What does a sunscreen label tell you?

In preparation for discussing the new sunscreen labels, I reviewed a post I wrote a year ago - here - and found that I really don't have new news. The labels do contain new language and unresolved issues are still unresolved.  But at least the labels are now on the products.

I will proceed with the post because as someone who can barely function on cloudy days, sun protection is very important to me.  It is also important because my job as a health educator is to remind people to be safe and smart about their time in the sun.  Evidence does support a link between sun exposure, especially sun burn, and skin cancer and early skin aging.*  (FYI: shoe hide skin is not becoming and your skin will become shoe hide like if you don't protect it.)

When you spend time in the sun:

wear sunscreen, and
make sure that the label says both of these things:

• broad spectrum
• SPF 30 (or more)

It is also good if the sunscreen has a seal from the Skin Cancer Foundation,** of which there are several types:

• Daily Use
• Active
• International
• Traditional

Click here to get the definitions straight from the source, but in case you don't click, I'll provide a brief rundown: the daily use is for people who are exposed to the sun for short bursts of time in their everyday life, for example, going from the car to a store, checking the mail, etc.  Active use is the seal I look for and it is for extended periods of sun exposure while engaging in outdoor recreation, like running, cycling, walking the beach. The international seal is for outside the US and is a little different than the daily and active seal I just described, but it is undergoing a revision so I don't have more details.  Lastly, the traditional seal is for products that block the sun (e.g., glasses, hats) that are not sunscreen.  All products which carry the Skin Cancer Foundation (SCF) seal have undergone rigorous testing (the manufacturer submits data to the scientific advisory committee at SCF). Not all of the products that have passed the 'test' have the seal on their label.  You can search for recommended products, by category here.  Although in my store visit yesterday, I did not see any spray-on products with the seal, I did see some on the SCF website. 

The new label on sunscreen - where the manufacturer uses terms like broad spectrum and includes the SPF factor - may also say that the product protects against skin cancer and early skin aging.  The reason the manufacturers can make this claim (as long as its SPF greater that 15 and broad spectrum) is because the company has to provide scientific evidence to the FDA that the product offers broad spectrum protection and spf 15 or higher, and those two factors have been empirically tested in regards to the protection they offer against skin cancer and early skin aging (think wrinkles). 

In addition, the label will now tell you how long you can wear the sunscreen while swimming or sweating before the sunscreen needs to be reapplied.  In other words, the sunscreen can be water resistant, but that declaration has to come with a time frame that has been tested.

The issue of  whether or not SPF protection over 50 is possible, has not been resolved, nor has the issue about spray-on sunscreens (they may not cover the body completely and may have toxic fumes).  However, any sunscreen with SPF under 15 has to have a warning that it does NOT protect you from either sun damage or skin cancer.  

I echo the sentiments of many others when I say, use lotion not spray, choose between SPF 30 and 50 and reapply every two hours, but I add this caveat.. . unless you are employed as an outside worker, 2 hours of direct sun a day is bordering on too much.  You need more than sunscreen  - long sleeves, hats, sunglasses for example.

I ran out of my sunscreen last weekend.  I had the spray-on kind, but after reading that the concerns about the fumes and full body protection continue, I opted for a lotion this time.  I agree that SPF 30 is sufficient.  I did choose a product with the SCF Recommendation Active.  Here are photos of my label.  Notice the information about how long this lotion is expected to protect me.

You can see the broad spectrum and SPF declarations and that this lotion is water resistant with the 80 minutes in parenthesis.  I have read that it might be a good idea to avoid oxybenzone, so I like that this product is free of it.  (Oxybenzone may have endocrine effects (related to hormone secretion/disruption)).  I later noticed that this compound is in the sunscreen lotion I recently purchased for my face. This  bothers me.  However, there is no scientific consensus on oxybenzone risks and               many dermatologist still                                                                       recommend it.  Read more here and here.)

The SCF seal is on the back of the bottle.  In the section that begins, Sun Protection Measures, is the language about sun exposure and risk for cancer and early skin aging and how products with broad spectrum and spf + 15 can protect against this risk.

*Epstein, J. H. (1983). Photocarcinogenesis, skin cancer, and aging. Journal of the American Academy of Dermatology, 9(4), 487-502.

