As we spend more time outside, it’s important to remember to protect our skin from the sun’s rays. While we know sunscreen is needed, it’s also important to know how to select the right sunscreen. Which chemicals in sunscreens should we avoid? How are manufacturers ensuring their products are safe and effective? And what ingredients provide the best protection against overexposure to the sun? We spoke to David Andrews, PhD, deputy director of investigations and a senior scientist at Environmental Working Group (EWG), about what to look for when buying a protective sunscreen, how to minimize our risk to harmful exposures, a step-by-step approach to protecting our skin, and EWG’s handy sunscreen guide.

Transcript

Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered Podcast. I'm Dr Neha Pathak, WebMD's Chief Physician Editor for Health and Lifestyle Medicine. Even though we usually associate summertime with sunscreen, the truth is we need sun protection all year long. In today's episode, we're going to focus on all things sunscreen and sun protection.

What are the safest steps to protecting ourselves and our skin? How do we make sense of all the labels, SPF, broad spectrum, UVA, UVB, chemical, mineral, and how can we be sure that we're using the safest and most effective products?  

To guide us through this topic is our guest, Dr David Andrews. Dr Andrews is Deputy Director of Investigations and a Senior Scientist at Environmental Working Group. His work focuses on finding ways to protect public health by educating consumers and driving change to government policies and regulations. Dr Andrews has been researching sunscreens for more than 15 years and has published a peer reviewed study on sunscreens with EWG colleagues and a book chapter with researchers in Australia. Welcome to the WebMD Health Discovered podcast, Dr Andrews.  

David Andrews, PhD: It’s a pleasure to speak with you today.

Pathak: Before we jump into our conversation, I'd love to ask about your own personal health discovery, your aha moment around the work that you do specifically around sunscreens.  

Andrews: I've actually been at EWG for just over 15 years now. My oldest just turned 16. So, I also have a few kids and know their response to sunscreen, some positive and some negative. What stood out to me was when I started researching the efficacy of sunscreens. In particular, I'm coming at sunscreen and sunscreen use from the perspective of really long term skin damage and increased skin cancer risk. What really stood out is kind of the lack of scientific knowledge still on what exactly causes in particular increased melanoma risk, and that linkage to sunscreens and some of the uncertainty that has enabled what is somewhat subpar sunscreens in terms of providing UVA protection. So providing protection from a portion of the spectrum.  

Part of that is really a reflection of how sunscreen use has changed incredibly over the decades and the initial products were really just to prevent sunburn. In my family growing up we referred to them as sunburn creams. But it was really that change in use and kind of the lack of really strong protection in the UVA region that stood out to me.

One piece that really stood out is when the FDA published what was more or less their more recent change to sunscreen regulations in 2011. They discussed how sunscreen use was associated with reduced risk of skin damage and skin harm when you use the products because it reduced the amount of UV rays that hit your skin.

But the FDA also noted that the few studies that had looked at sunscreen users found that they actually changed their behavior and spent more time in the sun and were actually getting slightly increased sun damage. There's this juxtaposition of we know UV rays and sun rays can cause skin harm and sunscreens reduce the amount of those UV rays. But if we're using sunscreen and changing our behavior, then we may actually be negating some of the benefits of sunscreen. Those complex science issues have really drawn me into this issue and have kept me kind of focused on trying to understand this and provide guidance to the public for the last 15 years.

Pathak: That's so interesting. Let's start with some definitions of some common terms. We all think of sunscreen as helping to protect us from damaging rays from the sun. Help us break down those components of solar radiation that we're talking about UVA, UVB, visible light, and infrared. Help us think about those different types of solar radiation that we're trying to protect ourselves from.

Andrews: It does get very complicated with the terms. The UV radiation or ultraviolet radiation is sun radiation we cannot see. The radiation is broken into two parts, typically, UVB and UVA, at least in the context of sunscreens. Those UVB rays are the rays most associated with acute damage that's turning your skin red and sunburns. UVB rays are also associated with increased skin cancer risk. But UVA rays are also associated with increased cancer risk as well as skin aging, long term skin damage and impacts on the skin immune system. So the ability to heal from sun damage.

But the original sunscreens primarily just block the rays that cause sunburn and actually led to increased UVA radiation. So it's those two portions of the spectrum that I often refer to. UVB is the portion that causes direct skin damage. You see the impact right away or within 24 hours. The UVA rays penetrate deeper into the skin and are associated with long term skin harm.

Pathak: Tell us about SPF and broad spectrum and some of these terms that we see on the sunscreens that we're buying. What are these different components? What are we supposed to be looking for when we're looking for a good protective sunscreen?

Andrews: I think of a good sunscreen or the ideal sunscreen as something similar to a shirt. A shirt actually provides perfect uniform protection against UVA, UVB rays, and even blocks visible light. People can't see you through your shirt typically, and so that is kind of the ideal. The SPF value in sunscreens is representative of the sun protection value. It comes from a measure of skin redness.  

The way sunscreens are tested, they apply small amounts on people's back, expose them to high intensity radiation for a short period of time, equivalent to, solar exposure, much stronger than the sun, and then look a day later and see how read the skin turned. That SPF number is the direct reflection on primarily UVB protection. The UVA protection or the broad spectrum protection is not incorporated into that SPF or UVB value, although there are some standards in the United States for how much UVA protection is required. The issue is those standards in the United States are very low. They actually lag the rest of the world. In part, that is due to the ingredients available to sunscreen manufacturers in the United States. The underlying concern here is that people are being overexposed to UVA radiation, which is leading to long term skin damage and skin harm.

Pathak: Can we have it all? Do we have products available to us in the United States that provide strong protection and also minimize the risk from certain chemical exposure. Is that a unicorn or can we find that on our shelves in the US?

Andrews: There are good options available. That is an important takeaway. Primarily these are products that are using zinc oxide. These are mineral based sunscreens. Sometimes they can be a little bit whitening, although formulations have improved significantly over the last decade. These zinc oxide mineral based sunscreens do a very good job of providing UVA and UVB protection, They do so without the use of concerning ingredients. There is a space there, and there's definitely options available to consumers, and we have typically directed people to first try those products and potentially you need to try a few different products to find one that works for you. But these zinc oxide based products are the best available option on the market currently

Pathak: What are some of the things we're looking out for if you have skin of color?  

Andrews: That's a really interesting question. I think it reflects a deficiency in both that SPF value and the current structure in the regulations from the FDA on how sunscreens are tested, and how the effectiveness is communicated. Primarily, these are products tested on very light skin types, that are looking for that skin redness.

I don't have a direct answer to that question of if there is no skin redness, how can you be sure that you're protecting the skin because of that lack of direct feedback other than the advice of if you're going out in the sun, especially for prolonged periods, consider covering up using a sunscreen or seeking shade.

I think it's important to come back to that, though, that in the context of sun damage, and sunscreens, the sunscreens alone are not the complete solution here. It is a mixture of wearing a shirt, covering up, seeking shade, and using sunscreens to reduce that overall exposure.

Pathak: I definitely want to talk a little bit more in depth around your step by step approach t