10 Stubborn Sunscreen Myths — from Dr. Patty Lucey
Patricia Lucey, MD, is a board-certified dermatologist at the Inova Melanoma and Skin Cancer Center, and has special interest in the diagnosis and management of melanoma and other skin cancers. This summer, she’s sharing 10 common sunscreen myths to help you take better care of yourself, your family, and your patients this summer. Follow Dr. Lucey on Instagram for more skin health and sun safety tips!
Myth 1: Sun exposure is natural, and a little is good for you.
Ultraviolet radiation (UVR) in sunlight is the most ubiquitous environmental carcinogen — skin cancers have reached epidemic proportions and their associated morbidity and mortality are substantial. The vast majority of melanomas are caused by the sun and on average, a person’s risk for melanoma doubles if they have had more than five sunburns — there’s no “safe” amount of sun exposure.
Myth 2: You only need sunscreen if you’re going outside
Ultraviolet light is harmful in all seasons — even if it’s overcast. Dermatologists diagnose more skin cancers on the left side of the face than the right, because people are often exposed through their car windows while driving. Using sunscreen everyday, on all exposed skin protects you from sun damage.
Myth 3: Sunscreen doesn’t actually prevent melanoma.
Early studies suggested little to no benefit for sunscreen use in protecting against melanoma, and given that early sunscreens contained little UVA protection, and the latency of melanoma formation, there were compounding factors.
More recently, a large prospective study (1,600+ adults) from Australia published in 2011, spanned more than a decade (1986-1996) and showed that daily sunscreen users experienced a 50% reduction in numbers of melanomas in comparison to non-users — with a 73% decrease in invasive melanomas, demonstrating that broad-spectrum sunscreens containing both effective UVA and UVB filters protect against both malignant melanoma as well as actinic neoplasia.
Myth 4: You shouldn’t wear sunscreen if you’re Vitamin D deficient.
Vitamin D is a vital nutrient for human health. The body makes it when the skin is exposed to UVB rays; however, human vitamin D receptors are fully saturated after 15 minutes! The safest way to get vitamin D is through food or supplements — all the benefits, none of the risk of skin cancer. Another thing I like to drive home with patients: tanning beds are primarily UVA rays, which do not result in the body creating vitamin D.
Myth 5: Tanning provides a protective base tan.
Tanning beds use high concentrations of UVA light to darken the skin quickly — whereas the sun includes both UVA and UVB light. Exposing the body to high levels of UVA light from a tanning bed creates a temporary tan that will do very little to protect the skin from sun exposure and sunburns caused by UVB light. Every tan is still a sign of DNA damage.
Myth 6: If you have darker skin, you don’t need sunscreen.
While it’s true that melanin does act to diffuse UVB rays, and may protect skin to some extent, people with higher melanin are still at risk of sunburn, skin damage, and skin cancer. UVA damage is not blocked by melanin — which means more premature skin aging and wrinkles. Melanin won’t protect the skin from extreme sun exposure — long hours in the sun — and absolutely everyone, no matter their skin tone, should wear broad-spectrum sunscreen.
Myth 7: You can wear sunscreen but still get tanned or burned.
There are many barriers to effective sunscreen protection — non-use, forgetting to reapply, applying suboptimal amounts, using sprays instead of creams, and more. If someone claims they apply sunscreen but still get tanned or burned, they aren’t doing it right. People drastically underestimate how much sunscreen they need to apply to be protected (as well as how often they need to apply it). Products’ declared SPF is based on the use of a sunscreen layer of 2mg/cm2 of skin — or about one ounce for full body coverage. However, most people only apply about a quarter of an ounce (0.5mg/cm2).
Myth 8: Sunscreen often causes adverse reactions.
UV filters generally block sunlight in one of two mechanisms:
- Physical/inorganic sunscreens: Contain active mineral ingredients which sit on top of the skin to deflect damaging UV rays away from the skin. The active ingredients in physical sunscreens are zinc oxide and titanium dioxide.
- Chemical/organic sunscreens: Contain organic, carbon-based compounds which create a chemical reaction and absorb UV rays, change them into heat, then release that heat from the skin. The active ingredients in chemical sunscreens are things like oxybenzone, octinoxate and avobenzone.
Some people report irritation when they use chemical sunscreens — which is why I always recommend physical sunscreens: they last longer in UV light, are better for sensitive skin, and less likely to clog pores.
Myth 9: Sunscreen is full of harmful chemicals.
There is a ton of concern about the chemical sunscreen ingredient oxybenzone. Initial concerns arose when a report demonstrated systemic absorption of oxybenzone in humans at a rate of 1% to 2% after topical application, and higher rates of cutaneous absorption in human subjects have been observed. However, for 40 years oxybenzone has been an ingredient in sunscreens, and there are no published studies that demonstrate toxic effects in humans caused by absorbed oxybenzone. There’s an easy fix for any skeptics, though — stick with physical sunscreen.
Myth 10: Sunscreen is bad for the environment.
Studies have suggested that oxybenzone can harm coral reefs and sea life, and some tropical locations have banned sunscreens that contain oxybenzone to protect the reefs. There are also concerns that aerosol sunscreens cause harmful air pollution. Protect both the sea life and the environment by opting for a mineral, cream sunscreen.
Widespread myths about sunscreen cause barriers to effective sunscreen use. Even for us healthcare providers — we’re no exception! Let’s educate ourselves and our families on the facts of sunscreen risks, benefits and proper use. Make sure to wear broad-spectrum sunscreen every day, and don’t forget to reapply!