**I read in a newspaper article that the companies who wish to submit their product information for a test to receive the SCF seal, must pay a fee or make a donation.  I do not know if that is true, but I have emailed a contact person at the SCF to find out. Meanwhile, the other information about broad spectrum and SPF language is by law and regulated by the FDA.

Really - the Sunscreen Laws are Here

On June 14th of 2011, I wrote this post and referred to another I had written in 2009 - both were about the changes in how sunscreen products in the United States could be labeled. Alas, the day has arrived (or will next month) - and most of what I told you in those past posts is now law.  There is one great exception - one great, unfortunate exception which speaks to the power of industry and the discretion of the FDA.  [this is of special concern to me because the same thing is happening with the law that mandates nutrition disclosures at restaurants... the law was passed years ago, and the FDA has the responsibility and the authority for the final rule but industry is pushing back hard... yet, so are scientists, so maybe this time the changes will be in our favor - she said in a major side bar]

The unfortunate label change no go for sunscreen is the ban on claiming SPF - sun factor protection - greater than 50.

First let me tell you what did survive from the original law:
No company can advertise its sunscreen as waterproof (sweat proof, or call itself a sun block).
I thought that all sunscreens would have to provide UV A (the kind most associated with cancer) and UV B (associated with burning) protection, but I just double checked the FDA website and now I am as confused as ever by their final rule (I am also losing faith in this government agency).

Anyway, instead of everyone having to provide both forms of protection, only those that do can call themselves Broad Spectrum.  Bottom line:if the product says Broad Spectrum and is SPF 15 or higher - that is the one you want to buy.

Broad Spectrum sunscreen protects against both types of UV Rays.

Mass confusion continues over what SPF actually means.  I will do my best to explain it in a moment, but science tells us that for a product to offer adequate protection the values should be between 15 and 50, but 30 is likely sufficient.  There is no evidence to support that SPF over 50 makes a difference, makes a clinically important difference, but the industry of sunscreen makers is still fighting to use the higher numbers.

As I understand it, the amount of time that a person can be in the sunlight, unprotected without beginning to burn is quite individualized.  It depends on the time of year, where you are physically located and your skin's pigment (fair or olive, e.g.).  It does not have anything to do with whether or not you have a 'base tan!'

SPF is related to the time it takes you to burn.  So whatever that time is, say I start to burn after 30 minutes because of my olive skin - if I use SPF 15, 15 x 30 = 450 or just over 7 hours.  I could be in the sun for over 7 hours wearing SPF 15 with reasonable assurance of not being burned (UVB protection) and as long as I have on Broad Spectrum SPF 15 - I should also be protected from the UVA rays during that time.

If I chose a 30 SPF, then I could stay in the sun longer (30 x 30) without beginning to burn.  
If I were a fairer skinned person, I might begin to burn in 15 minutes, and the math would be different.  SPF 15, 15 x 15 = 225 minutes so almost 4 hours;  SPF 30, 30 x 15 = as above.

Key to this protection is that the lotion be applied thoroughly and in a sufficient amount.  Any time one sweats, goes in the water and/or towels off, the lotion needs to be reapplied. Therefore, the labels advise that you reapply every two hours.

Sunscreens that are sprayed on may not be as effective.  The research is still pending (due to the body coverage issue) and there may be concern about breathing the fumes from the spray.

It is also important to limit your time in the sun, regardless of protection - 7 hours in full sun would be dangerous.  The best protection comes form hats, glasses, clothes and shade. 

 Of course, some time in the sun is necessary for Vitamin D production  - YAY!

Once again I link you to the Skin Cancer Foundation for more information.  I am sending you to the page with a sun safety quiz!  You better get a 100!

Beach "Seen"

We pay attention to the things in which we have the most investment. The things that matter to us get our attention and may rile up our emotions. My greatest investments include my physical health and activity, my job and health promotion. I also appreciate and thus attend to, my environment and surroundings. My favorite place is the beach - the ocean, the sand, the people, the waves - in Florida, I am blessed with the Gulf Coast.

I took a vacation day today. I drank my coffee and prepared for my morning run at my leisure - ran a nice six miles without worrying about getting ready for work -had breakfast and then drove out to Lido Key Beach. The drive should take 20 minutes, but the traffic has been heavy recently. On my way there and when I arrived, I noticed many things. I decided that I would write my blog about the things that got my attention - as they would be different from what other people might attend to, because my investments and passions are different. The deciding factor for this idea was that I saw positive things too. I wanted my readers to know that I am just as much aware and impressed by the good that I see.

