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At current rates, 1 in 5 Americans will develop skin cancer during their lifetime. Skin cancer/melanoma is caused by sun exposure: one bad sunburn in early childhood, a few bad sunburns once in a while or chronic, long-term sun exposure. By using sunscreen and sunblock properly as part of a total sun protection program, you can protect your skin from the sun and minimize your chance of getting skin cancer/melanoma.

How does the sun cause cancer? The sun has energy. This energy passes through the ozone layer of the atmosphere and reaches earth in the form of ultraviolet (UV) light. A thinning ozone layer increases the amount of dangerous UV radiation that reaches earth. UV light is made up of UVB and UVA rays. When UVB light enters the skin, it penetrates into the skin's upper layers of the and causes immediate, visible damage in the form of sunburn, and in some people, a suntan. When UVA light enters the skin, it penetrates into the skin's deeper layers and causes invisible damage that results in long-term injuries like wrinkles, leathery skin and skin cancer. In the United States, UVB rays are stronger in the summer, but UVA rays are constant year-round. This means sun protection is a year-round responsibility. What are sunscreens and sunblocks? Sunscreens and sunblocks are skin-based sun protection products. To be effective, they must be used properly and in conjunction with other forms of sun protection. Sunscreens and sunblocks protect against UV rays, but in different ways. Sunscreens chemically absorb harmful UV rays, and sunblocks physically deflect them. In both cases the negative effects of UV are reduced, not eliminated. No sunscreen or sunblock provides 100% protection against UV radiation. That is why other forms of sun protection like hats, sunglasses, clothing and shade structures (such as beach umbrellas and stroller canopies) are needed, too. Traditionally, sunscreens protected against UVB rays-not cancer- and wrinkle-causing UVA rays. Now that both UVA and UVB are recognized as dangerous, sunscreen makers have begun to include ingredients that guard against both types of rays. To find out whether your sunscreen is protecting you against both UVA and UVB rays, look at the label. Make sure the label identifies the sunscreen as a "broad spectrum" product. That means the product provides some protection against both UVA and UVB rays. Next, look at the list of active ingredients No product provides 100% protection against UVA, but some ingredients protect against more of the UVA spectrum than others. Avobenzone, also known as Parsol® 1789, blocks about 1/3 of the UVA spectrum, and is considered the most effective. Sunblocks like zinc oxide-the thick white paste that you might see a lifeguards dab on their noses-have long protected against UVB and UVA rays. But because these products are unsightly and conspicuous they have not been used widely. New preparations for sunblocks, such as micronized titanium dioxide and clear zinc oxide (Z-Cote®) are now available to provide inconspicuous, effective broad-spectrum coverage against UVB and UVA. Again, look at the list of active ingredients to determine whether or not your sunblock is doing all that it should. (Question: Don't some new sunscreens contain sunblock compounds in them - micronized titanium dioxide? Is it possible to find an all-in-one package? If so, you could address this in the next question) Both sunscreens and sunblocks are available in many different forms, such as ointments, gels, lotions, creams, foams, and wax sticks. Find what you like and what your children like, check the list of active ingredients and use it everyday! Does it matter if I use a sunscreen or a sunblock? No. Whether you use a sunscreen or a sunblock does not matter. What matters is that you choose a skin-based sun protection product that is proven to protect against UVA and UVB, that you like its texture and smell, and that you use it properly and regularly. Do children need to use a sunscreen or sunblock specifically made for children? No. Any broad-spectrum, high SPF sun lotion with the right active ingredients will work for children as well as adults. What is SPF? SPF stands for Sun Protection Factor. The SPF number communicates a product's ability to protect against UVB rays only. The higher the number, the more UVB protection the product provides when used properly. SPF does not relate in any way to a product's ability to protect against UVA rays. At present, there is no standardized system for measuring UVA protection. A product with a high SPF number is simply telling you that it can provide protection against burns caused by UVB overexposure. A high SPF number does not tell you it will protect against burns from UVA rays, aging, wrinkling, and other long term skin injuries that can lead to melanoma and skin cancer-unless it also contain the active ingredients that are proven to protect against UVA, too-Avobenzone (Parsol 1789®), titanium dioxide or zinc oxide. SPF is calculated by comparing the amount of time needed to produce a sunburn on protected skin to the amount of time needed to produce a sunburn on unprotected skin. A product is rated SPF 2 if a person who normally starts to burn after 10 minutes without sun protection begins to burn after 20 minutes with the sun protection product. (20:10 = 2). An SPF of 30 means that it takes a person 30 times longer to burn from UVB overexposure when using that product than if he uses nothing at all. Who should wear a high SPF, broad-spectrum sunscreen or sunblock? Everyone, regardless of outdoor activity, skin type, or age, should wear a broad-spectrum sunscreen or sunblock with SPF 30 or higher— everyday.

