Sunscreen Guide 2024: Dermatologist Recommended Essentials

Sunscreen Guide 2024: Dermatologist Recommended Essentials

 

Sunscreen should be part of your daily skin care routine, but that does not mean it has to be unpleasant.  With summer coming it is the perfect time to look into sunscreen and figure out your strategy.  The goal is to prevent the sun’s UV from accelerating aging and increasing your risk of developing skin cancer. To do that you have to use sunscreen consistency.  That requires you finding a sunscreen you like and I am here to help you with that! This is an overview of how to evaluate, choose and use sunscreen as part of your sun safe strategy. It's important to know that any sunscreen is better than no sunscreen, despite all the controversies that we will be touching on below. 

What Does SPF Mean? 

SPF stands for Sun Protection Factor.  It measures how much solar energy is needed to cause a sunburn on skin that has sunscreen on it. The SPF value indicates how long it will take the sun's UV rays to cause sunburn, compared to when there is no sunscreen. For example, an SPF of 50 means you can stay in the sun 50 times longer than you could without it before burning, but it does not take into account that sunscreen starts to break down as soon as it is applied to the skin.  Additionally, SPF only describes protection from UV-B rays, which are the sunburn rays that also damage your skin's DNA. UV-A rays penetrate the skin more deeply causing wrinkles and brown.  Because of this, you want to ensure your sunscreen is broad spectrum. This means it protects against UV-A and UV-B rays. Instead of looking for a product with the highest SPF, look for a product with at least an SPF of 30, that is also labeled as broad spectrum, and that you like enough that you will reapply it every 2 hours when out in the sun. 

SPF ratings generally relate to how well a sunscreen protects against UV-B.  The American Academy of Dermatology (AAD) recommends SPF of at least 30 to protect against sunburn and skin cancer.

  • SPF 15 sunscreen blocks approximately 93% of UVB radiation.
  • SPF 30 sunscreen blocks approximately 97% of UVB radiation.
  • SPF 50 sunscreen blocks approximately 98% of UVB radiation

People rarely use as much sunscreen as is recommended or used during testing to reach these SPF claims. Therefore, the AAD recommends a SPF of at least 30. 

What Does PA++ Mean

PA stands for "Protection Grade of UVA", and is a rating system that measures how well a sunscreen product protects your skin from UVA rays. The higher the PA value, the greater the protection. The PA rating system uses plus signs to indicate the level of UVA protection, with more plus signs indicating higher protection. For example, PA+ offers low protection, PA++ offers moderate protection, PA+++ offers high protection, and PA++++ offers very high protection.

What About Water-Resistance? 

Water-resistant sunscreens are essential when participating in outdoor activities where you are swimming or heavily perspiring because they are formulated and tested to stay on skin when you get wet. However, “water-resistant” doesn't mean “waterproof”, in fact, the FDA no longer allows the term “water-proof” to be used on sunscreen labels. 

The FDA classifies sunscreen as 40 minute or 80 minute water-resistant based on the results of testing.  If a sunscreen lasts longer than 80 minutes in testing all it can be labeled is 80 minutes, that is the highest. Regardless of the classification, you must continue to reapply throughout your time in the sun to keep your skin protected.

Three General Classes of Sunscreen 

There are many ways to classify sunscreens. I am going to do it with the active ingredients that provide the sun protection; you can have chemical, mineral or sunscreens with both.  

Chemical

(azobenzone, octisalate, octocrylene, oxybenzone, octinoxate)

Chemical UV blockers offer UV protection by penetrating into your skin and then absorbing the UV radiation from the sun and converting it into heat.  Recall that the sun emits UV-A radiation, which is associated with photoaging and melanoma, and UV-B radiation, which is more associated with burns, melanoma, basal and squamous cell skin cancers. The most common chemicals available in the US used include azobenzone (absorbs UV-A), octisalate (UV-B), octocrylene (UV-A & UV-B), oxybenzone (UV-A & UV-B), and octinoxate (UV-B). 