The first of my observations occurred on the way to Lido. I looked in my rear view mirror and saw a very large woman in the driver's seat of a truck. I would guess her weight at over 300 pounds - I noticed the handicap placard hanging from her mirror as I watched her smoking a cigarette. I could not really wrap my mind around it all.

Here are some other things that I zeroed in on today:

A child drinking root beer soda, but at least it was in the miniature cans.

Many people wearing sun glasses.

I wore a hat, some others did as well, while others wore visors or nothing. It is important to protect your scalp from the UV rays of sun.

I saw people applying sunscreen and people applying tanning oils. I heard a teen- aged boy tell his friend that he could not go in the ocean after the football because he had just put on sunscreen (yay!)

I saw some people with big hats and coverups - that is very smart.

I ratted on two women who were smoking next to me - Lido is one of several beaches in Sarasota County that are deemed tobacco free. It was not easy to pass that city ordinance and the youth in our SWAT teams had some influence there. SWAT is Students Working Against Tobacco. Unfortunately, when the lifeguard informed the women of the Tobacco Free Beach policy, they stubbed their cigarettes in the sand.

On my way to the restroom, where there is a concession stand, I passed a family that was eating lunch. They all had these sandwich wraps in their hands- and a little boy, maybe three years old, broke a peeled orange in half (seeming very happy to have this fruit to eat!). At the concession stand I saw people drinking fruity drinks with whipped cream and others eating french fries.

I saw many people drinking water and a few drinking beer.

People walked the beach. Children played in the sand and ran along the shore. I saw a little girl, maybe two years old. She was very white skinned and had blond hair. She had the biggest smile on her face. I hope she had on sun screen!

It was a beautiful day and I was impressed that people brought their coolers, had fruit and water, wore hats, sunscreen and glasses, walked and played and hopefully - the ones that did not - might do so next time.

Suncsreen, Vitamin D and Skin Cancer

When I was in grad school I did a little research project on tanning bed use and created a campaign to discourage it. I found it, find it, intriguing that white women in America believe that they will look thinner, richer and prettier with brown skin especially when our country has struggled with racism or prejudice against people of color.
It is also interesting to put this in a cultural perspective as in China, I have read, mothers will present their daughters for marriage and claim pure white skin as a significant positive attribute.

Whether or not you think tanned skin attractive, too much sun and too many burns, especially on fair skin, can lead to skin cancer. According to the Skin Cancer Foundation, more new cases of skin cancer occur each year than any other cancer. Skin cancer has a low death rate, but a high rate of disfigurement. Ironic if one ends up with scars on their body in an effort to achieve their perception of beauty.

Please go to this website for important information on skin cancer and free skin cancer screening - http://www.skincancer.org/

Now some sun is a good thing as we need it to create and or synthesize vitamin D. I need sun because it moderates my mood. I just love the sun. Ten minutes of sun a day is considered safe without sunscreen by some professionals. There is not a consensus however.

Sunscreen can be helpful but not all sunscreen is the same. The FDA has been working on labeling changes for sunscreen and this was reported in an article from WebMDHealth earlier this week.

First know that UV radiation has several parts but both UVA and UVB can cause cancer. One is more related to aging the skin and damaging the eyes while the other causes the reddening and burning of the skin. Both cause DNA changes and can lead to both non melanoma and melanoma cancers.

With the new rules, no sunscreen is going to be able to state that it provides more that 50 SPF unless it can prove so in evidence based clinical trials. No sunscreen maker will be able to say that its product completely blocks the sun, is waterproof, sweat proof or offers all day protection. The label changes have been deliberated for some time and the manufacturers will have 18 months to comply once the rules are final. The labels are also going to provide advice on skin cancer prevention, such as wearing protective clothing and reapplying sunscreen often.

I would say then, if you are spending a lot of money for a product that is claiming over 50 SPF and some of the other aforementioned claims, you might save your money.

Here is the link to the article that prompted my post:
http://www.webmd.com/skin-problems-and-treatments/news/20090521/fda-wrapping-up-sunscreen-label-changes?src=RSS_PUBLIC&print=true