In this article, I will discuss something that usually brings up a lot of heated debate and controversy. But I think people need to start thinking about it. It’s becoming a growing problem in our country and that is the overuse of sunscreen and people’s fear (mostly women) of being outside without being covered in very high SPF sunscreen.
There is a widely held belief that sun exposure is inherently dangerous and causes skin cancer. A non-disputed fact is that the sun produces UVA and UVB rays. The UVA rays are thought to produce the free radical damage which ages the skin, producing deep wrinkles, leathery skin, and splotches. UVA rays can penetrate down to the dermis, where this free radical damage occurs. UVB rays are the ones that are responsible for causing surface redness or erythema and sunburn after extended periods of exposure. You definitely want to avoid the free radical damage which causes aging, so applying some kind of sunscreen is a good idea when you are exposed to direct sun for more than 15-30 minutes. But applying sunscreen is often taken to the extreme, with no added benefit and may actually harm your health. Many people feel it is necessary to slather on very high SPF sunscreen (50+) all over every inch of their exposed body, even when sitting inside an office or house all day long. I know that’s a common practice, because I used to do the same thing. I had a belief that all UV exposure, even indirect exposure was bad and dangerous. This belief was picked up from seeing numerous sunscreen ads while growing up, listening to conventional medical advice, and assuming it was all true.
Over the years, I have come to realize after reading studies and many articles about sunscreens and vitamin D deficiency, that everybody needs some sunshine exposure to ensure good health and, ironically, prevent cancer. The sun is a vital part of staying healthy and should not be demonized as it has been for the last 30 years. In fact, vitamin D (which is produced by the body in response to exposure to the sun), is needed to create calcium for strong bones, boost the immune system, which in turns prevents many, many diseases such as cancer, musculoskeletal, and autoimmune diseases. You can easily find scientific studies which support these facts:
1. It’s well established that the majority of the US population (90%) is now vitamin D deficient. It’s quickly becoming an epidemic in all industrialized nations. Any level below 30 is considered deficient. People need adequate vitamin D, and the best way to acquire it is naturally, though moderate sun exposure a few times a week. Kids, especially, are suffering from lack of vitamin D due to a lack of outdoor activity and over application of sunscreens. Even rickets is becoming more prevalent in kids due to this lack of sun exposure and subsequent vitamin D deficiency.
2. Skin cancers are actually rising, in spite of heavy sunscreen usage and sun avoidance education in this country. This includes the fairly harmless version of skin cancers, basal cell and squamous cell cancers, in addition to melanomas. Basal and squamous cell cancers are easily treated and rarely fatal, while the opposite is true of melanomas. But the total of these 3 types of cancers is on the rise, 1% a year as opposed to 0.5% in other forms of cancers.
There are some commonly held beliefs that need to be revisited. If you do a search on the Internet, you will find that there is a lot of information out there which expose these beliefs as being unproven myths and half-truths. But you will never hear this from the major sunscreen companies or even dermatologists because it is a big billion dollar business selling sunscreens and treating skin cancers (most of which are nonfatal):
MYTH 1: A SPF 100 is 10 times as effective as an SPF 10.
Most people are under the false impression that the higher SPF you apply, the safer you are from sun damage, sunburn, and cancer. The way SPF is calculated is explained below, and this is the only test that must be satisfied before it can be used on a sunscreen label:
Sun Protection Factor (SPF) measures the length of time you can remain outside in full sun after applying the sunscreen without burning. For example, say it takes you 20 minutes to burn normally without sunscreen. If you apply a SPF 10 sunscreen, that only means you can stay out 10 times longer, or 200 minutes (20×10) outside without burning after applying the sunscreen. Most people don’t stay out 200 minutes or 3 hours at a time, so SPF 10 is more than adequate for daily use by the majority of people. If you apply SPF 100, that only means you can stay out longer, not that it provides any better protection. It’s the same level of protection as an SPF 10, just for a longer period of time. With an SPF 100, theoretically, that means you could stay out 2000 minutes (20 x 100) using our previous example. That equates to 33 hours of sun exposure. Do you think anybody would ever need anything more than SPF 10 or 15 given this fact? Most people don’t realize this is how SPF is calculated and have a false sense of security that higher must be better. In reality, higher SPF may be worse, as it encourages longer periods of exposure. Also, SPF is a good measurement of UVB protection (sunburn) but not UVA (free radical, cancer causing) protection. The higher the SPF, the more toxic chemicals there are in the sunscreen, and if you are applying it all over your body, it increases the likelihood of absorption into the body. Before you buy any chemical sunscreen, look up the ingredients and see if any are toxic, mutagens, or irritants. Many chemical sunscreens contain potential hormone disruptors or ingredients that are highly sensitizing and irritating. If you want to limit toxicity and skin reactions, try to use only physical sunscreens containing zinc oxide and titanium dioxide instead and only apply to the face, neck, hands, and chest…the areas where you want to avoid premature aging the most.
