You’re in the market for a new sunscreen. You want one that works, so you do your homework — or try to. If you Google “best sunscreen,” the first link that appears is an Environmental Working Group list of products that meet its safety criteria. Look further and you’ll see natural-health gurus proclaiming that many sunscreens are full of toxic ingredients like oxybenzone and retinyl palmitate, which could mess with your hormones or actually increase the risk of skin cancer. They advise sticking to mineral options with titanium dioxide or zinc oxide as the active ingredient. Yet others say even those formulas have the potential to be bad for you. What do you do now?
First, know that sunscreen is necessary to protect your skin from the harmful effects of ultraviolet light, according to Mona Gohara, M.D., associate clinical professor of dermatology at the Yale School of Medicine. “We know that 90 percent of skin cancers and 90 percent of the signs of aging come from ultraviolet light. That, we know for a fact. And the antidote to that is sunscreen,” she says.
The issue is that very few people are using sunscreen regularly (only 30 percent of women and 14 percent of men, per a recent study in the Journal of the American Academy of Dermatology), and those who do only use about half the recommended amount, according to separate research. And, sadly, people are still using tanning beds. To wit, rates of melanoma — the deadliest form of skin cancer — have doubled in the past 30 years, according to a recent report from the Centers for Disease Control and Prevention.
Skin cancer and premature aging are both preventable, but still, adults skip sunscreen. “People don’t use it partially because they don’t see the need for it,” Dr. Gohara told the Cut. “And some people just don’t think it’s good for them.”
Here, several myths about sunscreen and what's safest to use on your skin.
MYTH: Oxybenzone should be avoided at all costs.
There’s conflicting information online about the safety of chemical blocks like oxybenzone, which absorb UV rays (as opposed to mineral blocks that reflect light). Fears that oxybenzone can penetrate the skin and act like estrogen in the body stem from a widely publicized 2001 study in which rats fed oxybenzone had enlarged uteruses after four days.
Dr. Gohara says the dermatologic community takes issue with that piece of research since the rats were given “megadoses” of the chemical (1,500 milligrams per kilogram of body weight) and, as she explains, “consuming something is quite different than putting it on your skin.” A 2011 analysis published in JAMA Dermatology found it would take 200 years of daily sunscreen application to reach the level of oxybenzone exposure observed in the rat study.
In response, scientists have tested topical application of sunscreen on actual people. A 2004 study had 32 participants apply a basic lotion every day for a week. The following week, they applied lotion containing 10 percent oxybenzone (even higher than the 6 percent permitted by the FDA) and the researchers found no difference in hormone levels that could be attributed to sunscreen. Yes, the participants had detectable levels of oxybenzone in their urine, but that’s because your body excretes it that way.
“There’s no evidence that these [ingredients] are carcinogenic,” Dr. Gohara says. “That being said, if somebody’s not comfortable, they’re simply not comfortable and that’s fine. There are plenty of alternatives that don’t have oxybenzone.”
MYTH: Retinyl palmitate increases skin-cancer risk.
Animal research suggested that common inactive-ingredient retinyl palmitate (a form of vitamin A) could actually accelerate skin damage. But the study (which was conducted by the National Toxicology Program and never published in a peer-reviewed journal) was done on albino mice, which are more susceptible to skin cancer than humans. An analysis published in the Journal of the American Academy of Dermatology found there is no evidence that using retinyl palmitate in sunscreen raises cancer risk in humans.
MYTH: Sunscreen is for the beach.
Dr. Gohara says the average person gets the wrong idea from the name of the product alone. “It shouldn’t be called ‘sunscreen,’ it should be ‘ultraviolet screen,’” she says. “‘Sunscreen’ connotes that you should only be wearing it when you’re in the sun.” UV light is present even on cloudy or rainy days, she says. “What we see in skin-cancer patients and people who are aging prematurely is that either they don’t protect themselves or they only protect themselves in the sun,” she told the Cut. “Ultraviolet light is around all the time, whether you’re driving, or whatever.”
MYTH: SPF 100 blocks 100 percent of UV rays.
That isn’t how it works, Dr. Gohara says. In fact, no sunscreen blocks all UV rays, and SPF ratings refer only to protection against UVB, not UVA, rays (more on that below). The difference in protection is smaller than the ratings suggest: SPF 15 blocks 93 percent of UVB rays, SPF 30 filters 97 percent, SPF 50 blocks 98 percent, and SPF 100 blocks 99 percent. But only for up to two hours. You need to reapply that often — or sooner after swimming or sweating excessively — because the product wears off.
The American Academy of Dermatology recommends using broad-spectrum SPF 30 or higher, though the Environmental Working Group argues that SPF values greater than 50 could lead to a false sense of security. The FDA is aware of this issue: The agency proposed a regulation stating that products over 50 be labeled 50+, but it’s still under review.
One sunscreen regulation that’s already in effect is that “broad-spectrum” label: Only products that pass the FDA’s test by proving they block both UVA (aging) and UVB (burning) rays can make such a claim, which is good to know because exposure to both kinds can increase skin-cancer risk.
MYTH: People of color don’t need it.
Kerry Washington has been trying to spread the word about this belief as part of her role as a Neutrogena spokesperson. “There have been a lot of misconceptions, particularly in communities of color, that because you have melanin in your skin, you don't need to protect it,” she said in a recent interview with the Huffington Post.
Darker skin (or even tanned skin) might have more melanin in it than fair skin, but the protective effect is minimal: Experts say black skin likely has a max SPF of 4. And while skin cancer is less common in people of color, the average five-year survival rate for melanoma is lower among African-Americans (75 percent) than it is for Caucasians (93 percent). It might be because doctors aren’t catching it in time: One study found that late-stage melanoma diagnoses were more common in people of color than in white patients.
MYTH: Sprays are worthless.
They do work: You just need to hold the bottle a few inches from your skin, and rub it in so you don’t miss any spots. The exception is your face: The AAD recommends spraying the product into your hands and then applying it in order to avoid inhaling any fumes or particles. The FDA is investigating the safety of spray products but hasn’t made any rulings.
So what should you do? Use sunscreen and lots of it. The best thing to do is apply your broad-spectrum formula of choice before getting dressed, and 30 minutes before going outside. Stand in front of a full-length mirror and put that stuff everywhere, including your ears, hairline, the back of your neck, tops of your feet, and backs of your knees. Experts say that using less than the recommended one ounce (or two tablespoons) over your entire body drastically reduces your protection, though you might think you’re safe to stay outside. Reapply using the same amount every two hours.
And think beyond sprays and lotions: “It’s not just about the sunscreen, it’s about sunglasses, sun-protective clothing, and avoiding the sun during peak hours. Sun protection and skin-cancer prevention really is a lifestyle,” Dr. Gohara says. “It’s like if you have heart disease, you don’t just lay off the doughnuts — you have to exercise, you have to do a lot of stuff.”