Top Facts and Fictions About Protecting Your Skin From the Sun
Skin cancer isn’t the only reason to be diligent about sun protection. Photo: George Marks/Retrofile/Getty Images
Like so many older Canadians, Cyril Kesten, 75, discovered the importance of sunscreen late in life. This spring, he was diagnosed with basal cell cancer and underwent surgery to remove it from his nose. Last week, he got the stitches out.
“I’m assuming I damaged my skin by playing outside without sunscreen when I was a kid,” he says. “I’ve never liked the feel of oily substances on my skin so I haven’t used a lot of sunscreen as an adult.”
A resident of Victoria who spends a few winter months in Arizona, Kesten grew up in Winnipeg where the few months of hot summer prairie sun were something to be cherished. But, sun worshiping without protection can easily turn into sun damage that requires surgery.
Dr. Trevor Born, a plastic surgeon with practices in Toronto and New York, says he sees pre-cancerous lesions and basal cell carcinomas quite often. “Sun exposure is cumulative,” he explains, “and there’s a genetic risk as well. Some people are predisposed to develop skin cancer because there’s a genetic link missing that restores skin to normal after sun damage.
“Other people have pre-cancerous changes that never do convert to actual skin cancer.”
With any skin lesion he says, “It’s better to have it diagnosed early so you don’t risk having a huge hole.”
The holes are repaired, of course, with plastic surgery. Born has done four such surgeries over six years on the nose of his celebrity patient, actor Hugh Jackman.
Non-celebrity Cyril Kesten says his surgeon in Victoria “took a great big chunk out of my nose and then did his plastic surgery magic to cover the wound so that I would look relatively normal. Freezing and Tylenol helped.
“What I’ve learned? Slip, slap and slop. Long-sleeved tops, wear a hat and use sunscreen (no matter what it feels like!).”
Sunblock vs. Sunscreen
Born, whose wife, Dr. Lisa Airan, is a high-profile dermatologist in New York, is more specific about protecting himself from the sun. Tellingly, he uses the word “sunblock” instead of “sunscreen”.
In Hawaii, where he kiteboards, he uses a reef-safe chemical sunblock in the morning, after showering. Later, he adds a physical block. “When used in combination, you get better sunblock. The chemical block gets absorbed into the cells while the physical block stays on the skin. If the physical block smears off, you’re still protected.”
Among the products he uses: EltaMD Skincare UV Clear SPF46; SkinMedica Total Defense + Repair SPF34; Raw Elements Face+Body SPF30; Vertra Sun Care Premium Sunscreen Face Stick Reef Safe Broad Spectrum SPF38; Evasol Mineral Sunscreen 50+.
The idea, he suggests, is to throw on all the protection you can.
But that doesn’t mean that a 100 SPF is twice as good as a 50 SPF.
“Above 50, the SPF doesn’t become much more effective,” he says. Even 30 or 38 SPF is adequate but most important is using enough of the block and how often it’s re-applied. “The effectiveness wears off after an hour or hour and a half and most people put it on once and not again.”
Skin cancer isn’t the only reason to be diligent about sun protection.
Sun damage on the face can cause breakdown of collagen, fine wrinkles and lines,” says Born, “in combination with genetics of aging, weight loss or gain, age-related changes in collagen and volume loss.
“Sun damage is an important factor, for sure. If you’ve never been exposed to the sun, you probably have fairly good quality skin.”
Sunscreen Facts and Fiction
FICTION: The higher the SPF the better. Not really. According to MD Anderson Cancer Centre, an SPF 15 sunscreen blocks 93 per cent of UVB radiation, and SPF 30 blocks 97 per cent. After that, the difference in protection is small. SPF 50 blocks 98 per cent, and SPF 100 stops 99 per cent of UVB rays from reaching your skin.
FACT: You can use sunscreen left over from last year. Sunscreens are required by the U.S. Food and Drug Administration to remain at their original strengths for at least three years. This means that you can use leftover sunscreen from one year to the next. If the sunscreen is past its expiration date or has obvious changes in colour or consistency or smell, discard it. Keep sunscreen out of direct sun after you’ve used it.
FICTION: Any sunscreen with a high SPF rating will protect you from the sun’s rays. Not true. The fact is that only broad-spectrum sunscreen, which protects against both UVA and UVB rays provide necessary protection.
“Both kinds of ultraviolet rays can cause sun damage and increase risk of skin cancer,” according to the Environmental Working Group. “Broad-spectrum products provide protection from UVA rays that are associated with skin cancer, free radical generation and immune harm.”
UVA rays, while slightly less intense than UVB, penetrate skin more deeply. Exposure causes genetic damage to cells on the innermost part of your top layer of skin, where most skin cancers occur. “The sunscreen industry has for too long focused on advertising higher and higher SPF values and UVB rays, not on providing products with stronger UVA protection,” says EWG researcher David Andrews.
A study released by the U.S. Food and Drug Administration scientists in 2019 admitted that current sunscreen standards are inadequate. They said switching to sunscreens with higher UVA protection instead of higher SPFs might reduce skin cancer risks.
FACT: The No. 1 mistake people make is not applying enough sunscreen. So how much should you apply? Experts recommend a shot glass full of sunscreen or about six teaspoons. “The shot glass rule, that’s about one ounce and it’s enough for the entire body,” explains Australian dermatologist Dr. Monee Thomas. Use half a teaspoon on each arm, your face and your neck. Then use one teaspoon on each leg, your chest and back. Apply every two hours.
FICTION: You can get good sun protection with makeup or foundation with an adequate SPF rating. According to Consumer Reports, this is pretty much impossible. Using a foundation or powder that contains sunscreen may be better than nothing, but not by much. The biggest problem with SPF makeup is that it’s nearly impossible to use enough — or reapply frequently enough — to achieve adequate protection. You need to use a full teaspoon of sunscreen to protect your face.
“If you used that much foundation, your makeup would look caked on,” New York dermatologist Dr. Joshua Zeichner, told Consumer Reports. “Think of makeup with SPF like icing on the cake to give added protection over your base layer of sunscreen.”
FACT: It’s important to protect yourself by checking the UV (ultraviolet) factor in the weather report when you plan to be out in the sun, advises the Government of Canada. The higher the UV Index, the stronger the sun’s rays, and the greater the need to take sun safety precautions. In Canada, the UV Index ranges from 0 to 11+.
UV can cause sunburn, eye cataracts, skin aging and skin cancer. The amount of UV that you receive depends on the strength of the sun, as measured by the UV Index, and the amount of time you spend in the sun. If the UV Index is 3 or higher, you need protection, even if it’s a cloudy day.
You can download a free colorful poster and wallet-size card with a UV chart here.
FACT: The SPF number on the container is likely not accurate. Many sunscreens offer just a quarter of their stated SPF protection against UVA rays that increase the risk of skin cancer, a 2021 Environmental Working Group study found.
For the study, EWG scientists tested 51 sunscreens with SPF between 15 and 110.
“Most of the products we tested reduced UV radiation only by half of what would be expected from looking at the SPF on the label,” said study author David Andrews. On average, sunscreens tested in a laboratory but not on people provided a meager 24 per cent of UVA protection, compared to the labeled SPF value. Most sunscreens also failed to live up to boasts of protection related to UVB rays, which are largely responsible for sunburn.
FACT: The EWG provides a free, thoroughly researched guide to sunscreens, including recommendations and ratings. Among their recommended products is Attitude SPF 30 Sunscreen Stick, made in Quebec.