Spa Health: Under the Sunscreen
Brush up on the latest research, labeling and usage of SPF products and help clients make educated, skin-saving choices.
Despite increased awareness surrounding the importance of using sunscreen, melanoma rates are climbing. In fact, it’s the No. 1 cancer killer of women in their 20s, according to the Public Access to Sunscreens (PASS) Coalition, and one in five Americans will develop skin cancer in his or her lifetime.
Unfortunately, glacially paced approval of new sunscreen ingredients has resulted in ever-evolving regulations, less-than-perfect labeling, confusion and controversy when it comes to sun protection. Here, DAYSPA presents the latest information on SPF products so you can help your clients make smart choices when shielding their skin from the sun.
There are two basic types of sunscreens—physical and chemical—and, according to Hollywood, Florida-based dermatologist Gary Goldfaden, it’s important to understand the difference between them. “Physical sunscreens protect your skin from the sun by deflecting or blocking the sun’s rays, while chemical sunscreens work by absorbing the sun’s rays,” he explains. “Some chemical filters can scatter sun rays but still mostly just absorb them. Physical sunscreens have been approved by the FDA and show no issues at all.”
Goldfaden adds that chemical sunscreens are generally safe, depending on the ingredients used, though some chemical filters generate free radicals, which can cause skin damage, irritation and aging. For optimal protection, he advises using a sunscreen that offers both physical and chemical protection (with approved chemical ingredients).
Dr. Tunisia Finch Cornelius, a dermatologist at Atlanta Dermatology and Laser Surgery, notes that physical sunblocks typically contain titanium dioxide or zinc oxide as the main ingredient to block both UVA and UVB rays. “Most products marketed as sunscreens are a combination of both sunblock and sunscreen,” she says. “Ingredients with broad-spectrum protection include benzophenones (oxybenzone), cinnamates (octyl methylcinnamate and cinoxate), sulisobenzone, salicylates, titanium dioxide, zinc oxide, avobenzone (Parsol 1789) and ecamsule (Mexoryl SX).”
Dermatologist Brian Zelickson, director of Zel Skin Clinic in Minneapolis, believes that in physical sunscreens, micronized zinc oxide and titanium dioxide best provide uniform distribution of ingredients on the skin, but ingredient concentrations are not as important as SPF value. Overall, says Steven Q. Wang, director of dermatological surgery and dermatology at Memorial Sloan Kettering Cancer Center in Basking Ridge, New Jersey, 17 UV filters on the market have been approved by the FDA for sunscreens, and they may be present in a range of percentages. [pagebreak]
Since the turn of the decade, and in full effect by summer 2012, the FDA has put greater emphasis on UVA and broad-spectrum requirements for sunscreens. The FDA reports that “prior rules on sunscreens…did not address ultraviolet A (UVA) radiation, which contributes to skin cancer and early skin aging. After reviewing the latest science, FDA determined that sufficient data are available to establish a ‘broad-spectrum’ test for determining a sunscreen product’s UVA protection. Passing the broad spectrum test shows that the product provides UVA protection that is proportional to its UVB protection.” To be labeled as broad-spectrum, a sunscreen product must offer at least 90% UVA protection, while the SPF value reflects percentage of UVB protection, according to Zelickson.
Goldfaden explains that UVA makes up about 90% of the UV radiation that reaches the earth (the visible light that we see), while UVB makes up the remaining 10% and is strongest during peak hours of the day (11 a.m. to 3 p.m.). “Although both cause skin damage and have been shown to lead to cancer, UVB rays penetrate deep into the dermis layers and cause sunburn, redness and damage to the deep layers within skin,” he adds.
The new FDA labeling requirements determined that only sunscreens with SPF 15 or higher and active ingredients that filter both UVA and UVB rays can be labeled broad-spectrum, says Will von Bernuth, co-founder of New York-based Block Island Organics. He notes that UVA rays are present with relatively equal intensity during all daylight hours throughout the year and can penetrate clouds and glass, so protection is necessary year-round and regardless of weather.
“UVB rays are more prevalent from the spring to the fall and from late morning to late afternoon, but they’re still present in the winter—and with snow on the ground, you get a double dose due to reflection,” says von Bernuth. “However, glass is a pretty effective barrier for UVB rays.”
Ultimately, Wang warns against the common misconception that only UVB causes sunburn. He stresses that both UVA and UVB cause sunburn, though UVA penetrates deeper—but because both can trigger pigmentation and breakdown of collagen, a broad-spectrum product is crucial. [pagebreak]
SPF, or Sun Protection Factor, primarily measures UVB protection and is designated by comparing exposures. “When one wears an SPF 30, for example, she can stay out in direct sunlight for 30 times longer before UVA/UVB damage occurs, versus a person with no sunscreen,” explains Goldfaden.
