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Sunscreen: Are You Really Covered?

Our experts debunk sunscreen myths -- plus a top dermatologist reveals her favorite sunscreens.

Now that summer's in full swing, it's time to make sure you're fully protected from sun. But what kind of sunscreen should you buy? How long should you keep it? And just what are the factors for skin cancer anyway? In this special feature, we answer the top myths about sunscreen, bring you a top dermatologist's sunscreen recommendations, and offer a quick way for you to assess your own chances of getting skin cancer.

Top Sunscreen Myths

1. The higher the SPF, the better the protection.

FALSE. It sounds right -- a sun protection factor of 100 should be twice as protective as SPF 50. But it's only a few percentage points more effective. An SPF of 15 screens 93% of the sun's rays and an SPF of 30 screens 97%. "But the number becomes irrelevant if you aren't applying enough in the first place," says Mona Gohara, MD, a dermatologist in Danbury, Conn., and an assistant clinical professor at Yale University Department of Dermatology. Studies show the average person slaps on one-seventh to one-tenth of the amount of SPF needed to reach the number that's on the bottle.

"For better protection apply 1 to 2 ounces (the size of a Ping-Pong ball) of sunscreen on your body 30 minutes before going outdoors [so your skin can absorb it completely], and every two hours to any exposed skin after that," Gohara says. For your face, apply a dollop the size of a silver dollar every day, no matter what the weather. Note, too, that SPF refers to protection from UVB (the burning rays) only, not UVA (the aging rays). You need to guard against both, since both can lead to skin cancer.

2. It's OK to use last year's bottle of SPF.

TRUE. Most sunscreens have a shelf life of about two years, says Jordana Gilman, MD, a New York City dermatologist. If you are using sunscreen properly, however, you shouldn't have any left, since it takes about 1 to 2 ounces of sunscreen to cover the entire body, so a 4-ounce bottle should last for only four applications.

3. Sunscreen only needs to be applied to exposed skin.

FALSE. The average T-shirt offers an SPF of about 7, notes Gilman. Darker fabrics and tighter weaves provide more protection, but it is much safer to apply sunscreen to your entire body before you get dressed. Or better yet, wear clothing made of UV protective fabrics. These have been specially treated with colorless UV-absorbing dyes, and most offer an ultraviolet protection factor (UPF) of 50, which blocks both UVA and UVB. 

Don't want to invest in a whole new summer wardrobe? Spike your detergent with a wash-in SPF product you can toss in with your laundry.

4. Using makeup with SPF is just like wearing regular facial sunscreen.

FALSE. Certainly, applying makeup that contains SPF is better than skipping it altogether, but it's not as effective as wearing a facial lotion with sunscreen underneath. Generally, most makeup cracks on skin, allowing UV rays through. "For makeup to provide adequate ultraviolet protection, it would need to be applied in a really thick layer, which most women do not do," Gilman says. So unless you plan to spackle on your foundation, smooth on a layer of lotion with sunscreen first, and then apply your makeup.

5. Sunscreen can cause cancer.

FALSE. The only way sunscreen could be hazardous to your health is if it is absorbed into the body, which does not happen, says Amy Wechsler, MD, dermatologist and author of The Mind-Beauty Connection: 9 Days to Reverse Stress Aging and Reveal More Youthful, Beautiful Skin. "UV rays break down the chemical molecules in some sunscreens relatively quickly, long before they can seep into skin."

Still concerned? Use a sunscreen containing physical blocking ingredients such as zinc oxide and titanium oxide, which stay on the surface of the skin as a protective barrier. Don't be tempted to use babies' or children's sunscreens, which don't necessarily contain physical blocks. And make sure to check the "active ingredients" section on the label to see what the bottle contains. Even the same product can vary from year to year. Some dermatologists believe people should wear physical blocks only. They might be safer than a mix but are harder to find and not as easy to wear since they tend to be thicker and goopier products. Try a few to find one you like.

6. "Waterproof" sunscreen doesn't need to be reapplied after swimming.

FALSE. It's no surprise researchers at the Colorado School of Public Health recently found that vacations near the water were associated with a 5% increase in small skin moles, which in turn boosts a person's risk of melanoma. While the FDA recognizes the term "water resistant," it does not acknowledge the term "waterproof." "No sunscreen is truly waterproof," Wechsler confirms. Sunscreen should be reapplied every two to three hours -- and every time you get out of the water if you're doing laps in the pool or splashing around in the ocean. 

Under new FDA rules scheduled to take effect in the summer of 2012,  sunscreens that claim water resistance will need to have a label that explains how long they remain effective after a person swims or sweats. (This will be either 40 or 80 minutes.) Sunscreens that aren't water resistant will have to be labeled as such.

7. Wearing sunscreen can lead to vitamin D deficiency.

FALSE. There's no denying that our bodies need vitamin D (which can be obtained though sun exposure) to function -- without it, the body can't use calcium or phosphorus (minerals necessary for healthy bones). And according to a study published in Archives of Internal Medicine, three-quarters of Americans are deficient in the crucial vitamin. But that doesn't give you a no-SPF pass. "You still get enough sun to make plenty of vitamin D through the sunscreen," says Brett Coldiron, MD, a dermatologist at the University of Cincinnati. If you're worried about vitamin D deficiency leading to brittle bones, Wechsler says, ask your doctor about taking a supplement. The Institute of Medicine's recently revised guidelines recommend most adults get 600 international units of vitamin D a day; some people may need more.

