Sun protection should be easy. Pick a sunscreen. Slather it all over your body. Go outside safely. Bye bye wrinkles and cancer!
The reality is oh so different. So many sunscreens out there don’t protect your skin as well as they should. Worse, some travel from the surface of your skin – where they should stay to do their job – into your bloodstream.
FIY, that doesn’t mean they will kill you. But, if they’re not on your skin, how can they protect you? Exactly.
So, how the heck do you find a good sunscreen? What should you look for? And why should you even bother?
I’ll let Dr Denis Dudley, a board certified OB-GYN specialist and founder of Cyberderm, The Sunscreen Company, do the talking this time. Here’s his advice to effectively protect your skin from sun damage:
Hello, Dr. Dudley. Can you tell us more about yourself and why you decided to start Cyberderm – The Sunscreen Company?
I was a board certified OB-GYN specialist – focused on the sub-specialty areas of Maternal Fetal Medicine (MFM – otherwise known as High Risk Obstetrics), and Reproductive Endocrinology – dealing with female hormone disorders and infertility. Thirty years ago, I found the UV filter benzophenone (oxybenzone) in 3rd-trimester fetal blood – likely from expectant mothers using sunscreens and cosmetics that passed into maternal blood and across the placenta to the unborn fetus.
My wife was a photobiologist/ dermatologist – I jokingly asked her back then if her specialty was trying to pollute the next generation. She was unaware that certain soluble small filters- benzophenone and others – gained entry to blood and some could bind to dopamine and serotonin receptors in the brain. We both agreed that was reason enough to look for alternatives even before considering possible adverse effects on the developing fetus.
Over the next 20 years or so, we learnt that these substances were known or suspected hormone disruptors and that benzophenone was quite ubiquitous. A CDC study in 2008 (Calafat) showed that 96.8% of Americans aged 6 to7 – both genders – had benzophenone in blood or urine. Another CDC study on women having third trimester amniocentesis found 99% with the chemical in urine and 61% had it in amniotic fluid. Another study from the EU showed that 85.2% of nursing mothers had at least one UV soluble filter in breast milk.
My wife was also concerned about rising skin cancer rates and photoaging in younger women. I was concerned that no one told expectant mothers about entry to blood and possible effects on the most vulnerable of all humans. The global sunscreen market, particularly in N. America, is still dominated by UVB-biased sunscreens, since all of these soluble filters are UVB filters except for avobenzone with some UVA activity. They mostly prevent UVB effects like sunburn to some degree, but offer little or no protection against skin cancer or photoaging, where UVA (mostly UVA1) plays a major role. We believed that incomplete or UVB-biased protection contributes to rising annual skin cancer rates – 2-3% in N. America and an alarming 40% in the UK over the past few years. The mortality rate for melanoma just jumped by 20%in the USA.
CyberDERM was created to develop sunscreens with balanced UVA/UVB protection to prevent skin cancer and photoaging. Our sacred rule is to use only active ingredients that never gain entry to blood and be safe for pregnancy. Anything safe for the unborn would be safe for anyone, including young and adolescent children. It is disheartening that 65% of sunscreens still contain benzophenone, which is now known to be destroying coral and marine life as it washes off ocean bathers. Most expectant or nursing mothers, parents, or any consumer is still unaware that soluble UV filters reach blood, any tissue and even your brain. Even more egregious to me is that few physicians ever advise patients of this established fact and deprive them of making their own informed choice about sunscreens and whether they might consider taking a precautionary approach.
What are the effects of UV rays on the skin?
The UV band of radiation spans a spectrum of 290-400 nm. UVB accounts for 6% and UVA for 94%. The shorter UVB rays reach the last layer of the epidermis and the deeper penetrating UVA rays (320-400) reach the deep dermis. The amount of UVB reaching your skin will vary with time of day and latitude but UVA – particularly longwave UVA1 at 340-400 nm pass through clouds, window and auto glass and are of the same intensity anywhere on the planet. Both bands play a synergistic and combined role in causing all aspects of sun damage to skin- both elicit sunburn and the tanning reaction- both the first signs of sun damage.
Then both –but mainly UVA1 – play a role in the long-term or chronic sun damage that manifests in several ways- freckles, sun spots, the skin wrinkling, becoming thick and leathery, developing large blackheads or solar comedones mainly over the cheekbones, pigment abnormalities- red and brown called poikloderma. Then there are the precancerous lesions called actinic keratosis, and the various types of skin cancer. Twenty percent (1 in 5) Americans will develop a skin cancer within their lifetime.
