Tuesday, June 19, 2007
Does SPF provide a false sense of security?
Last week I blogged on the results of an informal poll of my friends and family regarding their use of sunscreen to illustrate the importance of skin protection for people of all skin types and colors. But, if you're like me and have never worn sunscreen, then the letters SPF probably mean nothing to you. Hey, even if you have slathered on sunscreen, SPF and all the numbers can still be very confusing. Does SPF stop you from getting skin cancer? Or does it provide a false sense of security?

For help on answering these questions and others, I spoke with Dr. Jodi Ganz, an Atlanta, Georgia, dermatologist. Here's what I learned.

The "Sun Protection Factor" or SPF is a rating system used by the Food and Drug Administration to express how much sun exposure your skin can receive before burning. This burning baseline differs per skin color, with fairer-skinned people tending to burn more quickly than those with darker complexions. The number you see on sunscreen labels (15, 45, 80, etc.), means the SPF value, or the protection against sunburn, is increased. The higher the number, the more the protection. But, it doesn't protect against everything! Which leads me to the next point...

Wearing SPF lotions, creams, and even clothing does not mean you can entirely avoid the sun's damaging UV rays, and therefore does not stop you from getting skin cancers. So if that's the case, how do we explain the more than 100,000 over-the-counter SPF products currently on the market? Well, the FDA believes prevention is the best solution. The products don't eliminate your risk, they minimize them. And if you take into consideration research from the American Cancer Society showing melanoma causes nearly 80 percent of all skin cancer deaths, then perhaps prevention is not a bad idea.

Dr. Ganz, says SPF protection provides a false sense of security if you're not informed. Knowing the options and their limitations means you're giving yourself one more line of defense. For instance, your SPF is effective only as long as the lotion remains on. Heavy sweat and spending time in the water can weaken the sunscreen and re-applications are important. In theory it should take longer to burn with an SPF 60, than with an SPF 30. But, how much longer depends on how fast a person burns in the first place. With that said, if you'd like to learn more, check out the article Separating Sunscreen Fact from Fiction on CNN.com.

I'm curious-- what is your skin type and what SPF sunscreen do you use? Have you changed your "sunning" habits in recent years? Why?
I'm of a mixed Irish & Czech heritage, so my skin is very fair. As a child my mother would insist on me applying SPF 40 sunscreens every two hours or so. Despite this I'd often times burn.

In 2005 I went to Kuwait for a four month stint during the summer and was outdoors almost all day. Despite a ridiculous amount of sun exposure I only burned on one occasion where I was exposed to a perfectly clear day with plenty of reflective sand for fourteen hours. I haven't worn sunblock since and haven't burnt on a single occasion, though I've lessened my sun exposure dramatically since I've been stateside.

Why? I suppose without the painful reminder of sunburn now and again I haven't even contemplated sunblock. Out of sight, out of mind.
I'm of mostly Western and Northern European descent, with some Mediterranean and Native American thrown in for good measure. That is: fairly light skinned, but I generally burn only in places and mostly tan.

I never used sunscreen as a teenager, and rarely burned. In my late-20s I got a severe (purple!) burn while in Bolivia, and I've used sunscreen ever since.

At first I used SPF 15, now I don't go out without at least SPF 30-45. (My husband was just diagnosed with melanoma in a spot that has rarely been exposed to sun.)
I understand. I have the same issue. I just don't remember the stuff. I'm African American and have been sunburned before. But, I still don't think about sunblock, because burns don't happen to me frequently enough. You're really right about minimizing your risk. Honestly, if there's simple things we can do, it's our responsibility to at least try. Thanks for the reminder.
I have lupus and I was told by my rheumatolgist to wear an sunblock with SPF of 50. I also wear a hat and wear clothing that keeps my skin covered.

