Shielding Kids From the Sun Isn’t Just About Sunscreen

Experts say other steps should include seeking shade, avoiding the most intense hours of sun exposure and wearing hats and clothing to protect the skin.

Comments: 70

  1. Also, remember to put the sunscreen on before going outside. By the time you've caught the kids (and adults) there can already be significant exposure to UV after the walk to the beach and set-up.

  2. A word to the wise. I was a freckle face blue eyed fair skinned kid who spent his teenage summers at the beach in Northern California. My nose and cheeks were sun burnt and peeling for months at a time. My dad warned me but I didn't listen. I spent a couple of years in Hawaii in my twenties. I worked outside, in forestry and construction, without a hat, until my forties. I stopped seeking the sun 25 years ago, but the damage was done. I had the first of four squamous cell skin cancers removed in my thirties; I had the last one removed last month. A few basal cells, including one on my nose requiring Mohs surgery. I see a dermatologist three or four times a year. I wear long sleeved shirts with a collar and a hat with a brim. I seek the shade. I cover up while swimming and surfing, and use sun block on my face. I hit the shade as soon as I'm out of the water. I'm probably an extreme case, but then again I see white guys my age who seem to be in denial of what the sun is doing to their skin.

  3. @Ralph: I was also a child of the 60's, but realized by the time I was 20 that I would never be a bronzed beauty and was a bit more reasonable. My damage was done as well, and I had an early stage melanoma removed two years ago, and a bunch of small things frozen off. A suspicious (although very probably non-melanoma) thingy will be removed from my forehead on Friday. I wear sunprotective clothes all the time (love the fashionable hats they now have) and swim with a full body bathing suit. Folks, know the symptoms of melanoma, and if you had lots of sunburns as a kid, get checked by a dermatologist regularly.

  4. "... [sunscreen] chemicals were absorbed into the blood and accumulated; that is, blood levels rose over the course of several days" After 40 years, it is pretty clear that not going into the sun has adverse health effects, and that sunscreens themselves may have adverse effects as well.

  5. The article doesn't discuss spray-on sunscreens, which I believe are not as effective because the skin is not absorbing the blockers well. They also tend to be inhaled, which can't be good for you.

  6. @Melitta - We use "Badger" Sun protection.

  7. It seems like everything under the sun has side effects. Including the sun!

  8. Any PAH UV filters being banned for toxicity to coral maybe more dangerous for humans, a fact that seems to get lost in recent news coverage. The FDA “watch” list has 12 hydrocarbon (petrochemical) filters as NOT GRASE (Generally Regarded As Safe or Effective). All are mostly UVB filters except avobenzone. They achieve UVB-BIASED filtering to prevent UVB effects but offer little protection for penetrating UVA1 rays, the main driver of skin cancer based on 15 modern papers. High SPF sunscreens (SPF 50+) still have little or no UVA1 protection, and could contribute to the rise in global skin cancer annual rates since 1960, where these sunscreens transmit up to 10X more UVA1 than UVB to your skin. If UVB-BIASED sunscreens may not prevent skin cancer, the Benefit Risk Assessment paradigm of sunscreen use shifts, where any level of risk, however low, may be unacceptable. A 2016 review of 85 papers, reviews from 2018-2019, in humans and lower species found that aromatic hydrocarbon UV filters and phenols change levels of every sex hormone, pituitary hormones, thyroid hormones and growth factors in pregnant and non-pregnant women. A change in a hormone level is evidence of HORMONE DISRUPTION. It is impossible to do definitive studies on toxicity, mutagenic, and epigenetic effects, or to assess the NOAEL (No Observed Adverse Effect Level) in a fetus. The numerous clinical consequences are another matter, and may not be evident for up to 40 years or more.

  9. Benefit Risk Assessment (BRA) is the linchpin of medical management, and a prudent approach to life in general. There are benefits to sun exposure - Vitamin D synthesis, pineal gland stimulation, serotonin and endorphin release which has health benefits and explains why some get immense pleasure from lying in the sun, and nitric oxide production - a benefit in conditions like hypertension and cardiovascular disease. But some skin cancers is attributable to UV radiation. Every 54 minutes someone in N. America dies from melanoma - 80% of which is theoretically preventable. Seeking shade when the sun is most intense is important but may protect against UVB more than UVA. Unlike UVB, UVA intensity is less a function of latitude and time of day. Melanoma may be more common in people who work indoors (Godar 2017) - where increasing UVR doses, did not significantly correlate with increasing melanoma incidence for people with any skin type anywhere in the world. Paradoxically, researchers found significant correlations between increasing melanoma and decreasing UVB dose in Europeans with skin types I-IV. Europeans and Americans in some age groups have significant increasing melanoma rates with decreasing UVB dose, which shows vitamin D3 levels and UVA (315–400 nm) radiation may be more involved. We are exposed to UVA through car glass, windows, and outdoors and with UVB-BIASED sunscreens. This may explain why some broad-spectrum sunscreens do seem to prevent melanoma.

  10. @Denis Dudley MD. Interesting. How does one control for what may be a confounding factor - sunscreens with predominantly UVB protection/little or inadequate UVA protection - allow people to spend far more time in the direct sun without burning - consequently absorbing far more UVA than that would have with no sunscreen at all? i.e.,before sunscreen, people would have been driven to seek shelter from painful sunburns long before they'd had a chance to absorb dangerous levels of UVA.