MYTH 2: Sun exposure causes melanoma and skin cancer.
There are no conclusive studies that show melanomas (fatal skin cancers) are the direct result of sunlight exposure. In fact, melanomas often occur in regions of the body where little or no sunlight ever reaches (soles of the feet, trunk and genital area, armpits).
Ponder this, if sun exposure is responsible for the increase of skin cancer in the last few decades, why has there been a steady increase in skin cancers with our increasingly sedentary indoor lifestyles and overzealous use of sunscreens? We should have had a population decimating epidemic of melanomas and skin cancers when most of the country was still involved in farming, agricultural, and outdoor lifestyles (pre 1930s), before the advent of TVs, radios, computers, and iPods, and before the widespread use of sunscreens. Prior to the 1930s, most people routinely spent most of their time outdoors in full sun, with no sunscreen. But there is no such historical evidence of epidemic skin cancer pre 1930s. So, something doesn’t add up here, if you are to believe that sun exposure causes skin cancer. As we have become a more sedentary and less active society, staying inside most of time, the skin cancer rate has steadily increased, more than any other kind of cancer. Also, non-lethal skin lesions such as basal cell and squamous cell carcinomas have nearly doubled from 1994 to 2006. A recent study published in the Journal of Investigative Dermatology, July 10, 2008 also showed that young women, but not young men, were experiencing a rise in skin cancers. So, what else could be causing these illogical increases in skin cancers? Read on below for my theories.
MYTH 3: Sunscreen protects against skin cancer.
As many studies have pointed out, cancers are actually on the rise in the US, despite widespread knowledge of sun protection, use of high SPF sunscreens, and the trend to stay inside and avoid sun exposure. There are no definitive studies linking melanoma (the deadly form of skin cancer) to just sun exposure. Just as puzzling, is that there are no studies definitively showing sunscreen can prevent cancer or melanomas. It is a widely held belief, but with little in the way of scientific study to verify its effectiveness as a cancer preventative. Yes, sunscreens can protect from UVB rays and sunburn, but as for UVA rays and preventing cancer, that is unsubstantiated. For an interesting scientific treatise about this, read the 440 page monograph which was written by the late, highly acclaimed, and respected dermatologist, Dr. Bernard Ackerman, “The Sun and the Epidemic of Melanoma: Myth on Myth.” He presents all the research regarding this topic up to 2008 and concludes there is no direct correlation between melanoma and sunlight exposure, or any scientific proof that sunscreens protect from melanomas. Dr. Arthur Rhodes, another dermatologist agrees that people are under the mistaken belief that melanomas are only caused by sunlight exposure and do not seek medical attention when such lesions occur on areas that never receive sun, such as the armpit, soles of the foot, which ultimately leads to certain death if not treated. Dr. Rhodes goes on to state “melanoma is a heterogeneous disease with multiple causes, arising from potential precursor moles that have little or nothing to do with sun exposure, including dysplastic nevi, congenital nevi, and abnormal moles on acral surfaces and mucous membranes.”
Possible Alternative Explanations for the Skin Cancer Epidemic
I think these are other, less obvious, explanations for the increased incidence of skin cancers. These are my opinions, but I think they are not unreasonable and should be studied further:
1. Perhaps skin cancers are higher in women because women are more diligent about applying sunscreen and also apply many more substances/topicals on their skin than men do, contributing to a higher exposure to toxic ingredients and cancer-causing agents. Chemicals in very high SPF sunscreens (50 to 100 SPF), which have been very popular in the last couple decades, are perhaps contributing to cancers, especially since many chemicals break down on the surface of the skin over time and release free radicals. Free radicals can cause damage to the DNA in our cells which, in turn, can promote cancers. True, sun exposure can also cause free radical damage, but the key is that you have to monitor your sun exposure and not over do it or burn. The skin has a mechanism that is triggered to protect the body’s internal organs from excessive UV damage, and that is the process of tanning. Tanning increases the production of melanin in the skin. Without the capability to tan, you would burn very easily, compromising your skin barrier and leading to serious burns, blisters, possible infections, and allowing bacteria to enter the body and affect the internal organs. So, tanning happens for a good reason, but the negative side effect of too much tanning is premature aging and leathery skin, like a hide. For that reason, I do recommend judiciously applied sunscreen if out for more than 15-30 minutes.
