Thursday, July 16, 2015

A General Guideline on Sun Protection

Sun protection is one of the most discussed topics when it comes to skincare. I think the reason there is no clear cut guideline for sun protection is because there are so many lifestyle and personal variables involved. Despite the best advice and research, it's ultimately up to each person to figure out what works best for them and their lifestyle. A few general things to get out of the way first:

1. Sun protection is important and necessary. Cancer is the second only to heart disease as the leading cause of death in the United States. Skin Cancer is the most common form of cancer.  All skin cancer prevention revolves around sun protection.

2. Even if that alone doesn't convince you, prolonged sun exposure significantly ages skin.

3. No, the sun is not bad for you. When it comes to personal health, we have the tendency to group things into the "good" and "bad" category. However, it's not that simple. The sun is necessary for sustaining life, plants require sunlight for photosynthesis, which in turn fuels the food chain. Sunlight triggers the synthesis of Vitamin D and has been shown to be effective as an anti-depressive stimulant.

With that out of the way, let's approach the following recommendations with the open mind of cultivating a healthy relationship with the sun rather than one that gravitates toward either extreme of complete fearful avoidance or unrestrained acceptance.

  • Sunscreens offer chemical protection. Chemical sunscreens are often thinner and more quick to absorb into skin however sunscreens must be applied 15-30 minutes before exposure for any significant protection and mostly - some ingredients provide questionable levels of protection and may themselves become volatile under sun exposure. 
  • Sunblocks offer physical protection. Sunblocks are heavier and require more work to absorb into skin. If you're looking for natural/green sun protection, this is where you'll need to look. Newer formulas are getting around the thick/visibility issue by offering tinted formulas that function almost like a BB cream/tinted moisturizer. 
  • It's not just about the sunscreens/blocks: Avoiding direct sunlight by staying in shaded areas, wearing UV deterrent clothing along with sunglasses and hats all help shield skin from potential sun damage.
  • Consider the areas you are most exposed: many men forget to apply product to their ears while women tend to forget ankles. Remember that burns can occur anywhere under prolonged exposure so no area is insignificant.
  • Wear an SPF 15+ when indoors and under low exposure while SPF 30+ is ideal for anything else. There are higher SPFs but the pay-off dramatically decreases beyond SPF 30. The numbers are not on a consistent scale and a SPF 15 will absorb around 93% of UV radiation while SPF 30 increases this to 97%. 
  • Re-apply. Apply your product 30 minutes before going out. Rather than crunching numbers with how long you're outside, the time in between exposure and your SPF -- even the best laid plans are useless if they're hard to follow. I have an easier way to think about re-application. For those in the office with a 9 to 5, once in the morning and once before going out for lunch. Active? Apply again after showering or heavy perspiration. 
  • Waterproof vs Water-resistant. Unless you're planning to swim, opt for the Water-resistant formula which is easier to rinse off in the shower. Water-resistant formulas are designed to withstand exposure to water for 40 minutes whereas waterproof formulas are designed to withstand exposure to water for 80 minutes. 
Top questions:
  • I am Vitamin D deficient, do I still need sun protection? Yes you do. A lot of people are Vitamin D deficient and that is an issue because Vitamin D is important for maintaining cell immunity. If you fall into this camp, I recommend speaking to your primary care physician about adding a Vitamin D supplement. Based on your blood work, they'll be able to work out a dosage with you. The supplement may not be as "natural" as getting your Vitamin D through sunlight synthesis however it outweighs the risks of deliberate sun exposure for this purpose.
  • I live in a cloudy area, do I still need to apply SPF? Yes, 80% of UV radiation is able to penetrate through that layer so while it may not seem like you'll get a burn, the danger is still very much present.
  • Is sun protection more important if my skin is pale? Well yes, because you're more prone to getting a burn which in turn increases the likelihood of melanoma. However it's a misconception that those with darker, more pigmented skin tones do not need as much protection as one of the fastest growing demographics for skin cancer are African-Americans. 
  • What is the best active ingredient to look for in sun protection? There are many active ingredients and you want to look for a product that offers broad spectrum protection. The single most effective active ingredient is Zinc Oxide, which (good news!) is a staple in nearly all natural/green sunblocks and can be found in many broad spectrum sunscreens as well.  Zinc Oxide is one the only ingredients that covers UVA and UVB damage. Nano-particle Zinc Oxide was shown to be potentially harmful but most companies stopped using this form of Zinc Oxide. There are some environmental concerns but if you avoid going into the ocean/sea - you should be fine for the most part.
  • I don't use SPF because it's too heavy and my skin is oily and prone to acne, I know I'm supposed to use SPF so what should I do? On the priority scale, it should be skin cancer > acne right? So let's always make SPF necessary regardless of skin type. Next, experiment with products by going into your dermatologist and asking for light formulas. Often times this doesn't need to be a "oil-free" as even liquid sunscreens can clog pores. Your dermatologist will be able to recommend some good products for you (most of us even have samples on hand). As a general rule, chemical sunscreens are lighter and fast-absorbing compared to sunblocks. For those who adhere to natural/green products, the good news is there are some newer products out that do a pretty good job of being as light as possible for a physical block - also Zinc Oxide can be beneficial for some acne sufferers due to its anti-inflammatory properties.
  • My eyes are very sensitive, should I apply SPF around my eyes? Yes - the skin around your eyes are the thinnest which makes it more susceptible to UV radiation penetration. Most of the time when there is sensitivity to SPF there, it's actually due to the product getting into the eyes which can come from sweat/perspiration and rain so I recommend looking for a water-resistant formula.
  • I know I should protect my lips but I also don't want to ingest the chemicals that I put on my lips, is there any way to get around this? You should protect your lips as they're very much exposed to sunlight. What I'm about to say may come across strange but stay with me: to avoid ingesting your SPF, physical blockers should be avoided because they're meant to stay on skin surface which makes them not very ideal for lips. Instead what I suggest is choosing a chemical sunscreen that you can apply when you know you won't be eating/drinking for the next 30 minutes. Once the SPF absorbs into your skin, you're clear.
  • Are there other products I can apply to help my SPF? Yes! A lot of foundations (especially mineral based formulas) offer SPF. Antioxidant serums are also good at boosting due to their ability to neutralize free radical damage. Look for face oils that have sun protection such as raspberry seed oil, carrot seed oil, sea buckthorn oil, etc. and avoid ones that use photo-sensitizing oils such as citrus oils. 
What products do you recommend?