  11. @Factumpactum Use a sunscreen with balanced protection - high UVA-PF not measured in N. America but inferred from a non-specific test called the Critical Wavelength. Not only is the SPF a hoax- measured in a lab under conditions of use that bear no relationship to REAL Life. When retested in sunlight - most sunscreens test at 10-15 SPF and not the 50-100 on the label. Many contain anti-redness agents -aspirin like - salicylates, bisabolol, niacinamide, aloe vera etc. They blunt your biologic warning signal and allow you to stay out longer instead of seeking shade, while the UVB BIAS radiates you with harmful UVA. • Tanning bed exposure (mainly concentrated UVA1) increases the risk of skin cancer and photoaging. The similarity of this pattern of UV exposure to using a UVB-biased sunscreen either on vacation or every day – escapes our regulators, most physicians (including dermatologists), and the industry. Studies show that UVB-biased sunscreens may be more dangerous than tanning bed exposure. Both provide asymmetric UVA radiation to your skin. A vacation model is acute and intense but what about cumulative everyday exposure with a UVB-biased sunscreen? Outdoor occupations reach or exceed vacation exposure. Since tanning beds cause more skin cancer, then providing a patient with a UVB biased sunscreen is an undesirable measure. There are sunscreens with insoluble particle filters and very high UVA protection that avoid the situation you describe.

  12. I had a niece who hated sunscreen so much as a small child that she called it " sun scream "! My own children would run when they saw me coming because they said I used too much. I grew up in S Texas on the Gulf coast before sunscreen was developed. I had a large basal cell carcinoma removed from the top of my nose about 12 years ago. The surgeon said : " Do not let this happen again because I have nothing left to work with here." He also warned me that if it gets into the cartilage it is disastrous. I love the sun but have trained myself to stay out of it for the most part. My children are sensible but we all love the ocean, hiking and boats. I do think that the little water shirts for girls and boys which are sun protective are a great development and you can get cheap ones at Target. They will wear them because they stay a bit warmer in the pool or the ocean too. I never go out to garden or walk the dog without a good smear of zinc oxide on my nose , cheeks and upper lip. If you just use it for spot protection you do not mind that it is thick and chalky especially if the alternative is what happened to Michael Jackson in terms of cartilage meltdown.

  13. @Consuelo Modern dispersions of 20-25% zinc oxide apply clear. A former First Lady with darker skin uses such a product. Staying out the sun may not protect against melanoma - see my prior comment. The typical sunscreens in stores use avobenzone as the main UVA filter. At maximum 3-4% it only attains a poor UVA-Protection Factor of around 6-8- unable to prevent skin cancer, which modern science shows is driven by UVA mutations moreso than UVB. Avobenzone and all 12 of the filters that the FDA listed as NOT Generally Regarded As Safe or Effective (GRASE) permeate into blood and are bioavailable even to the fetus. Prudent to avoid them particularly when they do not seem to prevent skin cancer. Some are known hormone disruptors related to serious disorders. They are petrochemicals similar to the oil and gas you use in you car. Like other phenols, they behave like DDT and BPA. I would never use them on my grandchildren. Use zinc oxide - you trusted it as diaper cream - now in sunscreens that apply clear. 25% zinc oxide with special particle dispersions apply in a light film and has a UVA-Protection factor of 20.4 about 3 X more than your typical drugstore sunscreen with avobenzone. The common pathway for toxicity to humans and the coral is first PERMEATION, then HORMONE DISRUPTION, DNA mutation and genotoxicity. Coral has an epidermis similar to ours (less complex). An unintended consequence of human use of PAH UV filters may be the degradation of the marine habitat.

  14. I get it. And I used to be a “no going outside without sunscreen” mom, but what are the adverse effects of all this sun protection & avoidance? The NYT has reported on the ineffectiveness of vitamin D supplements. Well, that leaves us with only one other option (essentially) for getting our vitamin D, which is (as I understand it) good & important for all sorts of reasons: moderate sun exposure. I’d love to see a balanced article on how to get enough (but not too much) sun. Avoidance & slathering on sunscreen hardly seems like a sensible solution.

  15. @NSF. Mineral and new insoluble particle filters can reach the high levels of UVA protection needed to prevent skin cancer and photoaging. The future is promising. The uniform reduction of UVB and UVA or “spectral homeostasis" shielding, attenuates the natural spectrum of sunlight without altering its quality, similar to the protection afforded by neutral density filters like densely woven textiles or indoor shade as suggested by Diffey in 1991. This is only possible with efficient UVA filters like zinc oxide and other synthetic insoluble particles. Most only need once a day application, not allowed on labels by regulators. Zinc oxide is a semi-conductor and adheres to your dead skin for 1-2 days (bioadhesive) when properly made.The soluble filters delisted by the FDA wash off and are absorbed into blood and need re-application. My wife - a dermatologist and photobiologist - applies a 25% zinc oxide sunscreen in a special dispersion once per day - she is Irish with fair skin - we spend 4 months a year in The Bahamas and the Caribbean. She snorkels, sails, paddle-boards, and has never re-applied and never gets a sunburn. She is 70 with very fair skin - has never had a skin cancer. A high UVA in a sunscreen to meet the principle of spectral homeostasis like dense textiles requires zinc oxide in 20-25% concentration. Applies clear in a light film with a dry touch sensory feel. can be used even by people with colored skin. Aesthetic and very protective - no slathering needed.

