Sunlight contains three different types of ultraviolent (UV) rays: UVA, UVB and UVC. UVC rays are absorbed by the Earth’s ozone layer. However, unprotected exposure to UVA and UVB rays is a major risk factor for skin cancer. Using sunscreen to protect your skin is one of the most important ways you can prevent skin cancer, sunburn and premature aging of the skin. According to the Centers for Disease Control and Prevention, skin cancer is the most prevalent type of cancer in the United States. The American Academy of Dermatology says one in five Americans will develop skin cancer in their lifetime, and nearly 20 Americans will die each day from melanoma, the deadliest form of skin cancer.
But, with all of the sunscreens on the market, choosing the best sunscreen for your needs and lifestyle can result in a paradox of choice. Edit Olasz Harken, MD, PhD, a board-certified dermatologist with the Froedtert & the Medical College of Wisconsin health network and MCW faculty member who practices at the FORME™ Aesthetic and Vein Center, explains the benefits of choosing a dermatologist-recommended sunscreen and answers some of the most common questions.
Drugstore or dermatologist-recommended sunscreen?
Dermatologist-recommended sunscreen is sometimes known as medical-grade sunscreen or pharmaceutical sunscreen, but it is important to know that sunscreens do not require a prescription. All sunscreens are regulated by the U.S. Food and Drug Administration (FDA) as over-the-counter drugs. Because of the abundance and variety of sunscreens on the market, dermatologists curate a selection of sunscreens to make it easier for people to choose products that are safe, effective and may have additional skin health benefits, such as anti-aging properties. Dermatologist-recommended sunscreen often comes from companies that perform additional research or testing on their skin care products, including clinical trials.
“It takes a lot of effort for consumers to decode a sunscreen label,” Dr. Olasz Harken said. “Choosing a dermatologist-recommended sunscreen can take the guesswork out of the process. We tailor the sunscreen to the patients’ skin type, skin cancer risk, lifestyle and medical procedures they may have had.”
The easiest way to purchase a dermatologist-recommended sunscreen is through your dermatologist’s office. The staff at FORME can guide you in making the right selection. If you are sunscreen shopping on your own, there are a number of blogs that list top sunscreen choices recommended by dermatologists that could help point you in the right direction. However, these lists do not usually provide detailed enough information on the recommended products for consumers to make the most informed choice. This is why it is so important to understand the sunscreen bottle’s label — so you know what to look for, what to avoid and you can choose a sunscreen that fits with what a dermatologist would recommend when it comes to ingredients (filters), SPF and other features.
What are UV filters in sunscreen?
Understanding what UV filters in sunscreen are and how they work is the first and most important step to better understanding a sunscreen label. UV filters are the active ingredients in sunscreens because they reflect, scatter and absorb UV light, thereby decreasing UV damage to the skin. No UV filter offers 100% protection. UV filters are categorized by their chemical composition and the spectrum of UV rays they protect against.
“Shorter wave UVB rays damage the outermost layers of the skin and are responsible for direct DNA damage and skin burning, which plays an important role in the development and growth of skin cancers,” Dr. Olasz Harken said. “Longer wave UVA rays penetrate the skin more deeply and are primarily responsible for premature aging, including wrinkles and uneven skin color, but most importantly, UVA rays also increase the risk of skin cancer.”
What is broad-spectrum sunscreen?
Broad-spectrum sunscreen protects the skin against both UVB and UVA radiation. In 2011, the FDA issued new proposed guidelines for sunscreen labeling aimed at making it easier for consumers to choose a safe and effective sunscreen. FDA regulations require companies to undergo testing and meet FDA standards for UVB and UVA protection in order to assign a sunscreen a Sun Protection Factor (SPF) value and label it broad spectrum. All dermatologist-recommended sunscreens should be broad spectrum.
SPF is an important consideration when choosing a sunscreen, but whether or not a sunscreen is broad spectrum is just as important, according to Dr. Olasz Harken. SPF is only a measurement of UVB protection — the rays that cause sunburn — so without the broad-spectrum label, the sunscreen will not protect against UVA rays.
“If you’re using a high SPF, you may think you’re adequately protected because your skin is not actively burning,” Dr. Olasz Harken said. “But, even when there is no burning, without a high UVA protection, the skin is still being damaged. This is why a broad-spectrum sunscreen is so key.”
Mineral vs chemical sunscreen: What’s the difference?
UV filters in sunscreens fall into two categories, mineral, also known as physical, and chemical. Sunscreens with mineral filters are called mineral sunscreens or physical sunscreens, and sunscreens with chemical filters are called chemical sunscreens. Many sunscreens combine both mineral and chemical filters.
Titanium dioxide and zinc oxide are the only mineral filters in sunscreen. Zinc oxide is the only filter approved in the U.S. that offers broad-spectrum protection. All other filters cover only parts of the UV spectrum. Dermatologist-recommended sunscreen generally contains zinc oxide because it offers broad coverage and is proven to be safe for the body.
