Preparing Patients for the Summer Sun: Derms Debunk 5 Sunscreen Myths

As the countdown to summer begins, so does the mountain of questions from patients about safe and effective sun protection products and strategies. Because these conversations may be difficult, Dermatology Times® invited leading clinicians to support you as you support your patients.

Renata Block, MMS, PA-C, is a board-certified physician assistant at Advanced Dermatology & Aesthetic Medicine in Chicago, Illinois.

Christopher Bunick, MD, PhD, is an associate professor and physician-scientist practicing general medical and surgical dermatology at Yale University in New Haven, Connecticut.

Doris Day, MD, is a clinical associate professor of dermatology at the New York University Langone Medical Center in New York, New York.

Corey Hartman, MD, is the founder and medical director of Skin Wellness Dermatology and an assistant clinical professor of dermatology at the University of Alabama School of Medicine in Birmingham, Alabama.

Debunking 5 Common Myths

Patients often present with misconceptions about sunscreen and sun exposure from social media, the internet, or other unreliable resources. As such, it is important to discuss these issues and help better educate patients.

Myth #1
Sunscreen is carcinogenic.

Bunick encourages clinicians to remind patients that the sunscreen itself protects individuals from skin cancer via UV damage that leads to basal cell, squamous cell, and melanoma cancers.

In May 2021, Valisure, an independent laboratory assessing product quality assurance within the health care industry, found 78 sunscreen and after-sun care products that contained high levels of benzene, a known carcinogen, as a result of the manufacturing process of aerosolized cans.¹ Bunick, who has closely followed the benzene issue, works to educate colleagues and consumers about the long-term adverse effects of benzene and what the future may hold. “The long-term implications of what this contamination means in all types of personal hygiene products remains to be seen. The hope is [that] it means nothing, but we can’t say that right now,” Bunick said.

Day suggests physical sunscreens for those concerned about what is being absorbed. This includes the zinc and titanium products that are not micronized.

Myth #2
I have dark skin, or I don’t burn. I don’t need to wear sunscreen.

Hartman shares that patients with melanin-rich skin have more natural protection, which may prevent skin from developing the minimal erythema dose that leads to damage, sunburn, and skin cancer.

Block takes time to elaborate on how the accumulation of UV radiation can cause damage. Remind patients that sunglasses are worn for that reason, because they do not want UV radiation damage to the eyes, and the same goes for the skin.

Myth #3
I don’t need sunscreen if it’s cloudy or cold.

Bunick tells patients that if they are outside and can see, then there are UV rays. In other words, if they can go out without night vision goggles and do their activities, then there is sun. Thus, if they are outside long enough, they can get burned on a cloudy or rainy day.

Day reminds patients that the temperature outside is not the best measure of danger from UV rays—the time of day is key. UV rays are strongest in the middle of the day, when the sun is straight up in the sky and there is the least amount of shadow. Day tells patients that that time of the day is when the greatest protection is needed, and she suggests to avoid being in the sun, even if it is cold or cloudy. She also uses the term daylight screen instead of sunscreen. Like Bunick, she tells patients that if they do not need a flashlight to see outdoors, then they need sun protection with SPF appropriate clothing.

Myth #4
There’s SPF in my makeup. I don’t need to wear sunscreen.

Block noted that the extra protection is not enough. Makeup uses a dab of product—maybe half the size of a chocolate chip—and 6 to 7 times that amount is needed to get the benefit of the SPF in makeup. The extra protection is great, but extra sunscreen is also needed.

Day delves into data on how the SPF protection in makeup are based on a controlled environment in a lab. In the real world, nobody uses that amount of product—it would result in such a thick coating of makeup that nobody would feel good about wearing. Day tells patients that if they have that same makeup for the entire summer, season, or year, then they are definitely not using enough of it.

Myth #5
My sunscreen is waterproof, so I don’t need to reapply it after swimming or sweating.

Bunick reminds patients that there is almost no sunscreen that is water resistant or waterproof beyond 80 minutes, and most labels indicate water resistance up to 80 minutes. Because 80 minutes is an odd value to say, Bunick tells patients to reapply sunscreen every 2 hours, especially if they are sweating or are in water.

Hartman shares the movement away from the term “waterproof” to “water resistant,” because that means the water can affect it, just not as much as other products that can be more easily washed off. The key is reapplication; in intense sunlight, whether you are in the water, sunscreen should be reapplied every 2 hours. Hartman reminds patients that the normal rigors of being active can make sunscreen break down a little faster, particularly when the UV radiation is very intense.

Reference

1. Valisure detects high levels of known human carcinogen benzene in several sunscreen products and requests FDA actions. Valisure. May 25, 2021. Accessed April 6, 2023. https://www.valisure.com/valisure-newsroom/valisure-detects-benzene-in-sunscreen