  16. @Denis Dudley MD. Thanks for sharing this helpful information. Like your wife I'm very fair, and have found an absence of visible gross UVA damage (melasma) only after using Ecamsule (trade name Mexoryl SX), even after a brief trip to the Caribbean (in addition to other sun avoidance methods). I'd prefer the formula you describe - is it made in compounding pharmacies?

  17. @Factumpactum The sunscreen is available commercially. I must however disclose that I was involved with its development and I am a principal in www.thesunscreencompany.com. I was a specialist in reproductive endocrinology and maternal fetal medicine and became very concerned, when in 1990, I found avobenzone and oxybenzone in fetal blood. My dermatologist wife and I could not convince anyone that any product safe for the unborn was safe for all, including the coral, so we developed our own. Our second rule is that high UVA will approach the protection of shade and clothing. The 25% zinc oxide is called Simply Zinc Ultra (SZU) and the facialist to Michele Obama recommends it for even people of color. Remember that ecamsule (Mexoryl SX) did permeate at lower levels in the FDA study. We cannot assess toxicity at a cellular level, particularly in young children or the fetus. I will not use ecamsule but like its sister filter Mexoryl LX - a large molecule that will not enter blood and is a good UVA filter. Problem is - it is not found w/o the toxic Polycyclic Aromatic Hydrocarbons just delisted by the FDA. Use 25% zinc oxide. Good old diaper cream - trusted on babies - now transparent. SZU applies clear in a dry touch. It has a UVA-PF of 20.4 tested in EU by HDRS an in-vivo gold standard. This is arguably the highest UVA protection afforded by any N. American sunscreen. Safe for the unborn, safe for humans, safe for the coral, and the best defense against skin cancer.

  18. The parts of the day with the highest sun exposure are also kids' most active times.

  19. Regular, non-burning sun exposure is essential to human health. Here are a few facts: •Seventy-five percent of melanoma occurs on areas of the body that are seldom exposed to sun. •Women who sunbathe regularly have half the risk of death. During a 20-year period compared to those who stay indoors. •Multiple sclerosis (MS) is highest in areas of little sunlight. •A Spanish study shows that women who seek the sun have one-eleventh the hip-fracture. •Men who work outdoors have half the risk of melanoma. • Women who avoid the sun have 10-times the risk of breast cancer. •Sun exposure increases nitric oxide, which leads to a decrease in heart disease risk. •Sun exposure dramatically improves mood through production of serotonin and endorphin. •Those persons who spend many hours daily outdoors have only 1/50 the risk of contracting Parkinson's disease! • Regular sun exposure is associated with about 45 minutes of extra sleep. •For each death caused by diseases associated with sun exposure, there are 328 deaths caused by diseases associated with sun deprivation. •Sun exposure increases the production of BDNF, essential to nerve function. •Sun exposure can produce as much as 20,000 IU of vitamin D in 20 minutes of full-body sun exposure. •In the U.S. vitamin D deficiency in children has increased by 83 times during a 14 year period. That is likely due to indoor living and sunscreen use. More information: Sunlightinstitute.org, and read Dr. Marc Sorenson's book, Embrace the Sun.

  20. This is all such old info, it’s disheartening to see. I guess it has to be repeated every generation. We are so vain and spoiled to think we can put something on our skin so we can spend more time in the sun, but we complain because it’s noticeable to others or that it has questionable chemicals. I have fair skin, and I’ve mostly dropped sunscreen, though I always have some at hand in case it’s needed. Instead, I just don’t spend much time in the sun, especially in the middle of the day, and never am out in it without SPF clothing, hat and sunglasses. I’ve known people with skin cancer, and it seems to really like thin-skinned areas: nose, ears, hands and top of heads. So if I need sunscreen, that’s where it goes.

  21. There are plenty of lightweight sunscreens out there. Wear sunglasses, hat, and protective clothing when you are going out for extended periods of time in the sun. I don't know why half of the comments are so negative. It's better to be safe than sorry. You can still enjoy life and the summer while being safe. I'm taking my precautions, I don't want skin cancer and look like a baked Turkey by the time I'm 40. I wanna age like fine wine.

  22. We've long heard the expression "sunlight is the best disinfectant." It may not be the "best," but it is indeed a disinfectant, because sunlight is radiation. The same type of radiation we get with x-rays, just a different wavelength. While the atmosphere shields us from the most damaging UVC rays, UVA and UVB are still radiation, and are known tumor initiators and promoters. Aside from cancer, the most common manifestation of sun on the immune system for most people is an outbreak of HSV-I after sun exposure. The WHO has has more information on the systemic risks of sunlight on the immune system. Enjoy the sun, by all means, but do it in the early or later hours, and avoid relying on sunscreen as a sole method of sun protection.

  23. I live across from a parklike area, that several area daycare centers use as an outing/recreation area for their little ones. I am constantly amazed by the number of infants who are wheeled around in those "stadium seat" strollers without anything on their almost bald or sparsely-haired babies. I am left to wonder did the daycare center staff forget to put hats on their heads or did parents not leave hats for their babies.

