so simple? First, by not putting on enough. Your face needs a quarter-size dollop. On your body, you should be using a shot glass’s worth—or, if you need another visual, “a golf ball,” says Mona Gohara, assistant clinical professor of dermatology at Yale School of Medicine. If one tube lasts you a summer, you’re flunking Sunscreen Application 101.
You need to reapply it every two hours if you’re outside, every four if you’re not. Working in an office all day doesn’t give you license to skip. Think about it: If you pop out for lunch, you’re probably doing so when the sun’s rays are strongest—10 am to 2 pm—and that’s likely to be at least four hours after you applied sunscreen that morning. If you leave the office for the day while it’s still light out—and the chance of that is greater in the summer—you’ll still catch some rays on the drive home.
If all this sounds alarmist, consider that although wearing some sunscreen may be better than wearing none, dermatologists say that putting it on once a day gives people a false sense of security that they’re protected from skin cancer.
Even if it looks gloomy outside, a certain amount of ultraviolet light gets through the clouds, says Dr. Gohara. You might not get burned if you don’t wear sunscreen on those days, but that kind of exposure can prematurely age you—and increase your chances of developing skin cancer.
The car windshield and your house and office windows block out UVB rays but not UVA rays, which are associated with aging and melanoma. A 2010 study in the Journal of the American Academy of Dermatology found an increased prevalence of skin cancer on the left side of the head and neck—which “may be explained by ultraviolet exposure to the left side of the body while driving,” the authors wrote. The trend was particularly pronounced in men, who tend to drive more often. As for sun exposure through windows, the study cited the example of a woman with severe photo-aging on her left cheek, the side that faced an office window for 15 years.
“People don’t realize that they need to wear sunscreen every day no matter what they’re doing,” says Gohara. “The threat of skin cancer and of premature aging is real even if you spend your life at the office.”
Truth in Labeling
Let’s say you’ve been applying sunscreen correctly—the marketing hype on the bottle could still give you false security about its effectiveness. For one thing, there’s no such thing as “sunblock” or “waterproof.”
“Nothing blocks out the sun 100 percent,” says Gohara. “And all of those so-called waterproof sunscreens still have to be reapplied”—meaning that technically they’re not waterproof.
Beginning in December, both of those terms will be banned from labels, thanks to new guidelines from the Food and Drug Administration. The rules will also make it easier to choose wisely from among the 1,700 sunscreens on the market.
“There will be a drug-facts box on the label like the nutritional label on a soup can,” says Henry Lim, chairman of dermatology at Detroit’s Henry Ford Hospital and president of the American Board of Dermatology.
The new labels will have to establish that the product has passed “broad spectrum” tests measuring the lotion’s ability to protect against two key types of ultraviolet rays: UVB (the ones that SPF, or sun protection factor, refers to—the ones that burn you) and now also UVA, the rays that sink deeper into the skin to cause visible aging and, like UVB rays, contribute to cancer.
In the past, most sunscreens did as they said when it came to UVB shielding, but a sunscreen could claim it offered “broad spectrum” protection if it included even a smidgen of ingredients that protected against UVA rays. Not anymore. For the first time, specific sunscreen testing is mandated by the FDA, and it’s pass/fail. “If something is even one point below, it fails and can’t make the broad-spectrum claim,” says Dr. Lim.
The designation “waterproof” must be replaced with “water-resistant”—but again, only if the product passes extensive tests. And the claim of “sweatproof” or “all-day protection” in the water is no more: Based on a sunscreen’s test results, it can claim either 40 minutes of water resistance or 80 minutes. If it’s neither, the label has to advise using a water-resistant sunscreen while swimming or sweating.
What about the actual SPF rating? Products with an SPF lower than 15 won’t be able to claim that they protect against skin cancer. Products of SPF 15 or higher must include the caveat that they protect only if applied every two hours.
What SPF should you use? The FDA isn’t stepping into that tropical storm right now. The American Academy of Dermatology recommends SPF 30, which is 98 percent effective at shielding you from harmful rays. Anything above SPF 30 at best reaches 99.9-percent effectiveness.
Says Dr. Tanzi: “There’s not a lot to gain above an SPF of 30.” (The FDA is considering a proposal to cap the SPF indicator at 50+.)
And a note to the ladies: If you’re applying moisturizer with SPF and then a foundation with SPF, you don’t get to add up the numbers. Says Tanzi: “You get the SPF of the most potent one you have on but, as with any sunscreen, only if you use it properly.”
What’s the most effective sunscreen in the world? “One that has a formulation you’re going to use,” says Tanzi. Here’s some help in choosing.
There are two kinds of sunscreens: chemical ones, which absorb and dissipate UV radiation and also absorb easily into the skin, and physical, which sit on top of your skin and deflect the sun’s rays. The latter often are marketed as “natural” or “hypoallergenic.” The sun protection is equally good in both.
“Physical ones are particularly good for sensitive skin because they’re not chemicals,” says Tanzi. Most physical sunscreens contain a combination of two minerals: zinc oxide and titanium dioxide; old and/or cheap formulations can be white and pasty. At one point, manufacturers got almost too sophisticated, with processes that turned the two minerals into nanoparticles so small that they potentially could have been absorbed into skin.
Because nobody knows the long-term effects of the skin’s swallowing up what are essentially metals—and because both doctors and consumers were wary—many cosmetics companies recently switched to micronized zinc and titanium, which makes the particles small enough not to be seen but not so small that they’re absorbed. You can’t tell from the label if the zinc and titanium are micronized, but if a product glides onto your skin and doesn’t look white and pasty, chances are they are.
An expensive sunscreen isn’t necessarily more effective than a cheap one, but it probably will look and feel better. “It does pay to spend more money, because it costs money to be able to manufacture the really elegant formulations,” says Tanzi. “There are some very effective sunscreens at the drugstore, but they’ll be whiter than those at Sephora or at the dermatologist.” If your budget doesn’t permit smearing pricey potions on your body every two hours, she recommends splurging for your face and using a cheap one on the rest of your body. Her favorites for the face include EltaMD UV Physical SPF 41 ($27) and Intellishade SPF 45 (about $40), both of which are tinted. Elta is at dermstore.com. Intellishade is available from dermatologists; visit intellishadespf45.com for a list.
An inexpensive two-in-one drugstore product recommended by some dermatologists is the non-greasy Cetaphil Daily Facial Moisturizer for All Skin Types SPF 50 ($13.19, drugstore.com).
For the body, every dermatologist we spoke to recommended Blue Lizard Australian Suncream Lotion SPF 30+ ($13.99, drugstore.com). The company’s products also are recommended for children—and the bottle itself offers a useful lesson for both them and you: It turns blue in intense UV light, meaning you definitely should be wearing sunscreen and reapplying it frequently.
Most dermatologists prefer physical sunscreens—Tanzi says zinc is “the best, hands down,” at protecting against UVA and UVB rays. Another plus for physical sunscreens is that zinc can be oil-absorbing and slightly drying, “so it can be great for acne-prone skin,” says Tanzi.
That doesn’t mean products containing zinc are off-limits for dry skin, she says—just look for one labeled “moisturizing.” If you have combination skin, try a lighter or oil-free formulation, particularly in summer, when your skin may be greasier. If you’re applying it after the gym or other exercise and you haven’t had time to cool down properly—meaning you’re still sweating—you may want to try a gel formulation; it’s a bit more drying.