Chemical based sunscreens tend to be more cosmetically elegant than mineral based sunscreens because they can be absorbed with minimal residue left on the skin. The downside is that this absorption can lead to unintended consequences.  Most notably, they have possible hormonal effects that could cause changes in our endocrine system.  They are also being increasingly detected in waterways with possible negative consequences to ecosystems and drinking water.  

A study that was published in the JAMA in 2019 showed that when we apply sunscreen to our entire body we absorb more of the active chemical ingredients than we thought AND we don’t know what that means. It does not mean that chemical sunscreens are bad for us, just that our blood levels of the active chemical are higher than we thought or previously identified as safe. We need additional studies to show that even at higher levels, these chemicals are still safe. The FDA has asked sunscreen companies to do this and those studies are going on now. 

Physical or Mineral:

(zinc and titanium)

These work by creating a physical barrier on the skin's surface to reflect and scatter UV radiation from the sun.  The main minerals used for this are zinc oxide and titanium dioxide.  Mineral sunscreens are considered non-toxic and have the advantage of well-documented safety and effectiveness.  They are the only sunscreen ingredients in the United States labeled as Generally Recognized As Safe (GRAS).  They are also more photostable, meaning they remain effective longer when exposed to sunlight unlike many chemical sunscreens, which start to break down as soon as they are exposed to UV.  They still need to be reapplied every two hours.  

Generally considered to be gentle on the skin, they are less likely to cause irritation or allergic reactions compared to chemical sunscreens. They are also less likely to cause irritation or allergy than chemical UV blockers making them more for sensitive skin and children.  Zinc in higher percentages (over 10%) offers broad spectrum protection against both UVA and UVB.  Titanium provides UVB protection.  Made from naturally occuring minerals, physical sunscreens are more environmentally friendly. The downside is they can be less cosmetically elegant by leaving a white residue on the skin and contributing to block pores.  

Combination

This is a newer category of sunscreens that are typically marketed as a clear mineral sunscreen.  They typically feature zinc oxide as a key ingredient, but have chemical UV blockers as well to reach a higher SPF claim and make the zinc more spreadable.  Historically, both types of UV blockers (chemical and physical) were highlighted on the active ingredient list, but more recently, a somewhat controversial chemical (butyloctyl salicylate) is being used, which is NOT considered a UV blocker in the US despite it being almost identical to octisalate.  Because butyloctyl salicylate isn’t categorized by the FDA as a chemical sunscreen, products containing it can still be labeled ‘100% Mineral Sunscreen’.  The take home point here is that if you are trying to avoid chemical sunscreens, take a look at the ingredient list on your mineral sunscreen and make sure it doesn’t have butyloctyl salicylate.  

I have an entire blog post dedicated to the differences between the mineral and chemical sunscreens HERE

What Does Natural and Organic Sunscreen Mean?

This blog post delves into how to decode labels on sunscreens. 

To summarize:

Natural: This is a generic and unregulated term that generally refers to mineral based sunscreens with more plant-based ingredients
Organic: Chemical UV blockers that are molecularly based on carbon chains.
Non-toxic: This is a generic and unregulated term that generally refers to mineral sunscreens.  A toxic sunscreen could be one considered as one that can cause irritation, allergic reaction, environmentally friendly, and free of any substances that can be absorbed and potentially harmful (i.e. chemical sunscreens).
Reef Safe Sunscreens: Reef safe generally means that it is not a chemical sunscreen.  Most notably, oxybenzone has been linked to coral bleaching and negatively impacting coral reproduction.

EWG Verified Sunscreens

Environmental Working Group (EWG) is an organization that raises manufacturing standards so that more products are made without harmful ingredients and chemicals.   They take into account several factors when they rate a sunscreen.  

Sunscreens that carry the EWG badge cannot:

  • Be in an aerosol or powder form, given the increased inhalation risk
  • Have an SPF value below 15 or higher than 50
  • Include marketing claims banned by the FDA, such as “sunblock,” “sweatproof,” or “waterproof.”

How to Pick the Right Sunscreen for You

Again, any sunscreen is better than no sunscreen and you will only use it if it agrees with your skin. 