I implore CNN to start informing the public about lupus, it could save someone's life.
I'm of Chinese decent and growing up it was looked down upon to get tans. My mother would nag me incessantly if I tried to get a tan by laying out so other then being dark as a child from playing outside, I've never had a tan much less a burn as a teenager to adulthood. Thanks to the lack of sun exposure, my skin is very soft and not sun damaged like some of my friends who were sun worshippers. I now wear sunscreen with an SPF of 30 whether I'm indoors or out. I've seen the effects the sun has on skin and I want to preserve mine as long as possible.
I am fair, of northern European descent. In my younger years we were not aware of sunscreens, never used them (had several burns as a young child)and in high school we actually used baby oil and iodine to get tans! For the past 10 years or so I have used sunscreen on my face year round (SPF 15 in the winter and SPF 30 in the summer) and on all exposed skin in summer time. I no longer try to get a tan. Thank goodness for the self-tanners with sunscreen - best of both worlds.

I started using sunscreen as a preventive measure against skin cancer, but it also helps prevent the skin damage that causes wrinkles and "age spots".
I'm Pacific Islander/Asian, dark complexion. I don't go out in the sun often but slather on SPF 50 when I do.
I'm a 37-year old woman of Eastern European and Swedish descent. I have very fair skin with lots of moles and freckles. As a child I had extensive sun exposure with many bad burns (blistering, peeling, etc.) In college I worked at a tanning salon. I am now paying the price. I now don't go out without sunscreen 365 days a year. I am even more vigilant with my 5-year old son who is blonde, blue-eyed and extremely fair skinned. He not only wears SPF 30 or greater, he does not go out without a hat. I don't want him to suffer the same consequences I now face as an adult.
I am of Northern European descent with red hair, green eyes and freckles. I avoid the sun, and wear SPF 40 everyday.

I see caucasians like myself, laying out to tan, and find it ridiculous. It makes about as much sense as skin lightening for negroes.

Be happy with who you are.
I'm a caucasian Canadain female with an olive complexion. Until a few months ago, I had never worn sunscreen. I tan very dark, very quickly and never burn.
(The greater part of my youth soaking up the sun during our short Canadain summers.)

That said, I'm now approaching age 39 and have recently started working with a dermatolgist to reduce what she refers to as "sun-spots" on my body.

The doc's advice on this issue - education and prevention are key: never, ever leave home without wearing a sunscreen of at least SPF 15.

The results of the doc's work combined with the regular use of SPF15 are amazing! I have the skin of a 20 year old again.

Regards,
Converted in Canada
I have read many articles recently that claim that several of the ingredients of sun screen are cancer-causing agents and that this could be the reason for some cases of skin cancer, not the sun. I have also read that some sun screens generate harmful compounts that promote skin cancer because the penetrate deep in to the skin leaving the outer layers of skin more vulnerable to sun damage. How can we be sure that the sun screen we are using will not give us cancer as opposed to the sun?
I'm of european descent (czech, german, british, swedish). I am very pale (palest foundation MAC makes!) but I have yellow understones to my skin.

When I was a teenager I would use SPF 15 or none at all and I would rarely burn. Now that I am older I use SPF 50 when I go to the pool but I don't put any on for golfing or other outdoor activities. I don't burn anymore and I don't tan so I'm not quite sure WHAT is going on...
I am 31 and fair skinned. I spent a lot of time in the sun as a kid - competitive swimming and lifeguarding - but not as an adult. This year I was diagnosed with melanoma. Very scary. Everything is fine now - but my doctor told me to wear wear sunscreen with UVA and UVB protection every day on any part of my body that is exposed. I do the same with my kids. It's all I can really do.
I recently spent 3 days outdoors at a rock festival in the glaring sun. I'm half Scottish and half Southern Italian - my skin leans toward the "olive" tone and I tan fairly easily. I slathered on SPF 50 several times a day, and didn't get a burn . . . but I did get a heat rash for the very first time in my life, which was worse than any sunburn I have ever experienced. Just goes to show that even sunscreen is not a cure all. I will be limiting my sun exposure this summer for sure.
I'm a very fair, standard Northern European/British Isles heritage American, but I tan and freckle to a very golden color after burning for a couple of days. I even life-guarded when I was younger sitting in the sun for hours on end. I wear SPF 15 at a minimum on my face every day, and if I'm going to be in the sun for long periods, I apply sunscreen all over, up to 45. I like to get childrens sunscreen, particularly with glitter. I also sunscreen spray my hair to make sure my scalp doesn't burn and put on SPF lip balm.