  24. I'm glad the article mentions different skin tones, but I'm disappointed that it doesn't actually go any deeper into the issue or offer practical advice. My husband is black and refuses to wear sunscreen as a matter of principle, even though he's actually very pale-skinned, and he just got a sunburn the other day. I offer sunscreen to him every time we go to the beach (anything less than a beach outing he won't even acknowledge as meriting sunscreen), but he refuses, almost as a matter of pride, because sunscreen is "for white people" who can't take the sun. What's worse is that our children are black/white biracial and even paler, and he resists putting sunscreen on them as well, for the same reasons. He grudgingly allows me to put it on them only because they're young. The kids got sunburns recently, too. This has been an uphill battle, especially because I'm not the fairest kind of white myself either, even though I'm technically white. So there's this general sense of "we're all naturally protected and that stuff is for the inferior others" that I keep having to fight against. I really wish there was more discussion and raising awareness of the issue, and that we talked more about darker-skinned people using sunscreen, to dispel the myths and fight the taboos. To destigmatize it and normalize it more. Because yeah, some people are more protected than others, but very few, if any, are 100% safe, and with summers getting hotter, this will only be more and more relevant.

  25. @Nefertiti - People of color have lower skin cancer rates but have a higher death rate. The lifetime risk for skin cancer in whites in N. America is 1 in 5. Skin cancer accounts for over 50% of cancers in fair skin. 2-4% of all cancers in Asians, and 1-2 % in blacks and Asian Indians. Yet skin cancer takes a greater toll in blacks where the 5-year melanoma survival rate for blacks is 69 % versus 93 % for whites. Bob Marley the iconic reggae singer died from metastatic melanoma, diagnosed late as patients and MDs forget to think of skin cancer. Marley was biracial with an Irish father. African Americans tend to suffer more melanoma deaths than any other ethnic group. African Americans and Asians get skin cancer more on their nails, hands and feet (acral lentiginous melanoma), which is particularly deadly. Caucasians get more cancer in sun exposed skin. Colored skin also needs sunscreen to prevent pigment disorders and skin tags - as in whites high UVA sunscreens with 20-25% zinc oxide will keep any skin looking younger longer. All races need a safe sunscreen - one that does not enter blood. Zinc oxide is safe for humans and coral. Good news! The facialist for Michele Obama says that the former First Lady uses a 25% zinc oxide sunscreen in her daily routine. New zinc oxide dispersions are clear using a scientific process - index matching - it is added to a medium with the same refractive index. Light passes thru w/o bending and the film appears clear to the naked eye.

  26. @Denis Dudley MD. Thank you! I will arm myself with this information in my home battles for sunscreen. I only use zinc oxide sunscreen for the reasons you mention. He has objections about that, too - because it doesn't look good on dark skin - but the pasty effect goes away fairly quickly. I think the bother of sunscreen is a small price to pay when it could help save your life. No risk percentage is small enough when the effort is so little and the price so high if you end up in those unlucky couple percent.

  27. @Nefertiti "My husband is black and refuses to wear sunscreen as a matter of principle,..." The NSW Aboriginal Health Service has a pamphlet called:"Skin Cancer does not discriminate". Says it all.

  28. Hormone disruption in humans is a fact. Vested interests continue to deny, deny, deny, based on outdated studies in rodents and humans. We are not large rodents and endocrine receptor function in humans is unique. A 2016 review of 85 scientific papers and more in 2018 & 2019 show that in humans and wildlife, polycyclic aromatic hydrocarbon UV filters and other phenols (like parabens), change levels of sex hormones, pituitary hormones, thyroid hormones and growth factors in both pregnant and non-pregnant women. A change in a hormone level is evidence of HORMONE DISRUPTION. Clinical consequences are another matter, and may not be evident for up to 40 years or more. Health and lifestyle decisions are personal. I exercise the Precautionary Principle here my grandchildren and patients are concerned. The divide among physicians and coral scientists is already being solved. With the recent FDA proposal, there may soon be only mineral sunscreens available in N. America for use by consumers. I predict that the industry will never meet the burden of proof for safety and efficacy under the FDA Proposal for the 12 polycyclic hydrocarbon filters for one simple reason – they are not safe or effective – never were and never will be. I am going to suggest again to Health Canada and the FDA that since permeation into our bodies is a FACT, then a WARNING label and a CAUTION for pregnancy and lactation is rational, as occurs for virtually any OTC or prescription drug on the market.

  29. Wearing UV protective clothing and sun avoidance is effective and harmless, if one takes Vitamin D. Wearing the wrong sunscreen is NOT, neither effective or safe. 12 Polycyclic Aromatic Hydrocarbon (PAH) UV filters were delisted by the FDA (Category III) - NOT Generally Regarded As Safe or Effective (GRASE). This applies The Precautionary Principle to sunscreens at long last. Studies now confirm that UVA is the main driver of skin cancer and photoaging. All the Category III filters are low Molecular Weight (MW) soluble chemicals that attain blood levels and be BIOAVAILABLE to humans, wildlife and the fetus. These are structural analogues to estrogen, DDT, BPA, and other phenols. All are hormone disruptors. First principle from basic endocrinology – isoform function – chemicals with the same structure will act the same on human cells and bind to the same receptors. Most US sunscreens use avobenzone at 3% or zinc oxide at inadequate levels of 5-10%. IF MEASURED properly this gives a UVA-Protection Factor UVA-PF) of 5-8, unable to prevent the UVA damage that disables the repair gene in human skin. Why use PAH filters that may not prevent skin cancer but affect human and wildlife health? Numerous studies confirm these adverse effects - over 100 last time I looked. I only use a 25% zinc oxide sunscreen on my grandchildren - applies clear, REAL life SPF 50+, UVA-PF 20.4 - no risk of photocontact allergy like PAH filters, no risk to humans and wildlife.

