What's the Deal with Sunscreen: Friend or Foe?

Lately, there have been numerous reports surrounding sunscreen....

Questions like "Is it beneficial or harmful" , "Is is worth it for a senior to apply sunscreen", "what difference does it make?" "Are all sunscreens the same? "It sings when I use it, should I try a different one?" "What is the story with the new sunscreen, Mexoryl Sx, that just received FDA approval?"... I will attempt to address some of these issues for you...

1. Recent studies have questioned whether sunscreen is beneficial or harmful. I dont suggest that I know the answer but here is some of the latest opinions... the American Academy of Dermatology, http://www.aad.org still feels strongly that the benefits of use of sunscreen outweighs the potential risks. Despite this , there was another controversial study in the August out of San Francisco by Dr. William Grant, a Ph.D. in the http://www.iiar-anticancer.org/research/research_index.htm Anticancer Research journal that looked at age adjusted types of cancer as plotted by the National Cancer Institute http://cis.nci.nih.gov/ and he found that increase exposure to UVB is associated with a reduced risk of 16 internal cancers, he also went further to show that cancer rates are higher in NE US vs the South and West where levels of environmental UVB is higher throughout the year... he controlled for factors such as smoking, alcohol and ethnicity and he contends strongly, that Vitamin D is critical in reducing the "angiogenesis around tumors, metastasis ....and in helping cell apoptosis". Basically, he is saying that he feels that Vitamin D is critical in reducing the risk for cancer and he feels that Sunscreen may limit the production of critical Vitamin D. Most Dermatologists would argue that throughout the course of the day, even with sunscreen, people get enough sun exposure to generate adequate levels of vitamin D. Dr. Grant asserts that dermatologists dont realize that people get alot of their vitamin D from solar radiation. He advocates going out in the middle of the day for 15-20 minutes so you can create Vitamin D, and minimize the risk of skin cancer. This is controversial as most dermatologists tell you to avoid sun in mid day.

I think this issue is still very, very controversial. From my standpoint, sunscreen clearly makes a difference in reducing the likelihood of getting skin cancer, the most common form of cancer in the United States. I am concerned that studies like Dr. Grants, retrospective multivariate analysis, though statistically sound, are also flawed in their isolation of the importance of the amount of Vitamin D as the critical factor in tumor angiogenesis. I would really like to see a study, that looks specifically at the amount of Vitamin D that is lost through the use of sunscreen and the amount of Vitamin D that is produced by the body in spite of sunscreen all against the amount of Vitamin D shown to be responsible for inhibiting tumor growth. I dont really have an appreciation of this data and thus, before recommending that people go out and get mid day sun and not use sunscreen, I would want more facts and better studies.

Just ask someone, that has had metastatic Squamous cell carcinoma of the skin, a very common scenario, one that accounts for more deaths annually than melanoma. And, one, that is clearly related to sun exposure. I can assure you that they wish that they had used sunscreen.

2. FDA approves new sunscreen...Mexoryl SX , which provides complete broad spectrum UV protection has recently received FDA approval. La Roche Posay http://www.laroche-posay.com/ will maket a broad spectrum sunscreen containing this and Parsol 1789 (avobenxone) and octocrylene. Mexoryl Sx is unique becuase it is highly photostable and filters out UVA and fills the gap left by some UVA sunscreens.

3. Sunscreens are not all the same, generally speaking the recommended sunscreens are those of at least an SPF of 15 and are "broad spectrum" such that they filter UVA and UVB light. After that, the difference really is in the vehicle..ie whether the sunscreen comes as a lotion (more liquid format), a cream, a gel, a stick or a spray on. The main issue here is to use whatever format you prefer as long as it doesnt irritate your skin and that you understand that you need to re apply it after sweating or swimming , for example.

4. Sunscreens are very expensive. Almost cost prohibitive if you use them the way the manufacturer recommends. This is an issue that for some reason is glossed over. I really think the costs of sunscreen is not discussed enough... I would recommend comparing prices via sites on the internet or typical retail outlets. Sometimes more expensive doesnt equate to more effective.

5. Putting aside the controversy of whether or not sunscreen is actually beneficial or harmful until more evidence is presented, I believe that sunscreen should be applied even if you are older and a senior. It is true that much of the sun damage you received is an accumulation over your lifetime, but, the sun you receive as a senior will do much more damage quicker than that same sun would do when you were young. In other words, you may still benefit from sunscreen as a senior and thus you should practice sun safety.