For myself and my family I choose zinc based sunscreens. I also recommend mineral based sunscreens during pregnancy and if you have sensitive skin. For oily skin and darker skin tones, mineral sunscreen may not be the right fit and a lightweight, non-chalky, chemical sunscreen can be easier to use. 

HERE are some tips to stay well protected. 

Sunscreens That I Recommend

Chemical Sunscreens

Combination Sunscreens

Mineral Sunscreens

  • DermaQuest SheerZinc SPF 30: It comes in sheer, as well as in tinted in multiple different shades, so it does blend with most skin coloring. It is very cosmetically elegant, but it does have a lot of silicone in it. 
  • Kinship Self Reflect: That also is 100% mineral, but doesn't have the silicone in it and is also a very cosmetically elegant option. 
  • Vanicream Facial Moisturizer:  This is a wonderful sunscreen. It is 19% Zinc Oxide. It's tolerated by really, really sensitive skin. I use this often on my body. It is not water-resistant, but it is something that I can use on my body if I'm out and about and not in the water or sweating. 
  • Isden Erythratona Actinica: It comes in two forms - the tinted and the white. It is also easy to apply to your body because it's quite milky. I like the tinted one for my legs. It's a little bit expensive for that, but it does make your legs just look nice and a little bit tanner when you're as pale as I am and it's very easy to use. 
  • Supergoop Play Mineral: This is actually 100% mineral. It's 16% zinc and this is water-resistant for 80 minutes. This is a great option to use if you want a body product that is 100% mineral. 
  • Tizo sunscreens: They have some good options. Their lip option is a nice one that's 100% mineral. That's hard to find. 
  • Colorescience Total Eye 3-In-1 Renewal Therapy: Colorscience has an eye sunscreen that's 100% mineral and it is also cosmetically elegant.
  • Supergoop Poof 100% Mineral Part Powder: Supergoop has a scalp poof powder sunscreen to protect your part lines.

What I Use

This really comes down to what I plan on doing for the day.  If it is a typical work day, I use the DermaQuest Sunscreen in Nude or the Kinship Self Reflect for my face. On my neck and chest, I use the Vanicream Facial Moisturizer with sunscreen.

If it is going to be a high UV index day, such as a beach day or boat day, I switch it up a bit.  For my body coverage, I use the ISDIN Eryfotona Actinica, either in plain or tinted. If I need it to be truly water-resistant, then I bump it up to the Supergoop Play. 

For my face, if I need it to be water-resistant I use the Skinbetter options. They have a tinted one and a sheer one, both of which will stay on quite nicely if you're going to be out in the sun and in the water for an extended period of time. 

In addition to those steps, I use vitamin C topically every day.  If I'm on a sunny vacation, I will apply my Day Preventive Treatment with 10% vitamin C to my face, neck, and chest both morning and night and skip my night treatment until the sunny vacation is over.  I also take oral Polypodium Leucotomos for added protection, there are two great options ISDIN and Heliocare. 

How to Incorporate Sunscreen Into Your Daily Morning Routine

First, this is something that should be done all year long, not just in the summer or on a sunny day.  Start with vitamin C treatment, add moisturizer (unless you are already oily), then sunscreen.  When you put sunscreen on, make sure you really focus on all the areas that are getting maximal sun exposure or are perpendicular to the sun, as those areas get the most UV.  Makeup can then be added as well. 

I also want to stress that sunscreen shouldn’t be the only thing you do to protect yourself from UV damage. It is just one part of sun safety which includes hats, polarized sunglasses, long sleeve shirts and seeking shade during the hottest hours of the day. You can learn more about things to do beyond sunscreen here.

 

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The information provided by Dr. Rogers is general health information inspired by this topic. The information in the Doctor Rogers web site, and related links, articles, newsletters and blogs, is provided for general information and educational purposes only. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Rogers has provided in her office for existing patients of her practice). Use the information and products on this site at your own risk. Use of this site indicates your agreement with these statements and the Terms and Conditions of Doctorrogers.com. If you do not agree to all of these Terms and Conditions of use, please do not use this site!  Never ignore your own doctor’s advice because of something you read here; this information is for general informational purposes only.  There is no doctor patient relationship implied.

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