  30. @Denis Dudley MD. If it's allowed to post on here, could you recommend a brand of 25% zinc oxide sunscreen that you trust and are happy with?

  31. @Nefertiti Please assure your husband he will not look like "Casper' with Simply Zinc Ultra - SPF 50 and 25% zinc oxide with a slight tint. He no longer will have any excuse. I have type 5 skin - I am Jamaican of Indian heritage. I wear that 25% zinc oxide every day. I mentioned It in another comment posted here. It has the highest UVA protection of any mineral sunscreen in N. America. The celebrity facialist to Michele Obama recommends all her clients any color skin, and has said publicly that the Former First Lady uses it as part of her daily skin care. Your husband will like it - as it applies dry touch. Even golfers use it as they hate greasy sunscreens getting all over their clubs. Most importantly it is safe for the unborn, young and adolescent children, and couples trying to conceive. Safe for Humans and the entire environment, all wildlife, the coral and vulnerable marine organisms. It is a Win- Win. Safe and effective to prevent cancer and slows the rate of photoaging. Remember despite folklore about genetics, 80% of visible aging is sun damage. Our computer simulation models show that if used daily from teenage years, an Ultra UVA sunscreen will usually ensure that a 70 year old will look 20-30 years younger. .

  32. @Denis Dudley MD. Thank you for the information. I will look for that sunscreen. The aged look doesn't bother me on its own, but I'm very afraid of any kind of cancers, so skin cancer is enough of a deterrent on its own. But yeah, I remember when I first came to the US for college and saw my American classmates' grandparents, I couldn't believe the smooth white skin they had. They were well off and probably sat inside or in shade their whole lives. Compared to my peasant grandparents who worked the fields of Eastern Europe their whole lives, and looked about 50 years older than their white American counterparts...

  33. I'm noticing a trend with dermatologists, which is acting against their intentions of convincing people to use sunscreen, even though I know they mean well. I've noticed it with the dermatologist I see, the one my husband sees, the one my sister sees, and even one pediatrician for my kids. So that would be too much of a coincidence, and I wonder if they are all instructed to say this to their patients, and if yes, why? What they've all been telling us is that we need to wear sunscreen every day, all year round, including in the winter on days when we don't go outside at all!!!! And this is given that we live in Boston, where it's winter pretty much 8 months a year and it's a real, dark, frigid kind of winter. The first time I heard that, I was utterly shocked and though maybe that particular dermatologist was a little over the top. But then I asked around and found that my husband and sister were told the same thing by completely different dermatologists (a second one in Boston and one in Colorado). And now I just don't know what to think. Indoors in the winter up in Boston? Seriously? This is how you lose your credibility as a doctor, and instead, come across as crazy and extreme. Dermatologists are sabotaging their authority on the matter. How am I gonna trust you with summer advice if you tell me to wear sunscreen inside my house in January? Why do they say this? It's counter-productive and will only turn people away from them and their advice!

  34. @Nefertiti Quoting Samer Jaber, MD “UVA are always present, and can penetrate clouds, glass, and deeper into the skin. UVA damages deeper skin layers, resulting in premature aging and increased risk of skin cancer,” Dr. Jaber says. “UVB rays, on the other hand, vary in intensity and season. UVB rays are greater on sunny days during the summer. They damage the more superficial layers of the skin, resulting in sunburns and skin cancer,” he says. The takeaway: UVA rays are potent year-round, therefore your skin needs year-round protection.

  35. Does anybody actually wear sunscreen indoors in the winter though? And what is the actual risk? I don’t mean getting ski goggle tan marks up on the slopes, I mean everyday winter life where you sit at home or in the office all day, and when you do go outside, only your eyes are showing because you’re bundled up and hidden under layers of clothing. What is the real risk then, and how does it compare to the risks associated with having sunscreen on your skin year-round? (If you can’t afford a year-round supply of the expensive “natural” stuff that’s supposed to be harmless).

  36. @Nefertiti I wear a face cream with SPF every day, all year round and my hand cream the I re-apply throughout the day has SPF. . In the winter I am wearing clothing that will block the sun except for my face and hands. So, yes, people wear sun protection allyear roud.

  37. Readers may be tiring of this but a “darkside” to PAH UV filters has emerged. They pollute our bodies, our waterways and oceans, coral and marine wildlife, and definitely affect human health and that of the environment. Industry shrieks as the FDA applies The Precautionary Principle to 12 of these petrochemicals - yes same class as DDT, gas and engine oil. The FDA study on 4 confirmed the obvious - chemicals < 500 Daltons (G/mol) will permeate human skin - established by earlier studies. The FDA has exposed my favorite paradox - an enormous irony – people use sunscreens to prevent skin cancer (and photoaging) – but they clearly do not as global skin cancer rates have almost doubled. Meantime we have polluted our bodies (96.8% of Americans have oxybenzone contamination), and the entire land and marine habitat. PAH UV filters show extreme UVB bias - up to 10 times more UVA than UVB reaches the skin. Asymmetric UVA exposure similar to a tanning bed - less acute and less intense but posing the same risks. UVA drives skin cancer and these global pollutants cannot really prevent skin cancer. SPF cannot guide exposure time as advised. 50 retail sunscreens with label SPF 50 or more had SPF values of 6-10 when measured in sunlight. Recall your last vacation - fair skin likely sunburned despite re-applying every 2-3 hours. UVA-Protection Factor needed to choose an effective sunscreen is missing from our labels. 20-25% clear zinc oxide solves most of these problems.

