When it comes to sun, it's safe to say that times have changed. Less than a generation ago, baking on a beach was considered not only safe, but healthy. Today, consumers know that excessive exposure to ultraviolet radiation emitted by the sun's rays is a major risk factor in developing the most common of all cancers, skin cancer.
Residents of the Wood River Valley need to be particularly aware of their exposure to the sun. According to Carol Wade, a family nurse practitioner at St. Luke's Family Practice in Hailey, we are at higher risk of exposure because the atmosphere at higher altitude is relatively thin.
"We are definitely more at risk, plus we have so much more sun here relative to other areas, so we're more likely to get exposure," Wade said.
Protection is the key. But the slew of sunscreen products available can be confusing. Is SPF 100 better than SPF 30? Do spray sunscreens, which are so handy, work as well as creams? Do waterproof creams mean there's no need to reapply after a quick dip?
Last year the U.S. Food and Drug Administration stated that sunscreen labeling is not adequate, announcing an expansion of labeling regulations. The new regulations include requiring manufacturers to clarify whether the product protects against UVA (long-wave) radiation, as well as UVB (short-wave) radiation. Accepted research has always targeted UVB as playing a key role in the development of skin cancer, but more recent research indicates that the greater penetrating power of UVA is more harmful than first thought (the fact that it can penetrate clouds, glass and some clothing makes UVA far more prevalent than UVB.) If a product protects against both types of ultraviolet rays it will be allowed to advertise itself as "broad spectrum," but it must pass an FDA test.
Additional restrictions include not allowing claims of a sun protection factor greater than 50 (because there is not adequate data to show higher SPFs provide any additional protection), banning products with an SPF lower than 15 from claiming they can reduce the risk of cancer and no longer allowing claims of "waterproof" or "sweatproof" (instead a product can claim water-resistance if it specifies how long the product is effective in those conditions).
In an interview with the PBS Newshour last summer, Dr. Ali Hendi, a dermatologist with the Skin Cancer Foundation, welcomed these changes.
"No. 1 is [that] a product has to have UVA and UVB protection to be labeled as a broad spectrum," he said. "Up to now, it's mostly been UVB. But UVA is a critical factor in development of skin cancer and sun damage and aging. A product cannot label itself as being waterproof or a sunblock. Those do not exist. There's no ingredient that is a total sunblock. And there's no product that is waterproof."
These labeling changes went into effect last month. However, to avoid a shortage in sunscreen over the summer months the FDA recently announced an extension for compliance to December 17.
In the meantime, the Environmental Working Group, a nonprofit environmental organization, has an exhaustive database of sunscreens, which consumers can consult. Based on extensive research, including reviewing 262 scientific studies and closely examining more than 1,800 SPF-rated product labels, it found that 75 percent of sunscreen products did not meet the standards set by the organization. Until the labels accurately reflect the efficacy of these products, it is important that consumers educate themselves on how best to be protected from the damages of the sun.
"Avoid the midday sun, 10 a.m. to 4 p.m.," Wade said. "And if you do have to be out in it, apply sunscreen liberally. We recommend a minimum SPF of 30, and there are some estimates that it takes at least an ounce of sunscreen to apply enough to protect from the sun, and most people don't apply nearly enough."
EWG recommends choosing an SPF 30+ sunscreen with broad-spectrum protection and containing zinc or titanium. Water-resistant sunscreens should be used during exercise or water-based activities. It also suggests skipping sprays, powders and anything over SPF 50+, as well as avoiding products containing oxybenzone and vitamin A (see sidebar).
The American Cancer Society also recommends that people wear protective clothing, including long sleeves, sunglasses and a hat that shades the face, neck and ears. It advises that people apply sunscreen 15 to 30 minutes before going outdoors to give time for the sunscreen to bind and absorb into to the skin and to reapply every two hours.
Children need to be even more carefully protected as, according to the EWG, one sunburn in childhood doubles the chances of developing skin cancer in later life.
"Children aren't as aware of potential sunburn happening, so they are more at risk just for that reason," Wade said. "Also, sunscreens are not approved for use under 6 months because we don't know the effect of the chemicals on babies, and infants aren't able to sweat and regulate their body temperature the way an adult is, so if you put sunscreen all over them you clog their skin. They need to have a physical barrier between them and the sun."
According to Dr. Hari Cheryl Sachs, a pediatrician at the FDA, the best approach is to keep infants under 6 months out of the sun altogether.
"If there's no natural shade, create your own with an umbrella or the canopy of the stroller," Sachs said. "If there's no way to keep an infant out of the sun, you can apply a small amount of sunscreen (at least SPF 15) to small areas such as the cheeks and back of the hands."
Living in a town called Sun Valley, it's no surprise that avoiding the sun isn't easy, or even desirable. However, being informed and acting sensibly is.
Jennifer Tuohy: firstname.lastname@example.org
FDA Zebulon Rogerson
The new FDA regulations for more informative sunscreen labeling went into effect last month, although consumers will likely not see the changes until early next year. Previously, sunscreen labels were required to carry a SPF value that informs users how well the product protects against UVB light. Now, UVA star ratings will be prominently displayed on sunscreen labels, near the SPF rating.
Which sunscreen is best?
The Environmental Working Group has an online database of sunscreens rated 0-10 (10 meaning avoid). The rating takes into account UVB and UVA protection, UVA/UVB balance, sunscreen stability and health concerns. Individual products, not general brands, are rated.
Locally available sunscreen products that scored in to 0-1 (recommended) range and are recommended by EWG include:
- Alba Botanicals Natural Very Emollient Sunblock, Fragrance Free SPF30 and Very Emollient Sunblock, Kids Mineral Protection SPF30.
- Aubrey Organics Natural Sun Active Lifestyles SPF 30, Natural Sun Green Tea Sunscreen SPF30, Natural Sun Sports Stick Unscented Sunscreen SPF30, Natural Sun Saving Face Sunscreen SPF15.
- Aveeno Baby Natural Protection Mineral Block face stick SPF50+.
- Badger All Natural Sunscreen SPF15, All-Season Face Stick SPF 35, Baby Sunscreen Chamomile & Calendula SPF30, Broad Spectrum Sport Sunscreen SPF35.
- Beyond Coastal Kids Natural and Natural Sunscreen SPF30.
- California Baby Everyday/Year-round Sunscreen Lotion/Stick SPF30, Face & Body Sunscreen Lotion/Stick No Fragrance SPF 30, Summer Blend Sunscreen Lotion SPF 30, Super Sensitive No Fragrance Sunscreen Lotion SPF30.
- Coppertone Water Babies Pure&Simple Sunscreen Lotion SPF50, Sensitive Skin Sunscreen Lotion SPF50.
- Kiss MY Face Kids Natural Mineral Sunscreen with Hydresia SPF 40
For a full list and to find the rating for your current brand download the smartphone app EWG or visit www.ewg.org/sunscreens.
EWG advises against aerosol spray sunscreen. It claims these products will soon be required to display FDA-mandated warnings such as "use in a well-ventilated area" and "intentional misuse ... can be harmful or fatal." According to the EWG website "These cautions highlight growing concerns that sprays pose serious inhalation risks. Spray sunscreens also make it too easy to miss a spot, leaving bare skin exposed to harmful rays."
In addition, in its 2011 sunscreen rules the FDA says it doesn't have data to know if sunscreen wipes are safe and effective.