Have We Been Overdoing It On the Sunscreen?

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It’s not even Memorial Day yet and I am exhausted by the sunscreen discourse. We’ve already had our annual bout of a celebrity declaring they’ve sworn off SPF, this time under the guidance of a self-proclaimed wellness guru who cites our ancestors’ lack of Banana Boat as evidence that we don’t need the stuff. (As many have pointed out since, those ancestors were dying before the average onset age of skin cancer.) And this is coming on the heels of increasingly high-profile complaints that American sunscreen isn’t effective enough, with much of the blame falling to the FDA, which regulates the product as a drug with all the attendant red tape. (The FDA has not seen fit to approve a new sunscreen ingredient since 1999, leaving us far behind our sunscreen-consuming peers in Asia and Europe.)

The latest article to go viral in my more beauty-centric group chats is titled “Against Sunscreen Absolutism.” Written by Rowan Jacobsen for The Atlantic, it centers largely around the Australian Skin and Skin Cancer Research Centre’s recently updated sun safety guidelines, which acknowledge two facts: 1. Australia has the highest incidence of skin cancer in the world (the majority of which can be attributed to UV exposure). 2. There are health benefits to exposing your skin to the sun (mostly with regard to vitamin D levels). The group’s final conclusion is a break from public health guidance in that it makes three different sets of sun protection recommendations based on an individual’s risk for skin cancer, rather than one sweeping directive for the entire population. (Those with dark skin, for example, are advised that they only need to wear sunscreen when they will be out in the bright sun for an extended period.) Jacobsen notes that the National Health Service in the UK appears on the brink of making similar guidance, but that a spokesperson for the American Academy of Dermatology (AAD) told him simply that the organization cannot recommend getting vitamin D from sun exposure because of the risk for skin cancer.

After more than a decade editing skin-care content, I recognize that the world of beauty journalism can be a bit pushy in its sunscreen evangelism. I recently received a draft of a to-be-published Allure story about sun protection that suggested we should be wearing (and reapplying!) full body sunscreen all day, every day, even in the middle of winter when you have no plans to leave the house. That, I’m sorry, is absurd—but it’s in line with what we’ve heard time and time again from dermatologists who no doubt have seen patients take the inch they’re given and run a mile in the blazing midday sun.

After more than three decades of living as a person in the United States, I also have come to the conclusion that we simply do not do nuance over here. I have loved ones who tell me they never have and never will wear sunscreen, citing concerns over putting “chemicals” on their skin. (They are not, however, opposed to the “chemicals” in the injectable anesthetics they’ve received when having multiple basal cell carcinomas sliced from their bodies.) I fear that any public policy change that acknowledges some sun exposure can have positive health benefits will only empower sunscreen skeptics to turn up their noses, putting them at risk for a disease that will at best require a surgical procedure and at worst kill them. “We know that 90% of skin cancers come from daily unprotected UV exposure,” Mona A. Gohara, MD, a board-certified dermatologist and associate clinical professor of dermatology at the Yale School of Medicine, told me quite plainly when I reached out to her this morning as I sat down to write this story. The numbers on the health benefits of sun exposure remain less cut-and-dried.

Besides, to be clear, even those of us wearing sunscreen daily in keeping with the current guidelines, are getting sun exposure. There’s a reason that the FDA prohibited the use of the term “sunblock” 25 years ago (along with the terms “waterproof” and “all-day protection”). Sunscreen is essentially a filter, helping to minimize our skin’s exposure to the sun—it does not fully block anything. And Allure has reported in the past that, on average, most sunscreen wearers are applying about half of what they would need to get the SPF listed on the bottle. And are they then reapplying every two hours? (I know I’m not. Are you?)

The only way to ensure that nary a UV ray touches your skin when you venture outside would be to wear layers of both sunscreen and UPF clothing from head to toe, reapplying several teaspoons worth of sunscreen every two hours. Dr. Gohara estimates that, on a daily average, about 80% of her patients are wearing sunscreen; only half of those are reapplying every two hours. Maybe 20% wear sun protective clothing, she estimates. And these are people engaged enough in their skin health that they’re seeing a dermatologist (something that the vast majority of Americans do not do regularly, or in many cases ever).

So how many times do we need to have the sunscreen talk? Much to my dismay (sunscreen is, in my opinion, quite dull as far as beauty-adjacent topics go), the limit likely does not exist. Scientific understanding of how much the risks of sun exposure outweigh the benefits can, and should, keep changing as more research is done.

But, for now, I feel compelled to remind you amidst all this chatter about whether the imagined sunscreen lobby has gone too far: There is no medically-backed recommendation that we should toss our sunscreen stash altogether or burn our rash guards en masse. Even research that shows some UV exposure might be beneficial only recommends spending five to 30 unprotected minutes in the sun. (A chemical sunscreen takes 15 to 30 minutes to start working, so this just means applying sunscreen right before you walk out the door.)

We don’t need to be shaming people for walking to their mailbox without reapplying SPF, but we should feel good—obligated even—in offering up our spare sunscreen to the group on a beach day. As with most things in life, the answer likely lies not in extremes but in moderation, though we may never find a way to effectively communicate this widely. “It is a slippery slope,” Dr. Gohara says. “It is like saying it’s OK to smoke half a cigarette, but not the whole thing. UV light is a carcinogen any way you slice it.”

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