If I'm going on vacation, I use tanning beds for 5 minutes, building up to 12 minutes a few times a week for up to a month to avoid a blistering burn. I also use Mystic Tan, which is great, during other times so that I can have a tan without the constant UV rays.
I am only 26 years old but I have red hair, freckles and moles. Thanks to all of the media attention I have started examining my skin for changing moles. I have had over 15 moles removed and biopsied and luckily I have had only 3 come back that needed to be removed. Thanks to my natural hair color and fair skin I will have to see a dermatologist regularly for the rest of my life if I do not want to have skin cancer.

Prevention is the key!!
I do think that Sunscreen in general gives people a false sense of security. The best prevention is avoiding the sun during peak sun hours as well as putting on that sunscreen! In the summer, in addition to wearing sunscreen, my family tries to avoid full sun exposure activities like going to the beach or swimming during the strongest sun hours. Unfortunately, this leaves us as somewhat social outcasts as everyone heads to the pool at mid-day. I find it somewhat disconcerting that people don't heed that additional warning: wear sunscreen AND avoid the sun during peak hours.
I am a 25 year old female of South Spanish and Norwegian descent...very fair skinned. I have never tanned in my life and never will, I always used a small spf on my face but just recently started using an all over sunscreen/moisturizer. I get compliments on my skin all the time :)
Never before in the history of mankind have we used more amount of sunscreen. At the same time, never before have as many people been diagnosed with skin cancer. Plus, people spend less time outside than ever.

What's the logical conclusion?

I think lotions may actually cause skin cancer. Even more than the sun itself.

- Christian Goodman
http://ChristianGoodman.com

PS: Coincidence, I wrote an article on my blog today asking: "Do blood pressure medications cause false security?" My conclusions was very similar there.
I'm Asian American and a Southern California beach bum. I spend lots of time outside and I have fairly dark skin. Even though I always seem to tan, I rarely burn, but most of the time I put on SPF 30 when I'm at the beach or at the pool.

On my face however, I put on SPF 45 every day if I'm going to be exposed to any sunlight -- as my dermatologist recommends.
31 yrs. old, Irish/Italian descent. Unfortunately got the Irish skin and mild rosacea. Even with regular application of sunscreen, I will burn and can get sun poisoning at the drop of a hat. Please ignore the conspiracy theorists that claim sunscreen is the culprit - it's completely unfounded and alarmist. I do wish sunscreen makers would make a product that didn't sting, and one that oculd be used around the eyes.
I am a 26 year old Caucasian female. I tan easily and rarely burn. I spend a lot of time outdoors skiing/ swimming/ hiking/ running/ etc. I never wore sunblock in my life until the age of 24 when I was diagnosed with melanoma of a non-sun exposed area (a fingernail matrix). Now, knowing that I am susceptible to melanoma and since I prefer to not cover myself in a chemical sunblock and I am not willing to give up my outdoor activities, I wear UPF rated long pants, long sleeve top, wide brimmed hat, and sunglasses every time I go outside (even to the beach). For the small amount of skin that is exposed, I use a sunblock containing micronized zinc-oxide with an SPF of 45.

My melanoma appeared at the age of 18 on a non-sun exposed area of my body (nail-matrix) it was not caught until I, by chance, saw a dermatologist about an unrelated issue at the age of 24. Other doctors, including my GP, told me it was a bruised nail bed. I am lucky that it was slow growing and caught while it was still in an early stage.

Although damage due to ultraviolet radiation is responsible for most melanomas, I believe that it is important that people understand and are aware of other types of melanoma. I would like to see an article or more news coverage pertaining to other types of melanoma and how to recognize them.
I am a 26 year old Caucasian female. I tan easily and rarely burn. I spend a lot of time outdoors skiing/ swimming/ hiking/ running/ etc. I never wore sunblock in my life until the age of 24 when I was diagnosed with melanoma of a non-sun exposed area (a fingernail matrix). Now, knowing that I am susceptible to melanoma and since I prefer to not cover myself in a chemical sunblock and I am not willing to give up my outdoor activities, I wear UPF rated long pants, long sleeve top, wide brimmed hat, and sunglasses every time I go outside (even to the beach). For the small amount of skin that is exposed, I use a sunblock containing micronized zinc-oxide with an SPF of 45.

