Summer Breeze: Dr. Karen’s Guide to Sunscreen

In Dr. Karen M. Pendleton, Health and Beauty by Lola Magazine

If you’ve ever experienced a sunburn, then you know all too well about the negative effects the sun can have on your health. Heat rash, premature aging, and skin cancer are other painful outcomes from being outdoors without adequate protection.

But spending time in the sun—wisely—can prove valuable to our health. Sunlight increases serotonin in the brain, which is associated with improved mood and energy levels. It also creates vitamin D, which can aid in heart health, increase weight loss, and boost immunity. This article will answer some of the questions I’m often asked about enjoying summer safely, but first let’s set the stage with a few definitions:

  1. SPF stands for sun protection factor and is helpful when comparing the strength of two different sunscreens. The American Academy of Dermatology recommends using a sunscreen with an SPF of 30 or higher.
  2. UVA: Sunlight contains ultraviolet (UV) radiation, which consists of different types of rays. UVA rays have the longest wavelength and can lead to damage deep in the skin, cause skin to age prematurely, and are associated with some skin cancers.
  3. About 95% of the rays that reach the ground are UVA rays.
  4. UVB rays have shorter wavelengths and damage the outermost layers of the skin. Overexposure to UVB rays leads to sunburn and damage to your DNA. They are also thought to cause the most skin cancers.
  5. About 5% of the UV rays that reach the ground are UVB rays.
  6. UVC rays have the shortest wavelengths and can cause the most serious damage—but fortunately, the ozone layer (what’s left of it) filters these out. These rays never reach the ground.
  7. Welding torches, mercury lamps, and special bacteria-killing light bulbs are examples of man-made sources of UVC.
  8. As a fellowship-trained ophthalmologist, know that chronic exposure to acute intense UVC rays can lead to cataract formation and retinal damage.

Now that we’ve got the basics out of the way, here are the questions my patients ask most often about sunscreen.

With hundreds of sunscreens available, how do I choose?

There are only two types of sunscreen: mineral and chemical. The main difference is found in their list of ingredients. Mineral sunscreen contains zinc oxide and titanium dioxide—ingredients that form a physical barrier on the skin and protect it by reflecting away the sun’s damaging UV rays. Chemical sunscreens contain non-natural ingredients. The most problematic are octinoxate, oxybenzone and octocrylene. Before these chemicals can offer any UV protection, your skin must absorb them.

I don’t recommend chemical sunscreens.

What are the dangers of using chemical sunscreen?

A recent study published in The Journal of the American Medical Association showed that six active ingredients in chemical sunscreen were absorbed into the body. More alarmingly, some of the ingredients were beyond the FDA’s threshold of concern for three weeks after the test subjects stopped applying the sunscreen. After a single application of sunscreen containing oxybenzone, blood concentrations of the chemical rose 180 times beyond the FDA’s level of concern.

Oxybenzone may affect breast development, infant birth weight, and sperm function. In 2021, Hawaii banned the sale of sunscreens containing oxybenzone and octinoxate because those ingredients have been shown to contribute to the killing of coral reefs in the ocean. In addition, the National Toxicology Program recently released findings linking oxybenzone exposure to a higher risk of thyroid tumors in female rats.

Stay away from chemical sunscreens.

Is sunscreen safe for babies and breastfeeding moms?

Breastfeeding moms have an additional reason to avoid chemical sunscreens: they can leech into breastmilk.

A study by Dr. Margret Schlumpf of the University of Zurich found octinoxate in 64.7 percent of the sampled women’s breast milk, along with significant amounts of oxybenzone, octocrylene, and padimate O. Mineral sunscreen is a safer choice for moms (whether breastfeeding or not) and approved for use on babies older than six months.

One additional caution: Pay close attention to expiration dates on sunscreen, or your precious little one could suffer a serious sunburn.

Are aerosol (spray-on) sunscreens a good choice?

No. I don’t recommend aerosol sunscreen for 4 reasons:

The spray can be inhaled accidentally and irritate your lungs.

It’s difficult to tell if you missed an area, which could result in a painful sunburn.