Hence, if it takes 30 minutes for unprotected skin to start turning red with sun exposure, using an SPF 30 sunscreen theoretically prevents reddening for about 15 hours, says Cornelius. “Currently, there is not a rating to indicate the degree of UVA protection; therefore, it’s important to pay attention to ingredients,” she adds. “Ingredients that offer UVA protection include ecamsule, avobenzone, oxybenzone, titanium dioxide, sulisobenzone and zinc oxide.”
But, Cornelius emphasizes, sunscreens with higher SPFs offer only a small increased benefit; an SPF 30 product is not twice as effective as an SPF 15 product. “It’s the law of diminishing returns: as an SPF gets higher, the gains are smaller,” explains von Bernuth. “The FDA has even admitted that the SPF testing system may not accurately measure anything above SPF 50.” He adds that a broad-spectrum sunscreen’s SPF rating measures UVA protection in proportion to UVB protection. “This means the higher the SPF rating on a broad-spectrum sunscreen, the better the UVA protection should be,” says von Bernuth. “But it doesn’t mean it will have the same level of UVA and UVB protection.”
Zelickson offers the following stats: SPF 15 blocks 93% of UVB; SPF 30 blocks 97%; and SPF 45 blocks 98%. However, he adds, because most consumers put on only 25% to 50% of the recommended amount of sunscreen, using at least an SPF 30 is best.
Meanwhile, Wang believes that SPFs of 50 or more can be beneficial for those who are susceptible to sunburns or who have a history of skin cancer, especially when outdoors. “People don’t use sunscreen properly, so they might achieve an SPF of 20 to 25 even if they’re using SPF 50,” he explains. “We recommend at least SPF 30 for daily use and SPF 50 when outdoors.”
As experts suggest, SPF products have limitations, often due to inadequate application. “Protection really depends upon how well you apply and reapply the sunscreen,” says Zelickson. “Sunscreens are not total blocks, so everyone should use them along with protective clothing and smart avoidance of the sun.”
Wang recommends applying 2 milligrams of sunscreen per square centimeter of skin, or 1.2 to 1.4 ounces to cover the body, and product should be reapplied at least every two hours. But Goldfaden notes that in direct sunlight, reapplying each hour is important; use at least SPF 30 if you’re going to be outside for 20 minutes or more. Cornelius adds that more frequent reapplication is also necessary when sweating or swimming, but generally a shot glass worth of sunscreen, or two tablespoons, covers the body (including a penny-size dollop on the face).[pagebreak]
In recent years, Goldfaden reports, the FDA has added strict enforcements and regulatory measures to ensure all SPF products follow a mandate on the use of FDA-approved sunblocking agents that are used in products claiming SPF. “Furthermore, the FDA outlines the template that companies must use in disclaiming the product’s safety and SPF on the secondary packaging,” he says. “This ensures that all companies are following the same guidelines, restrictions and safety for consumers.”
But the most notable and recent change Goldfaden cites is the claim of SPF levels greater than 50. “You won’t see sunscreens on the market a year from now claiming SPF levels of 100,” he promises. “Sunscreen products above SPF 50 do not offer an increase in sun protection, according to current FDA regulations.”
As far as claims and product labeling requirements, “use of the label ‘broad-spectrum protection’ now means the sunscreen has been proved to protect against both UVA and UVB rays, although the UVA protection may be comparatively weaker,” Zelickson explains. “Any product with an SPF lower than 15 must carry a label warning that it will not protect against skin cancer. Products cannot claim to be waterproof, only water-resistant, and water-resistant labels must note a time limit before the sunscreen is ineffective.”
The FDA states that only broad-spectrum products with SPF 15 or higher are allowed a claim for decreasing the risk of sun-induced skin cancer and early skin aging—if used as directed with other sun protection measures, which include avoiding the midday sun and wearing protective clothing. Meanwhile, the Water-Resistance Test requires test subjects to apply the sunscreen product then immerse themselves in a tub of water for either 40 or 80 minutes, after which they’re exposed to doses of UV. Products tested according to the water-resistance test may be labeled as “water-resistant (40 minutes)” or “water-resistant (80 minutes),” depending on whether they were tested using the 40- or 80-minute water immersion time.
Finally, keep in mind that new sunscreen ingredients are in the works—but are moving slowly through the approval process. The PASS Coalition was formed to work with the FDA on approving new sunscreen ingredients. According to the organization, the last over-the-counter sunscreen ingredient to be approved was in the 1990s; since 2002, eight new sunscreen applications have been filed and are still awaiting review. New technologies awaiting approval in the States have been widely available in other countries, in some cases for more than 15 years. Find out more or get involved at passcoalition.com.