2. Perhaps the inhibition of vitamin D production brought on by overuse of sunscreen and lack of sun exposure is actually diminishing the immune system’s ability to fight off cancer cells and, thus, promoting cancers or allowing cancers to grow out of control.
3. Maybe there is no epidemic of melanomas, just the increase in incorrect diagnosis of harmless lesions such as basal and squamous cell carcinomas which are being reported as stage 1 melanomas. With all the public awareness about sun and skin cancer, undoubtedly more people are having suspicious growths checked out, and more diagnoses and treatments are being done for “precancerous” lesions, which may or may not become melanomas.
4. Maybe all the topicals we apply on our skin, which include skincare, makeup, sunscreen, moisturizers, etc. are contributing to the formation of more cancerous lesions. Free radicals are generated as a result of chronic inflammation and many ingredients in our skin care and personal hygiene products can cause sensitivity and chronic inflammation over time…this is especially true of exfoliative treatments and peels.
Sensible Sun and Sunscreen Tips
Here are some guidelines for safe sun exposure and sunscreen usage. Everybody needs some sunshine in their daily routine. Even if it’s just a few minutes a day. It brightens a person’s mood and makes life more enjoyable. Just be aware of how much exposure you are getting and don’t overdo it to the point of sunburn or sun damage.
1. To prevent as much sun damage or free radical damage to the skin, do not over exfoliate or have your skin in an inflamed or irritated state when outdoors. Keep the skin’s natural barrier (the epidermis) healthy and intact as much as possible. If you do exfoliate on a regular basis, you are thinning the epidermis, and increasing the chance of UV damage and hyperpigmentation. Even applying heavy-duty sunscreen cannot totally prevent sun damage to skin which has been severely stripped by constant peels and acids. An intact epidermis provides the best protection from UV rays, a natural SPF, in effect. That’s why the epidermis exists, to protect the body from the elements, and sun exposure is a major outdoor element.
2. Don’t wear sunscreen if you don’t have to. Let your skin go bare whenever possible. Even if I’m just driving in the car for a half hour, I will forgo sunscreen entirely. I’ve never experienced hyperpigmentation as a result of minimal sunscreen use, and it’s been years since I’ve stopped using heavy-duty sunscreen on a daily basis. If your skin is healthy, it can take tolerate more sun than a thinned, compromised skin, and will not burn or tan after moderate exposure to sun. The little exposure sun you might get from not wearing sunscreen every day will be good for vitamin D production and your overall health. Expose some areas of the body like the arms or legs for a few minutes (10 or 15), a few times a week, to get the vitamin D production going. If you can’t do that, take a vitamin D3 supplement and periodically test your levels. Strive for a level of 30 to 100, at least 60 if you have had cancer in the past.
3. For those times you will be out for more than 15-30 minutes in intense sun, use a physical sunscreen, one which sits on top of the skin instead of absorbs into the skin, ones containing natural ingredients such as zinc oxide and titanium dioxide and not loaded with other unnecessary ingredients such as antioxidants, essential oils, fragrance, or actives. Or wear a hat, even better. If you must use a chemical sunscreen, use the lowest SPF you can get away with, to avoid exposure to unnecessary ingredients and toxins. SPF 15 is usually more than adequate for regular daily use. Wash it off as soon as you come inside. If you are applying SPF 50 or above, you are not getting anymore sun protection and probably paying a lot more for more chemicals.
4. If possible, limit your sunscreen to mineral powder-based sunscreens. This avoids the added ingredients in lotions that can clog pores and irritate the skin.
5. Be sun sensible and don’t allow yourself to burn. Don’t lull yourself in believing a high SPF will protect you for longer periods of exposure. Go out during the early morning or early evenings if you plan on doing extended outdoor activities. Avoid the hours when the sun is at its hottest and straight above you, generally around 11 to 4 p.m. Some sun exposure is needed to keep healthy, but sunburn is never a good thing. Though I don’t normally use lotions, I will use lotion sunscreen on beach days or really extended periods of sun exposure. 302 SPF 15 and 30 lotion sunscreens (tinted or non-tinted) are very nice, light, not fragranced, not greasy, and not ghostly white. They will not clog the pores and are suitable for acne and oily skin types.
And finally, keep in mind that the sun has been around since the beginning of man, so it must be important to sustain life on earth. So, get out and enjoy the sun without being afraid of it!