Skin-based sun protection products are not just for the beach. The American Academy of Dermatology recommends that anyone who is going to be outside for more than 20 minutes use a sunscreen or a sunblock as part of their daily ritual. Being outside does not necessarily mean being in the sun. Clouds permit 80% of UV light to pass through. And being in the sun does not necessarily mean being outside. Glass windows do not block out UVA rays. The American Academy of Dermatology's recommendation really means that everyone-whether you spend your day inside or outside-should wear some form of skin-based sun protection-everyday. Skin-based sun protection products are not just for light-skinned people. A recent study from Australia finds that because of genetic variations even people who have darker complexions or people who tend to tan instead of burn can be at increased risk for melanoma. This means that susceptibility to melanoma and the need for sunscreens and sunblocks cannot be judged based primarily on skin type, hair color, or eye color. Everyone needs to Be Sun Sensible. Skin-based sun protection products are for infants and children, too. The American Academy of Pediatrics states that sunscreen and sunblock can be applied to infants as young as six months old. At the park, in the car, or on a walk, babies and children get direct and incidental UV exposure. Sidewalks, sand, and snow, for example, reflect light. Tree and stroller canopies do not provide full shade coverage. Playgrounds and school recesses are outside. For these reasons, sunblock needs to be part of every baby's and every child's routine--everyday! Infants should be kept out of direct sunlight and covered by protective clothing to minimize exposure to incidental light. The melanin-production system of infants is immature and cannot handle UV exposure. NOTE: Sunscreen is only part of an effective sun protection program. Small children and infants need to be covered up and be in the shade whenever possible.

How should high SPF broad-spectrum sunscreens be used?

Sunscreens and sunblocks should be applied everyday liberally to dry skin and lips 30 minutes before UV exposure. By putting sunscreen on dry skin and lips and applying it ahead of time, you are letting your body absorb the product and you are increasing the possibility of maximum sun protection. Sunscreens and sunblocks should be reapplied at a minimum of every two hours-even waterproof products. Sunscreens rub off with towels and sand and wash off with water and perspiration. They need to reapplied regularly. Even water resistant products begin to lose their effectiveness after only 80 minutes in the water. Gel-based products are lighter and need to be reapplied more frequently than lotions or creams. Sunscreens and sunblocks need to be used everyday liberally wherever skin is exposed. One ounce of sunscreen (a shot glass full) is the amount required to cover the average adult's body-with special attention to the face, arms, and hands because they are generally exposed the most. Sunscreen products should last for as many applications as they have ounces. A 7-ounce bottle should be empty after 7 uses. That's a lot of sunscreen for one person in one year! Skin-based sun protection products do not last forever. The active ingredients in sunscreens and sunblocks wear out. Check the expiration date on each package to make sure that you are not using a product that is no longer good. Save the skin you are in... If sunscreen is not applied properly, it cannot do its job of protecting your skin and saving your life.