I like these brands: Elta MD, Coola*, Suntegrity*, Mustela*, Skinceuticals, Avene, La-Roche Posay, Pratima*

*Denotes natural/green options available

If you're purchasing a green physical block, be sure the packaging is air tight as the formula tends to be prone to drying over time, resulting in wasted product. I've seen this happen with sunblocks from John Masters, DeVita and Osmosis. 

I personally use Elta MD Physical sunblock because it's a well-balanced formula although not green as there are some chemicals that help with the texture to make it more easily absorbed. I don't believe these chemicals, used in the amounts presented will harm skin and I think they carry significant benefit in helping the sunblock bond with skin to be more effective. For days when I'm mainly indoors, I like Pratima's Neem Rose Sunscreen which is a very simple formula.


  1. Hi Green Derm,
    I can't thank you enough for all the valuable information you share with all of us (green community) It's so refreshing to get honest feedback from a Dermatologists point of view! Not someone who promotes every brand or new product release in order to make a buck through affiliated marketing or to get free products. I can see why so many people are confused & suffering from skin issue's. Perfect example with the citrus oil. I know people highly recommend using a product that contains this oil as a daily primer, under make up.

    It blows my mind how easily persuade people are by marketing. They fall for all these reviews, must have, summer/fall/winter/spring essentials, top shelf, holy grail, updated daily routine, etc... that are sent out on a daily/weekly basis. How can they not see right through all this bs? I would think less is more and way more beneficial for our skin and health? Please tell me if I'm missing something? I am open to new product's being released. I don't fall into the media hype right away. Occasionally, I think a few are worth investing in, if it's beneficial for me. I don't see your email or where to sign up for your blog? I would like to ask you something without ruffling anyone's feathers! No need for you to get heat for my concerns.

    1. Hi! You can send me emails to greentechderm @ gmail

      I think in general people do have to look to others to see what is working and what is not working so often times if they are drawn to a "personality" it's easy to just believe what they're saying. Have you seen the movie The Joneses? Great example of targeted advertising.

  2. Thank you for the loads of great advice. I have a question on Vitamin D: my dad is a very old school "you don't need sunscreen" type and he gets about 30 minutes of direct sunlight each day as he says that is what the animals do. We have turtles and dogs who do lie in the sunny areas in the house, is there a reason for this? Is what he is doing right?

    1. There are three considerations:

      1. The sun does have anti-depressive properties and basking in the sun is something a lot of animals do to laze around. In nature where food may be scarce, the sunlight provides warmth and helps to regulate body temperature for warm-blooded animals.

      2. One of the great things about advancements in our knowledge is that we discover new ways to live better. It wasn't until really the turn of the last century that cancer started gaining acknowledgement as a serious disease and even now, we still don't fully understand it. So yes, through out history sunscreen was not needed but they also didn't live as long and it was impossible to figure out the prevalence of cancer - which does not mean it didn't exist.

      3. People live very differently now from how we used to live. Our natural habitat is no longer out in the open, we dwell in houses, office buildings, shopping centers, schools, etc. Our skin doesn't quite manage UV light exposure as efficiently as it used to before. In fact even anti-sunscreen advocates recommend building your skin up to tolerance in the sun due to it's inability to suddenly process so much natural sunlight.

      So given all we know now, put on your sunscreen.