“Mineral sunscreen filters work mainly by reflecting and scattering the light, and they are effective as soon as applied to the surface of the skin,” Dr. Olasz Harken said. “Since chemical sunscreen filters do not filter out the whole UV spectrum, several filters need to be combined in order to achieve a broad-spectrum sunscreen. They also require more time to settle into the skin after application, so they need to be applied about 15 minutes before sun exposure.”
Chemical sunscreens are cosmetically more elegant as they appear transparent on the skin. They are generally less expensive than mineral sunscreens. Mineral sunscreens are more difficult to formulate, more expensive and may leave behind a white layer after being rubbed into the skin. Tinted mineral sunscreens have a more appealing appearance when applied.
What do I need to know about sunscreen ingredients?
The FDA requires sunscreen companies to list UV filters separately on the product’s label, under “active ingredients.” Only zinc oxide and titanium dioxide — mineral filters — are generally recognized as safe and effective (GRASE) by the FDA. Zinc oxide and titanium dioxide are the main ingredients in most dermatologist-recommended sunscreens.
The FDA says more research is needed on the effects of certain chemical filters in sunscreens because studies have shown they are easily absorbed into the skin and the body. In January 2020, the FDA published the results of a randomized clinical trial in the Journal of the American Medical Association that showed six common active ingredients found in sunscreens absorbed into the bloodstream when applied every two hours. Those same ingredients were also absorbed into the bloodstream with just a single application. This study supported the FDA’s proposal that chemical filters, including those that were studied (avobenzone, oxybenzone, octocrylene, homosalate, octisalate and octinoxate), require additional testing in order to obtain the GRASE designation. However, because sunscreens with these ingredients have been used effectively for decades by consumers, they remain on the market.
These are the 16 active ingredients, or filters, in sunscreen approved in the United States:
Mineral Active Ingredients
- Zinc oxide
- Titanium dioxide
Chemical Active Ingredients
- Aminobenzoic acid
- Padimate O
- Trolamine salicylate
Is higher SPF better?
The American Academy of Dermatology recommends using a broad-spectrum sunscreen with at least SPF 30. If a higher SPF is available, Dr. Olasz Harken encourages you to use it.
“People apply 20-50% of the amount of sunscreen needed to obtain the labeled SPF,” Dr. Olasz Harken said. “FDA testing is performed with 2 mg/cm2 of sunscreen, which is a much larger quantity. So, if your bottle says SPF 50, you may only be applying enough to achieve an SPF of 30 or less.”
What is the best dermatologist-recommended sunscreen for sensitive skin?
If you are prone to redness, irritation and breakouts, look for sunscreens with zinc oxide or titanium dioxide as the active ingredients. For children or people with sensitive skin, dermatologists do not recommend sunscreens with chemical filters. Chemical filters can cause allergies for some people. Avoid sunscreens with fragrances and choose a formulation that is non-comedogenic, which means it will not clog your pores.
What is the best sunscreen for aging skin?
UVB and UVA rays cause premature skin aging, so the best sunscreen for aging skin is a broad-spectrum sunscreen with the highest SPF available. Other ingredients to look for that are available in some sunscreens are antioxidants, like vitamin C, that offer an additional layer of protection against UV rays and environmental damage, collagen-stimulatory peptides, which slow down the aging process by stimulating skin cell renewal and regeneration and lipids that replenish the skin barrier. Dermatologists also recommend water-resistant sunscreens because they tend to stay on the skin longer and do not rub off easily or come off with sweating or water.
Should you wear sunscreen every day?
Applying sunscreen should be part of your daily routine, no matter how much time you plan to spend outdoors.
“Sunscreen is the No. 1 anti-aging cream to use each day,” Dr. Olasz Harken said. “UV rays are always present. If you’re out in full sun, you’re exposed to UVA and UVB rays. Even if the sky is overcast, some rays will reach your skin and most UVA rays can penetrate through a window. Everything adds up, and cumulative sun exposure is one of the main reasons for skin aging and skin cancer.”
Many cosmetic brands have moisturizers that contain sunscreen, but be sure to choose a product that is labeled broad spectrum. Consult with your dermatologist if you’re looking for a daily use product with added benefits. The staff at FORME can help identify a product that can serve as your anti-aging product, moisturizer and sunscreen, all in one formulation.
The bottom line: Four final tips to protect your skin from the sun
Wearing sunscreen is a must to reduce your risk of skin cancer and keep your skin looking youthful, but it is only one component of a “sunsmart” lifestyle.
Follow these four tips from Dr. Olasz Harken to protect your skin from the sun:
- Never intentionally tan.
- When you are outdoors, seek shade as much as possible.
- Use sun-protective clothing as much as possible.
- Apply sunscreen every morning.
In general, Dr. Olasz Harken recommends sunscreens that are:
- Broad spectrum
- Contain only mineral filters
- SPF 50
“It is best to ask your dermatologist which sunscreen is the most appropriate for you based on your skin type, skin cancer risk and lifestyle,” Dr. Olasz Harken said.
FORME Aesthetic and Vein Center carries several broad spectrum sunscreens from trusted brands. If you have questions about choosing dermatologist-recommended sunscreen, call our team at FORME at 414-955-1050, or visit our website to learn more about the medical-grade skin care products available at FORME.