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Skin cancer is the most common form of cancer in the United States. Yet despite the well-documented and well-publicized association between sun exposure and skin cancer, only 30% of adults report that they apply sunscreen when exposed to the sun. Among teenagers who are outside for more than an hour on a sunny day, only 14% of girls and 7% of boys regularly use sunscreen. “This data is extremely disappointing,” says Dr. Joshua Fox, Medical Director of Advanced Dermatology, P.C. “The vast majority of skin cancers are caused by exposure to the sun. And despite the widespread promotion of best practices for prevention, the incidence of melanoma, the most dangerous form of skin cancer, has been increasing for thirty years. We can’t prevent all sun exposure but there are simple steps we can take to minimize the risk.”
Everyone knows the basics of skin protection – stay out of the sun between 10:00am and 4:00pm, wear a hat and other protective clothing, and use sunscreen. But there are hundreds of brands and varieties of sunscreens, not to mention the confusion caused by SPF ratings and advertising claims. Dr. Fox sorts through the issues and answers your questions about sunscreen:
Ultraviolet radiation from the sun is a known cause of skin cancer. Two types of rays, UVA and UVB, damage DNA in ways that cause cells to grow out of control and become cancerous. Sunscreen serves an important protective function by blocking or absorbing ultraviolet rays. It should be used by everyone – dark-skinned as well as fair-skinned people – all year round, even on overcast days, when as much as 80% of the sun’s rays pass through the clouds.
The sun protection factor (SPF) rating is a measure of how long it will take for protected skin to burn compared to unprotected skin. The Skin Cancer Foundation recommends sunscreen of SPF 15 or higher for everyday activity and SPF 30 or higher for intense or prolonged exposure. Individuals with higher-than-average risk – those with a personal or family history of skin cancer and those with particularly fair skin and hair – can get some additional protection from SPF factors up to 50. According to the Food and Drug Administration, there is no evidence of additional protection above SPF 50.
SPF is a measure of protection from UVB rays. To be protected from UVA as well, it’s important to choose a sunscreen labeled “broad spectrum,” which offers protection from both types of radiation.
Apply sunscreen 30 minutes before going outside to give the skin a chance to absorb it. Reapply at least every two hours and immediately after swimming or sweating. Use about an ounce – the amount in a shot glass – to cover all exposed skin and pay particular attention to the more delicate skin on the face. Every time you apply sunscreen, also apply lip balm with SPF of 30 or above. And don’t depend on cosmetics or facial moisturizer for protection from prolonged exposure.
Sunscreen is generally effective for two to three years. Check the expiration date on the container. Store it in a cool place.
Children are even more vulnerable to sun damage than adults. A blistering sunburn in childhood or adolescence more than doubles the risk of developing melanoma later in life. Infants under six months old should be kept out of the sun entirely and well protected with a hat and clothing anytime they are outdoors. For babies older than six months, use sunscreen with SPF of 15 or higher, 30 or higher if they spend a lot of time outdoors or are fair-skinned.
Sticks are fine and particularly convenient for children. They offer another choice along with lotions, creams, gels and sprays. Drinkable sunscreen, on the other hand, should be avoided. It purports to have ingredients that ward off UV rays and prevent them from penetrating the skin. There is no research or evidence to support the claims and dermatologists recommend against using it.
“Sunscreen is a key element of a sun protection program,” Dr. Fox concludes, “but it isn’t enough. You should stay out of the sun when rays are strongest, cover up with clothing and a wide-brimmed hat, and wear UV-blocking sunglasses. With some common sense precautions, you can enjoy all the pleasures of the great outdoors.”