8. Sunscreen with antioxidants provides better UVA/UVB protection.

TRUE. While they aren't necessarily active sunscreen ingredients, antioxidants are great SPF supplements. Sunscreen alone does not block all of the damaging rays from the sun -- even an SPF of 50 blocks out only 98% of UV rays. "Antioxidants are a good way to catch the UV radiation that 'sneaks' past the sunscreen," Gohara says. Sunscreens infused with antioxidants such as skin-loving green tea extract or polyphenols from tomatoes and berries are proven to reduce the formation of free radicals (small chemical particles that wreak havoc on skin and can cause skin cancer) in the presence of UV light.

Understanding Sunscreen Labels

By the summer of 2012, products labeled as "broad spectrum" will have to pass the FDA’s test to demonstrate protection against both UVA and UVB. The higher the SPF rating on those products, the higher the protection against both kinds of radiation. Only broad-spectrum sunscreen products with SPF of 15 or greater can claim to reduce the risk of skin cancer and early skin aging if used as directed along with other sun protection measures. Under the new rules, sunscreen manufacturers also won't be able to claim that their products "block" the sun or "prevent" skin cancer or aging.

To ensure that you're getting the best protection possible, look for a broad-spectrum UVA/UVB sunscreen. How do you know you have the right product? Even if the front label of the bottle advertises UVA and UVB protection, turn to the back and scan for a combination of these ingredients. Sometimes the front labels can be misleading.

These ingredients block UVA rays (the rays that cause aging):

  • Avobenzone
  • Ecamsule (Mexoryl)
  • Zinc oxide
  • Titanium dioxide

These ingredients block UVB rays (the rays that burn skin):

  • Octyl methoxycinnamate
  • Octyl salicylate
  • Octocrylene
  • Zinc oxide
  • Titanium dioxide

A Top Dermatologist's Sunscreen Picks

Ever wonder what sunscreens top dermatologists slather on themselves? "It has to be SPF 30 or higher, and I like it to protect against both UVA and UVB," says dermatologist Jordana Gilman, MD.  Here are some SPF picks she swears by (all these protect against both types of rays).

Best Sunscreen for the Face

La Roche-Posay Anthelios 60 Ultra Light Sunscreen Fluid ($29.50) is made with a filtering system of avobenzone and octocrylene to protect against both UVA and UVB rays, while boosting photostability (the rate at which a sunscreen breaks down under sunlight).

Coppertone Oil Free Foaming Sunscreen Lotion SPF 75+ ($9.99) is easy to apply over facial hair, plus it's noncomedogenic (meaning it won't clog your pores).

Hawaiian Tropic Sensitive Skin Oil-Free Face Lotion SPF 30 ($6.99) is lightweight and nongreasy -- a great option for those with sensitive or acne-prone skin.

Best Sunscreen for the Body

Aveeno Positively Ageless Sunblock Lotion SPF 70 ($11.99) is infused with feverfew, soy, and vitamin E, powerful antioxidants.

Lubriderm Advanced Therapy SPF 30 Lotion ($8.99), which is pumped up with a healthy dose of vitamins B5 and E, dries on contact.

Best Sunscreen for the Lips

Nivea A Kiss Of Protection Lip Care SPF 30 ($2.49) contains sun-shielding titanium dioxide, plus moisturizing shea butter to protect your pout.

Best Sunscreen for Sports

Neutrogena Wet Skin Sunblock Spray SPF 85 ($8.99) can be applied over wet skin after swimming or exercising (and it doesn't leave white marks!).

Best Sunscreen to Put in Your Laundry

Spike your detergent with SunGuard ($1.99), a powder laundry aid that amps up the ultraviolet protection factor (UPF) of your clothing to 30 and lasts through 20 washes.

The opinions expressed on this page are of the experts and are not the opinions of WebMD. WebMD does not endorse any specific product, service, or treatment.

Risk Factors for Skin Cancer

When 24-year-old tabbiecat_PCSM asked the WebMD skin cancer community about a mole on the back of her thigh, the moderator quickly responded. "Because skin cancer runs in your family and you are worried, I would definitely get it checked out," she wrote. Family history is just one risk factor for melanoma. Do you know the others?

1. Do you have fair or freckled skin that burns easily?
Yes      No

2. Do you have light-colored eyes or red or blond hair?
Yes      No

3. Have you had a lot of sun exposure or a history of blistering sunburns?
Yes       No

4. Do you have a family history of melanoma?
Yes      No

5. Do you have many large, irregularly shaped moles?        
Yes      No

Answers: Each is a risk factor for skin cancer. Sun exposure and sunburn are big risk factors; most skin cancers occur on areas that have been regularly exposed to the sun. People with light eyes, skin, and hair are at greatest risk, even during cold-weather months. But even those with darker complexions can get all forms of skin cancer, so everyone should practice sun safety. Having lots of large, irregular moles makes you more likely to get a form of skin cancer called melanoma. So can a family history of melanoma or severe, blistering sunburns during childhood or adolescence. Ask your doctor to examine irregular moles, and make a thorough skin exam part of your regular checkups.

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