Skin cancer is the most common human cancer at slightly more than 50% of all cancers. The major types of skin cancer include Non Melanoma Skin cancer (NMSC) that includes Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), and the most lethal form or Malignant Melanoma (MM). In the past 30 years, more people had skin cancer than all the other cancers combined. BCC is the most common and affects over 4 million Americans each year and SCC over 1 million, while about 90,000 new cases of MM is expected this year in the USA. There is a major economic impact from UV damage. Just the 5 million plus skin cancers will have a significant economic cost this year at over 8 billion dollars in health expenditures.
Most of these cancers are potentially preventable. The effects of chronic UVA damage are exemplified by the consequences of the UVA radiation exposure in a tanning bed. More people develop skin cancer from tanning than get lung cancer from smoking every year- about 420,000 in the USA each year. The same UVA rays that play a major role in skin cancer also cause photoaging. Ninety percent of skin aging comes from UV radiation exposure, mostly UVA present even on cloudy days. UVB initiates sunburn and DNA damage. It acts as modulator for UV effects and UVA- particularly UVA1 – completes the damage cycle, and supresses the protective immune responses that would remove an abnormal cell and repair tissue damage.
How can we make sure our skin is adequately protected from sun damage?
A photoprotection strategy must be diligent and consistent. Radiation effects are cumulative- no point protecting your skin on most days then spending an hour in unprotected sunbathing. The essential measures must include:
- Sun avoidance particularly between 10-2 PM when the sun is more intense- an effective measure for UVB but less so for UVA that penetrates clouds and is more or less constant.
- Wear protective headgear, sunglasses, and regular or UV protective clothing.
- Conventional teaching is to apply sunscreen to unprotected skin when outdoors. We advocate that you apply a sunscreen every day to face, neck and back of hands, and any exposed skin even if you do not plan to be outdoors. 65% of lifetime UV radiation exposure is ambient and the rest from recreational or vacation exposure. Certain outdoor occupations increase the need for everyday application. The problem is most sunscreens may prevent sunburn to some degree but lack the UVA protection to prevent skin cancer and premature photoaging. You need one that gives spectral homeostasis where the protection is virtually equal and uniform across the UV spectrum. Most sunscreens in America fail to do this despite label claims to the contrary. This requires a minimum amount of UVA protection that cannot come from the UVB filters in most brand name sunscreens. There are a few UVA filters but zinc oxide is the single best broad spectrum filter available in N. America if used alone in adequate amounts or in combination with another insoluble particle type UVB filter to avoid entry into blood.
What should we look for in a sunscreen?
First what to absolutely avoid- avobenzone, oxybenzone, homosalate, octisalate, octocrylene, Mexoryl XL™, Eusolex™ (4-methylbenzilidene camphor), octinoxate (un-encapsulated)- most are known or suspected hormone disruptors, photoallergens, and carcinogens. The fact that they attain levels in your blood is reason enough to avoid them even without considering risks, particularly for expectant or nursing mothers, young or adolescent children, and couples trying to conceive.
They belong to a group of 1000 plus hormone disruptors, for which the WHO and The Endocrine Society provide scientific data showing strong evidence for links to adverse effects in humans. These include female reproductive disorders (infertility, uterine fibroids, endometriosis, PCOS) reproductive cancers (uterine, breast cancer, and prostate), thyroid cancer, childhood disorders (asthma, ADHD, and autism), neurodegenerative problems (Parkinson’s and Alzheimer’s disease), and metabolic disorders- obesity and type 2 diabetes.
Look for the large molecular size insoluble particles or engineered filters: Zinc oxide, titanium dioxide, encapsulated octinoxate, Mexoryl SX™, Tinosorb S™, Tinosorb M™, Parsol SLX™, iscotrizinol, octyl triazone, and bisdisulizole disodium. They have no entry into blood and none are hormone disruptors or photoallergens. They give balanced protection without any risks to human health or the environment. Unfortunately only the first 4 are made available to Canadians and Americans by Health Canada and the FDA. In N. America Mexoryl SX is usually combined with an undesirable soluble filter.
Search for and be persistent until you find zinc oxide alone in concentrations > 20%, or combined with the efficient UVB filters titanium dioxide or encapsulated octinoxate at 7.5%. You should select an SPF of 25-50 understanding that the majority of sunscreens only achieve < half of their labelled values. Do not plan your exposure time based on the labelled SPF value- cut that calculation by two-thirds based on the performance in sunlight.
Thank you, Dr Dudley! Stay tuned for part two, where Dr Dudley reveals the #1 mistake women make when applying sunscreen and how you can reapply this skincare hero throughout the day – even if you’re wearing makeup. In the meantime, you can find out more about Dr Dudley’s work and Cyberderm here.
What’s your biggest takeaway from this interview?