They’re considered less effective than gels or lotions because applying a spray evenly is a challenge.

The cans are flammable.

Is the sunscreen in my makeup enough to protect my face?

No. Even if your favorite foundation contains SPF 50 sunscreen, it’s probably not enough. In an article featured on the Cleveland Clinic website (health.clevelandclinic.org), Dr. Amy Kassouf explains most SPF ratings are overestimates. When testing sunscreen, skin care companies apply an extra thick layer. But in the real world, we would never use that much. “We put on just as much as we feel we can spread easily, then we’re off to the races. So we don’t usually get the full protection listed on the label,” Dr. Kassouf says.

My recommendation: Apply a layer of sunscreen beneath your makeup and choose a foundation that also contains a sunscreen. You’ll be doubly protected.

Which sunscreens are a good choice for black skin?

Although dark skin does offer more natural protection from the sun’s harmful rays than light skin, it’s a myth that people of color won’t burn or suffer skin damage.

And while it might be helpful for me to recommend specific

sunscreen brands, it’s difficult because each person’s skin type (oily, dry or combination) influences which product will work best. A quick search on YouTube for mineral sunscreen for dark skin will provide dozens of reviews that will help you spend your money wisely.

Black Girl Sunscreen is a brand that might seem like an obvious choice, but I don’t recommend it. While it doesn’t contain the worst chemical filter—oxybenzone—it does contain others. There are better options available.

Do I really need to wear sunscreen every day?

Yes! Apply sunscreen every day to protect against premature aging, sunburn, and skin cancer. According to the National Institutes of Health, almost 900,000 Americans require a procedure known as Mohs surgery to remove skin cancers every year. Small spots can run deep, and the surgery sometimes results in a need for reconstructive surgery. Don’t risk your beautiful face!

Does wearing sunscreen interfere with vitamin D production?

Clinical studies have never shown that using sunscreen leads to low levels of vitamin D. One of the reasons for this is that no matter how much sunscreen you use, some of the sun’s UV rays still reach your skin. And very few people use sunscreen perfectly. With that said, I do recommend that my patients spend time outside each morning upon rising. Just 15 minutes of early morning sunlight will lead to better sleep cycles as well as stimulate production of vitamin D.

I hate wearing sunscreen. Can’t I just take a pill instead?

Companies that sell “sunscreen pills” claim they help block the sun’s UV rays just as well as regular sunscreen. Unfortunately, sun protection doesn’t work that way (from the inside out). Unlike drugs, the supplements industry is largely unregulated and FDA approval is not required prior to bringing a product to market. When those products represent a danger to public health, however, the FDA can and will step in and issue a warning statement. In 2018, the FDA issued a statement on sunscreen pills: “These companies…are putting people’s health at risk by giving consumers a false of security that a dietary supplement could prevent sunburn, reduce early skin aging caused by the sun, or protect from the risks of skin cancer.” Don’t be lured in by bogus claims.

How do I know if I have sun damage?

Dark spots, wrinkles, and blotches are the obvious signs of the sun’s damage to your skin. But if you want a more in-depth look, UV imaging can provide the details.

Here are my images from a scan earlier this year:

The process takes just a few minutes and is quite comfortable. Armed with the results, your skin care expert can recommend the best treatments to improve the appearance of your skin. Search online for Visia skin analysis to find a provider near you.

In summary, here are my “rules” for safely enjoying the sun this summer:

  • Stay out of the sun between 10 a.m. and 4 p.m.
  • Wear sunscreen every day and reapply as directed.
  • Choose a broad-spectrum sunscreen with a minimum SPF of 30.
  • Use mineral sunscreens only.
  • And if you really want to feel good about your skin, honor yourself by seeing a dermatologist for a full body check.

In good health,

Dr. Karen

Disclaimer: The information presented here is for educational purposes only. It is not intended or implied to be a substitute for the diagnosis, treatment or advice of a qualified, licensed medical professional. You are encouraged to confirm any information obtained from or through this article with other sources and review all information regarding any medical condition or treatment with your physician.