Media reports on effectiveness of sunscreens can confuse consumers

Consumers often have questions about what kind of sunscreen to use and how to use it because of confusing reports. Dermatologists need to be ready to confidently answer those questions. In the end, the best answer is that data show that using higher SPF sunscreens helps reduce the risk of skin cancer.

“Dermatologists have to understand reports about sunscreens in the media and understand their weaknesses so that when we talk to patients we can be objective,” Darrell Rigel, MD, MS, said in an interview about his Friday presentation, “Does High SPF Sunscreen Offer Better Protection?”

Darrell Rigel, MD, MS

Consumer confusion arises from two annual reports published each May by Consumer Reports and the Environmental Working Group (EWG), said Dr. Rigel, clinical professor at the Ronald O. Perelman department of dermatology at the New York University School of Medicine. He spoke during “Photoprotection” (F043).

“Last year, Consumer Reports said that many sunscreens did not meet their SPF levels in its testing, which is different from the way the government does its testing. That is part of the issue, but the concern was that sunscreens were not meeting their rated SPF,” Dr. Rigel said.

In its report, the EWG lowered its scores of sunscreens if they had ingredients EWG determined to be detrimental or if they were applied as a spray or a powder.

“In that report, nobody had integrated the data to make it be clinically relevant. Some of these reports are taken out of context in terms of risk,” he said. “The other thing is that the sunscreen products they do recommend, if you click on them, they go right to Amazon and they get click-through revenues for them.

“It is not an objective system, but consumers see it. It is important that we, as dermatologists, know this and explain that the rating system is done by looking at ingredients that may not be dangerous whatsoever. It is not really measuring how effective they are in terms of protecting you from sunburn,” Dr. Rigel said.

Another concern of consumers is the effectiveness of sunscreens in reducing the risk of cancer. That is a question answered by many prospective studies, including a recent study that showed regularly using sunscreens rated SPF 15 or greater reduced the risk of getting melanoma by one-third, he said.

Even though it is accepted that the greater the SPF the better, there has been a debate on whether to cap the SPF level at 50. SPF 50 blocks 98 percent of the sun’s rays while SPF 100 blocks 99 percent of the rays, but at a greater cost. In addition, the greater concentration of chemicals required for a greater SPF could lead to more allergic reactions.

An important factor in this analysis is that most consumers do not apply sunscreen at the tested and recommended amounts, so it is not as effective as it could be, but under-applying a higher SPF sunscreen will still provide UV protection at a reasonable level. Dr. Rigel said he recently completed a prospective trial, which has not been published, that backs up this reasoning.

“It was a real-world usage study. This study definitively showed an advantage of SPF 100 over 50. The higher SPF sunscreens do make a difference and protect more effectively,” he said.

  • Dr. Rigel discussed other points about suncreens:
  • Several agents used in sunscreens outside the U.S. could potentially improve sunscreen effectiveness. The Food and Drug Administration has indicated that it needs more data on these ingredients before they can be approved for use, but Dr. Rigel hopes this will be re-evaluated
  • Allergies to sunscreen occur in less than 1 percent of the population. Most issues attributed to allergies are actually a reaction to fragrance or using a heavy sunscreen that may cause acne.
  • The FDA recommends more studies on the impact of zinc nanoparticles in sunscreen.
  • Sunscreens with antioxidants often may have added sub-therapeutic levels so that they may have little impact on UV protection.
  • When using insect repellants and sunscreen, apply the repellant first so absorption into the skin can be minimized.
  • Getting a base tan does not help reduce the risks of sun exposure.
  • Sunscreen may break down in excessive temperatures, such as in cars parked in the sun in the summer heat, where the temperature can exceed 150 degrees. It remains stable in 100-degree weather on the beach.

The best sunscreen? — “The one people will actually apply and use on a regular basis,” Dr. Rigel said.

To learn more about sunscreen ingredients that have not yet been approved by the FDA, visit www.aad.org/dw/monthly/2016/may/a-recipe-for-public-health.

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