  38. This time of year, groups like EWG scare people into not using effective sunscreen because chemicals. The FDA tests these products rigorously, showing that the presence of a chemical does not mean it’s poisoning you, and Consumer Reports has a stellar list of the most effective products. Spoiler alert...the least effective ones are “natural” sunscreens.

  39. @Sarah Consumer Reports (CR)merely repeats flawed tests with inter observer and intra-lab variability. The SPF as measured in a lab based on false premises. The lab or label SPF is < 15 compared to the real life value in sunlight. The lamp used emits 290-400 nm based on the false assumption that early erythema was caused by mostly UVB and less so by UVA. Visible Light at 400-740 nm and Infra-red beyond 740 nm may cause 20-30 % of the erythema response. Sun has 5-6 X more UVA than the test lamp hence SPF cannot be used to estimate safe exposure time outdoors. Fair skin mostly sunburns with prolonged outdoor exposure, despite using high SPF re-applied every 2-3 hrs. Professor Brian Diffey (a physicist) confirms that a sunscreen of any label value cannot achieve a SPF > 25 against SUNLIGHT ( not a test lamp in a lab). HDRS is the gold standard for actual protection on human skin - a 25 % zinc oxide sunscreen has a UVA-PF of 20 compared to 5-8 of all the so called "chemical" sunscreens touted by CR. New science shows UVB ( SPF) has less to do with skin cancer, mostly driven by UVA. All sunscreens are chemical organic vs. inorganic. All 12 delisted by the FDA are bioavailable to your brain and the unborn. We have known this since 1998 - kept from consumers. You make the choice. As a physician my sacred trust is "First do no Harm". As a grandparent I err on the side of caution - I choose inorganic sunscreens with ultra UVA protection.

  40. @Sarah Typical organic - linked benzyl rings - UV filters with avobenzone at 3% as the UVA filter - attain a UVA-Protection Factor of 5-8, tested by HDRS (Hybrid Diffuse Reflectance Spectroscopy) and in-silico - both are gold standard - in vivo first and an algorithm - both non- radiating to human test subjects - a serious ethical objection for in vivo SPF, PPD for UVA. Physicists have told FDA and others that these tests do not predict performance in sunlight. They have methodological problems with zinc oxide that must read low. So CR says "natural" products protect less. Natural? Another myth. Minerals ARE STILL CHEMICALS - inorganic made by a geologic system (mother earth). They are now processed, highly refined, milled, doped and coated - “naturally derived” and so altered, they are semi-synthetic not natural. Using accurate and valid tests like HDRS and confirmed in-silico, a 25% zinc oxide in a particle dispersion has outdoor SPF of 50 and a UVA-PF of 20.4 compared to typical 3% avobenzone products at 5-8 regardless of SPF. Zinc oxide is a semiconductor - can be made to bind to dead skin to need once per day application. Final myth - mineral products are not "physical" - they do not reflect or bend light as said by most dermatologists - even old pigment grade reflected only < 15% of sunlight . ALL organic and inorganic filters absorb photons - electrons shift orbits and bad rays are converted to less noxious bands - usually heat. Myths die ever so slowly.

  41. @Sarah -- The FDA is behind the a-ball when it comes to sunscreen protection. European sunscreens offer a more comprehensive protection. EWG does not scare people -- you are not forced to take their advice.

  42. Why is eye protection (sunglasses) not mentioned by any of the physicians in the article?

  43. With all the discussion of sunscreen there has been no mention of sun protective clothing. Clothing made of spf 50 fabric is now widely available. Wearing it negates the need for sunscreen except in the exposed areas. You will be completely protected in and out of the water, and it is more cost effective than total body sunscreen every day for you and your kids. I am a dermatologist and use this for my family and recommend to all my patients!

  44. I’ve been curious about SPF clothing! Do you have any recommended brands?

  45. @Vera You should check out HiHo as a brand. Living in the Caribbean means we have to be incredibly careful about sun protection.

  46. Coolibar is a good brand. Available on their own site and Amazon

  47. Come to Utah where we have the highest skin cancer rates in the Nation. Too often I see barefoot children with no hat or shirt. Parents take the free range approach to the max here.

  48. I am concerned that kids are not getting enough vitamin D from the sun -. It’s important that they get some sun each day without sun screen. Taking a Vitamin D pill is not have the same effects as getting vitamin D from the sun.

  49. @Paul Popick - Its pretty common here for doctors to prescribe Vitamin D due to lack of sunshine. Its been pretty gloomy almost all month and I think today was one of the few days that I put on shorts. But as the sun set, I grabbed a hoody because it got too cold.

  50. Ours is the iodine and baby oil generation. We were encouraged to go outside and stay there until we were called for supper. So, most of us spent our summer vacations living in the sun. Then there was lifeguarding and working in the hay fields. Anyone suggesting sunblock would have been laughed out of the barn. Eventually, Vietnam had it’s turn. The result...18 years and counting of quarterly visits in a medically supervised, dermatological/surgical weight loss program. Smokers sued the tobacco companies for billions. Who is left for us victims of, “get outside and play”, to sue? After surgery I always stop by my grandson’s place for show and tell. Like it matters. Honestly though, knowing what I know now, if given the chance to go back and do it all over again, I wouldn’t change a thing. I loved staying out til supper...chicks dig lifeguards...but, you can have the hay fields and Vietnam. Something is eventually going to kill me, but, with a good surgeon on my side, it ain’t going to be skin cancer. It’s a price I’m willing to pay.