My melanoma appeared at the age of 18 on a non-sun exposed area of my body (nail-matrix) it was not caught until I, by chance, saw a dermatologist about an unrelated issue at the age of 24. Other doctors, including my GP, told me it was a bruised nail bed. I am lucky that it was slow growing and caught while it was still in an early stage.

Although damage due to ultraviolet radiation is responsible for most melanomas, I believe that it is important that people understand and are aware of other types of melanoma. I would like to see an article or more news coverage pertaining to other types of melanoma and how to recognize them.
I had my first skin cancer tumor removed when I was 27. I'm fair with blond/red hair and a Scottish background. It didn't look anything like a mole, it was just a pink, shiny bump. I have been vigilant about sunscreen since I was about 12 and I know my mother tried hard to keep me covered up, but I still had a number of very bad sunburns.

I buy the highest sunscreen I can find...this year I got some Neutrogena 70. Being a redhead naturally teaches you that tanning is bad (futile, really)so my face has been spared a lot of damage. I have younger co-workers who tan (one who had melanoma at 23!) and have deep wrinkles on their foreheads and around their eyes that I still don't have at age 31.
I think that sunscreens give people the bogus idea that once they put the sunscreen on they are protected from sun damage for the rest of the day. Sunscreen is only part of the answer. Staying indoors between 11 am and 3 pm helps out a lot more than just sunscreen.

For the rest of the question, I'm a pasty white person with red hair, green eyes and freckles of german/irish descent. I've been wearing spf 50 for the past few years. My parents didn't believe in sunscreen,so I've had a lot of burns, complete with blisters and peeling... not a good thing.
I am 3/4 Ulster Scot(a.k.a. 'Scots Irish'), and 1/4 Native American Indian. I burn fast and can get severe burns and blistering in the early part of Summer. I use the water resistant SPF 45 or higher every day, and I reapply it liberally as per the label. I have totally changed my habits. I grew up practically living in the water. I surf, swim, scuba dive and kayak every chance I get. I still do. Only now I don't sunbathe, I wear SPF lotions with labels stating they are for UVA and UVB rays. I cover up before burning. Our surf and dive shops have clothing with SPF ratings that are comfortable enough to wear while snorkeling and exposing only the back for a long time. Watch out for that burning while snorkeling if you're a tourist going to the beach, especially in the tropics!

The board certified dermatologist I had as a kid used tanning booths as part of his treatment for acne, and told my parents to encourage me into sunlight and salt water as often as possible. He meant well, and worked with the information available to him at the time (early 1980's.) Hopefully I'll get away with that past exposure. Regular screenings to check for skin cancer are now a must, as are self exams. Thank goodness we have better information today! Act accordingly!
You bet I've changed my habits. My first skin cancer was removed on my chest about 10 years ago. Any time I do yard work, the SPF 45 or higher goes on. And a hat. Since I don't do well in the heat anymore, staying out in the sun is not that much of a problem, and as a nurse I'd like to add that melanoma can be fatal. It's not worth the risk.
I posted a little bit about SPF a week ago--It wasn't in as much detail as what you have written, but being a master of textile engineering and chemistry myself, your comment about clothing isn't complete. So I'll fill in the gap.

Clothing does shield you somewhat from UV radiation. If you want complete (100%) protection from UV radiation, you would need to wear several layers of clothing. Still, one layer of clothing is better than any high SPF sunscreen.

The yarns that make up your clothing aren't perfectly smooth, nor do they cover you completely. BUT, differences in cover for most textiles can be neglected in this case because those differences are relatively small. Yes, light (w/ UV) can get through the fabric, but the intensity will be far less than without anything covering you at all. Light is reflected off the surface of the fabric, and because the yarns aren't perfectly smooth the light can also be scattered. So even if light passes through the fabric, a good bit of it has already been reflected and scattered away from your skin.

Sunscreen works on the same principle. It, too, attempts to scatter and reflect light from your skin. If it is reflected/scattered, it won't destroy skin cells, and your risk of acquiring skin cancer is far less.

I have fair skin, and I find that the best protection is clothing. I don't tan...I go from fair to lobster in a hurry.
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