I used a high SPF broad-spectrum sun lotion properly and my skin still changed color. What happened? Remember: No sun lotion provides 100% protection against UV radiation. Even the best sun lotions fail to protect you against about 1/2 of the UVA spectrum. This is why you still get color even though you used a high SPF broad-spectrum sun lotion. Sun lotions alone cannot protect you from the sun's harmful rays. What is a healthy tan? There is no such thing as a healthy tan. A tan means skin damage. Tanning is the body's response to sunburn and overexposure to UV light. As UV rays pass through the skin's inner layers, the body produces more melanin as a response to the injury. Over a 48-hour period, melanin moves to the skin's outer layers and becomes visible as a tan. Tans and darker skin tones are the body's attempt to deflect UV light off the skin. What about tanning booths? In spite of what you might hear, tanning booths and sunlamps pose the same dangers as natural sunlight. Tanning booths and sunlamps claim that they offer a safe way to tan because their artificial lights only emit UVA rays. But UVA rays can result in sunburns as well as long-term outcomes like premature aging, wrinkling, skin cancer and melanoma. Am I safe from sunburn and sun damage in my car or in my house? You are not safe from sunburn or sun damage in your house or car. Glass windows block UVB rays that cause short-term damage and sunburn, but they do not block UVA rays that cause long term damage, wrinkling, skin cancer and melanoma. This means that even when you are in your car or your house, the sun could be doing harm to you. The damage may not be visible and immediate because the sunburn is not as extreme, but the UVA rays are penetrating deep into your skin and causing invisible long-term damage that could result in skin cancer or melanoma. Note: glass coating products are available for your car or house windows to screen out UVA rays, but you need to request them from the dealer or installer. What else should I know about sunlight, skin cancer, and sun protection?

Heat, altitude, and wind increase the effects of UV radiation. Take extra care to protect yourself from sun damage on hot or windy days and in high altitudes where there is less atmosphere to shelter you from UV radiation. Learn about the UV Index in your area. On a scale of 1 - 10 (low to high), the UV Index tells you about the next day's amount of exposure to UV rays in your area. When the UV Index is over 5, special precautions should be taken to minimize exposure to UV. For more information on The UV Index, contact The EPA Stratospheric Ozone Hotline (http://www.epa.gov/ozone/ or 1-800-296-1966) or The National Weather Service's Current UV Index Forecast (http://www.cpc.ncep.noaa.gov/products/stratosphere/uv_index/uv_current_map.html) or http://www.weather.com. Beware of reflected light. Surfaces like sand, sidewalk, water, and snow reflect UV radiation. Clouds do not block UV radiation. Nearly 85% of the sun's damaging rays pass through clouds. Don't you know someone who was deceived by a cloudy day and got sunburned even without the sun? Eyes also need protection from UV damage. The sun can cause cataracts, ocular melanoma, macular degeneration and other forms of eye damage. Sheltering your eyes from UV radiation is a critical part of a total sun protection program. Children who will not wear sunglasses to protect their eyes should, at a minimum, wear a wide-brimmed hat. UVA radiation is constant year-round. Sun protection is a year-round responsibility—not just something to worry about in the summer months or during a trip to the beach. Beach umbrellas and tee shirts do not provide full protection. If light is passing through, UV rays are too. Babies under the beach umbrella or children in white tee shirts are getting minimal protection-not maximum shelter. Light passes through the umbrella and gets reflected light off the sand. A white tee shirt has an SPF of about 6, and when it gets wet, the SPF drops to 2.

A high SPF (30+), broad-spectrum sunscreen or sunblock is only one component of a total sun protection program. Skin-based products work in conjunction with sun sensible behaviors: covering up with a hat, shirt, and glasses; seeking shade; and minimizing sun exposure between 10 a.m. and 2 p.m. SUN PROTECTION IS NOT JUST ABOUT PREVENTING A PAINFUL BURN TODAY. IT IS ABOUT PREVENTING CANCER TOMORROW.

BeSunSensible is an educational website for informational purposes only. You should not use this information to diagnose or to treat a health problem or disease without consulting a qualified healthcare provider. The information contained on this site is not intended to be a substitute for professional medical advice. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.To view our Privacy Policy, click here

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