  51. There was a very successful sun protection campaign by the Cancer Council in Australia that promoted the cardinal rules of: Slip on a shirt, Slop on the 50 sunscreen, Slap on a hat, Seek shade or shelter, Slide on some glasses used to block out sun. — "Slip, Slop, Slap, Seek, Slide". Now embedded in Aussie culture.

  52. Chemical compounds in these lotions are breaking down after the lotions are showered off forming a new compound 1-4 Dioxane which enters the water table causing cancers within the body through bathing or ingesting contaminated drinking water. https://www.newsday.com/long-island/environment/1-4-dioxane-lawmakers-1.32820819 Zinc Oxide from sunscreens is bleaching the Earth's coral reefs.

  53. Gee -- born in S.C. raised in OH -- we slathered on the baby oil an iodine to try to get a tan. Seventy five years people did not worry about sunscreen... and sunlight is known to allow the body to produce vit D which along with calcium promotes better bones. I do wear a hat -- sunblock only in special circumstances-- never in NYC... (trying to get a tan on the beaches here many years ago now-- was big problem.) Have had a few major sunburns -- one or two... on shoulders -- keep covered along with face. The modern hysteria I find ridiculous and wonder what goes on with the vit. D level in children. I know there were apparently instances of rickets in protected dark-skinned children. People rarely write about protecting eyes-- cataracts anyone? --and IMO sunglasse do a poor job (need them in snow however) you need a hat.

  54. @Auntie Mame--I grew up in Pennsylvania, and all my teenaged girlfriends and I also did the baby oil thing. We were frying ourselves like french fries! It seems so shocking now. When we were younger, my family went to Atlantic City for vacations, and my mom would put some zinc oxide on our noses and shoulders and send us to play in the sand. That was all the protection we got. My sisters and I were sunburned every year. Of course, I'm paying for it now with dark spots on my cheeks and chest and a few scares with pre-cancers that had to be removed. It was a different time. I don't agree that the concern now is 'hysteria.' Sun damage is a danger and can and should be avoided.

  55. The only common cancer in my family is skin cancer, so I have used sunscreen religiously for decades. If any of you think a suntan is attractive, look at the people you see with saggy skin who look older than their actual age - sun damages the elasticity of the skin and ages the skin even if you are fortunate enough to not need MOHS surgery to remove sections of it. I am 71 and am met with frequent expressions of surprise when my age comes up in conversation. When asked "what's your secret" my reply is always - sunscreen. It's the only makeup I use.

  56. We could adapt the Australian campaigns, mentioned by others. It should be UNTHINKABLE to send a child outdoors without a hat. And long sleeved sun protective clothing should be encouraged. Those of us with a lot of sun damage, or worse, recurrent "minor" skin cancers, or the deadly one, learned through experience that while it was great to be active, the sun is relentless source of damage to our cells. And IF only we had really understood years ago . . . we would have been more careful.

  57. I was shocked on my most recent trip to Puerto Vallarta at the number of infants and toddlers I saw at the beaches and pools. Most wore hats, but their little bodies were exposed to that harsh Mexican sun. There are many nationalities that visit Mexico, so it wasn't only American families that I saw. I did see several moms putting sun screen on their little ones, so I hope that helped protect them. With all the sun-protection clothing and swimwear available now it's hard to understand not dressing young children to protect them.

  58. I am envious of today's children, clad in rash guard clothing + sun hats. We were so stupid. How I wish I was born 30 years later, to sun smart parents in Paris, France, who would clothe me in rash guard + slather my face + neck in aesthetic fragrance free sunscreens from La Roche Posay. The mom would teach me the importance of protecting my face + neck at the very least.

  59. I love a daily dose of Vit D and fresh air (when temps et al are just right). I am a passionate hat-wearer, especially for my eyes. The quality and character of sun light has changed since the 1940s and 50s. It seems stronger, brighter, sometimes more ferocious. On the other hand, perhaps I am more sensitive. I strongly advocate staying indoors quite a lot more or staying a shady places, etc.

  60. People also need to consider the environmental impact of sunscreens. This is being ingested by aquatic life and getting into our water supply. On top of this, there will never be a sunscreen that is as effective as sun avoidance (avoiding the sun during peak hours, wearing a hat, carrying an umbrella, etc.).

  61. What about the chemicals in sunscreen? What kind of endocrine disrupters are being absorbed by the skin? What’s the best option to chemical loaded creams and lotions and what about getting enough vitamin D? I spent years slathering myself with sunscreens and ended up with an autoimmune condition and dangerously low vitamin D levels.

  62. Slip, slap, slop - as Australia has been training kids for years. Slip on a shirt, slap on a hat, slop on the sunscreen and avoid skin cancer.

  63. We also recommend vaccinating them 1-2x per day.

  64. Growing up in Southern California in the 1960s, I and my siblings used to sunburn our backs on purpose for the fun of peeling the dead skin off each other a few days later. (That lovely sensation can be replicated today with a tube of peel-off mask.) Fortunately, by the late 60s my parents caught on and started enforcing the sun screen. Seeing what the sun did to sun worshipers’ skin did the rest. In Italy, people taking their children to the beach usually stay nearby in a hotel or rented house so that they can easily seek shade when the sun is strongest. Clearly they get too much sun anyway, but unlike in California I never saw sunburned Italian children (only Northern European, both because of their lighter skin and because they tended to stay at the beach all day.) I am convinced that, as others have stated, a certain amount of sun is very important for good health, but a little goes a long way, especially if you are light-skinned. And you can keep your face, neck and décolleté protected while getting a bit of health sun elsewhere. I have been using a very nice micronized zinc sunscreen from Australia. I will try the Zinc Ultra mentioned in the comments (numerous times! :-D) by the doctor who developed it. Thanks! Many of my most useful discoveries come from these NYT comments.

