More than two million people are diagnosed with skin cancer annually, and sunburns in children are proven to increase the risk of developing skin cancer later in life.
These facts supported by the National Cancer Institute lead Air Force Maj. (Dr.) Christopher Bunt to recommend to his patients the liberal use of broad spectrum sunscreens.
“When covering all exposed areas, patients should get about a shot glass full of lotion,” he said.
That means 1-1.5 fluid ounces. But Bunt, a medical educator and physician in the department of family medicine at the Uniformed Services University of Health Sciences in Bethesda, Md., said, “Most people only apply about 20 to 50 percent of what they should be applying.”
Reasons for underuse may include misconceptions that getting a tan is healthy and that sun exposure is needed to absorb a healthy dose of Vitamin D.
“A tan is just evidence you are getting skin damage,” Bunt said. “Most people get enough Vitamin D in the course of normal daily living.”
In the past year, the U.S. Food and Drug Administration updated sunscreen product labeling requirements. Labels must now state whether the sunscreen is broad spectrum, covering both UVA and UVB rays, which are different kinds of natural radiation.
“The reason we care about getting that broad coverage is that UVB causes visible sunburn and UVA causes the invisible underlying skin damage which can lead ultimately to cancer,” Bunt explained.
Four ingredients proven to include significant UVA protection are oxybenzone, avobenzone, titanium dioxide and zinc oxide.
Updated FDA rules also replace all waterproof claims. There now are three rating levels for the amount of water resistance the sunscreens provide—none, 40 or 80 minutes. Even so, Bunt recommends reapplying sunscreen after any length of time in water or sweating.
Another FDA label change limits the maximum advertised SPF (Sun Protection Factor) at 50-plus. Bunt said that is because there is no evidence that anything over 50 provides extra protection.
“I choose the 50-plus [SPF] and at a minimum you want to look for SPF 30. That’s what the American Academy of Dermatology also recommends.”
There are a few exceptions. Children under six months old should be kept out of the sun when possible. Use hats and umbrellas and, if sunscreen is applied, remove it as soon as the baby is out of the sun. Also, due to a theoretical risk of an estrogenic hormone effect suggested by a few lab and animal studies, parents may consider avoiding oxybenzone sunscreens for children.
Bunt also advises against the use of combined sunscreen/bug spray products.
“You need more sunscreen than bug spray. If you are going to use bug spray, apply sunscreen first, then apply the bug spray.”
For the most part, Bunt said concern over chemicals in sunscreens is not credible.
“There is a rumor that sunscreens can cause cancer, but there is no scientific evidence of that. There is however, evidence, that using sunscreen prevents cancer.”
That, he said, is the bottom line of his recommendation to use broad spectrum sunscreen liberally to protect against skin damage and reduce risks for developing skin cancer.
More sunscreen tips are available at the Environmental Protection Agency and Centers for Disease Control.