  65. “Shielding Kids From the Sun Isn’t Just About Sunscreen” This week I was interested in the article about the effects of sunscreen because I never knew that there are harmful effects of using sunscreen. I thought the more sunscreen the better, but after reading this article I know that sunscreen can be harmful and could release toxins in our blood stream. As a child, I was taught that sunscreen was only beneficial and should be used all day long when I was on vacation or in the sun all day. Now scientists are telling parents to shield the sun with clothing, hats, or shade before using sunscreen. The chemicals that accumulate in the bloodstream when too much sunscreen is applied, rise blood levels. Although the chemicals are not considered dangerous, scientists say that there needs to be more studies done to see if the chemicals in sunscreen are dangerous to others. Not only are the chemicals a threat to humans, but also to the sea life. The harmful chemicals in sunscreen, oxybenzone and octinoxate, are poisonous to animals and plants who live in the sea. Hawaii recently made a law that bans those chemicals in sunscreen to preserve the life of the ocean starting in January 2021. After reading this article, I now know that there are harmful effects of sunscreen. From now on I plan to take precautions when using sunscreen and I plan to try to use shade to block the sun before putting sunscreen on.

  66. "Shielding Kids From the Sun Isn’t Just About Sunscreen" This week I found this article and it interested me because they are now telling us that sunscreen can be bad for us. If you use too much sunscreen then it could rise your blood levels, but if you don't use any or not enough you could get a sunburn. Which could raise the risk of skin cancer and other harmful skin problems. The article is telling us to not use so much sunscreen but to shield the sun from our skin by shade or clothing. I was taught to put on sunscreen when I got outside for a while and to reapply, so that means you use more sunscreen. This article could give mixed feelings to people, they could stop using sunscreen because they think it will harm them, or they could think that they should just not go in the sun too much. People should still be using sunscreen but they should also find other ways to protect them from the sun. Some sunscreens are not harmful and can be used without caution, but some are harmful for the environment. What the article is telling us is to be careful of what sun protector we chose.

  67. The article I picked this week from the New York Times website was an article called,’’ Shielding Kids From The Sun Isn’t Just About Sunscreen.’’ This article caught my eye right away because now that we are currently in summer and spending loads of time in the sun, on the beach, and in the pool, protecting ourselves from the sun is a must do thing to protect our skin from burning from the hot sun. What interested me in this article were a couple of things. Some of which being the topics of skin damage, what sunscreen can actually be doing to your body, and what are some other things to do to protect ourselves from the sun. In this first topic of the article that caught my eye, skin damage by the sun, foreshadows the point of why we should be using sunscreen to protect ourselves from the sun. Some risks we take by not applying sunscreen are stated in the article by Dr. Lawrence F. Eichenfield. He says’’ We know that the sun can have harmful effects including increasing the risk of cancer, sunburn, aging of skin- sun protection makes sense.’’ This quote stated by Dr .Lawrence is telling us that using sunscreen is something to definitely consider using when out in the sun. Especially on hot summer days. The next thing that caught my eye was very interesting because although Dr. Lawrence said that sunscreen is worth using, some may say otherwise. Some sunscreens have a chemical that is released into the skin and can cause damage in the blood stream.

  68. I found this article interesting because the sun is omnipresent and there is no way to not have sun exposure and, knowing what to do to make sure you are safe is important to know. During the summer it is extremely hot naturally so people tend to wear less layers but, that increases the amount of areas absorbing sun. This simple thing that many love summer for can cause us more problems then keeping us cool and looking cute. People just lather themselves in sun screen and expect that to make up for the oppressive sun. Based on the article its more than that which also interested me. Not only is sunscreen required people must use shade as much as possible and as well as hats. This reduces the amount of direct exposure that aids in keeping us safe. As for wearing clothing that covers more parts of the body sounds almost like a joke in the oppressive heat the summer provides but, for the sake of your safety a little more sweat shouldn't be too large of a price to pay no?

  69. Oh, my. How have I survived? My entire youth was spent outside, all summer, no hat, short hair, a good peel to start every summer, and here I am at 74. No cancers so far, but I have real medical problems to distract me, so who knows what might be sprouting on my unexamined dorsal dermis. This all strikes me a bit, well, hysterical. This is a first world problem, created because we have invented some molecules that solve it. Oh, wait, those molecules accumulated in the blood? What's that do? Oh, and they kill the coral reefs? What else do they kill? After all, almost all of those molecules will wind up in water--oceans, great lakes, reservoirs. All of us middle class and up folks, who are consumers of dermatology, can lather ourselves up, but what about the other 90% off humanity? Are they being knocked off by epidemics of skin cancer? Should we start a charity to provide sunscreen for them? We humans have survived for somewhere north of a hundred thousand years, mostly spent working in the sun to grow enough food to continue existing. But we're feverishly enveloping our children in clouds of unknown invented molecules to save them from having my history of sun exposure when they get to my age. I hope this isn't the Thalidomide of this generation...