2015 Sunscreen Treatise

I believe sun protection is essential in promoting skin health and there is tremendous misinformation and poor understanding by patients and doctors alike about sunscreen.  When I was in training, some doctors were advocating for patients to use sunscreen, but when I asked what they used they often weren’t using sunscreen themselves.  When I found out about sunscreens that dermatologists were recommending, most of these were because they had a high SPF rating to prevent sunburns, but I didn’t like the feeling on my skin.  Additionally, sunscreens can be irritating to sensitive skin types and some have questioned the safety of utilizing some of the chemicals in some sunscreens.  The science behind sunscreens is significant, so here is my treatise on sunscreen and my advice on choosing the best sunscreen for your skin and finally some of my favorite sunscreens:

Use a physical-based instead of a chemical-based sunscreen for the broadest protection. Chemical sunscreens (avobenzone, PABA, etc) work as resistors of certain wavelengths of ultraviolet radiation and in turn produce heat on the skin surface.  Physical sunscreens (zinc, titanium) work as mirrors on the skin, reflecting the light.  Old physical sunscreens were obvious because it was like paint on your skin, and we saw it used on people who were getting lots of sun (think white-coated noses of lifeguards and surfers).  Nanotechnology and cosmeceutical additives such as hyaluronic acid now make physical sunscreens very elegant and wearable.  I actually prefer the tinted sunscreens for the face, because in addition to blocking UVB and UVA, they block visible light, which is important in melasma and brown discolorations on the face.

SPF isn’t everything.  For a long time, we have been told that SPF30 blocks 97% of the suns rays and that anything higher than SPF30 doesn’t end up giving much additional protection.  Although technically true, this is very misleading.  (1) The SPF number rating only accounts for the erythema or redness protecting ability of the sunscreen from UV-B only.  UV-B is important in the development of common skin cancers like basal cell and squamous cell carcinoma.  Surprisingly, when a sunblock that says it is SPF 100 it doesn’t have to cover a bit of UV-A radiation and UV-A is important not only in the development of melanoma, but is even more important in the development of aging because it brings about brown discolorations wrinkles, loss of elasticity and blood vessels or redness in the skin.  (2) The SPF number rating is based on using 3-4 times the amount of sunscreen that most of us put on our skin.  It requires a tablespoon of sunscreen on your face & neck in order to achieve the actual SPF number rating that is on the label.  The truth is, when you put SPF 30 on your face, most people usually achieve SPF 3 to SPF 5 based on how much they apply.  Although I do not advocate for putting a whole tablespoon on your face and neck, higher SPF ratings than SPF30 will actually give you better protection because we aren’t applying it as thick as they do for SPF testing in the laboratory.  This also may help you understand why the sunscreen added to your makeup isn’t enough. 

“Broad Spectrum” can still legally be narrow

When a sunscreen says it is broad spectrum, it means in addition to the UV-B coverage (SPF) it also covers some UV-A rays.  But a minimum threshold amount of UV-A coverage is not required in order to use that term, allowing manufacturers to literally cover a small 5-10% of the UV-A wavelengths of light to make this claim.  Physical sunscreens cover broadly because they act by reflecting the UV-A rays as well.

A bit on Usage and Activities & Water-resistance

Most of us who love to be outside are active and busy and the last thing we want on our run or bike ride is a mix of sunscreen and sweat getting into our eyes.  Sunscreen needs to integrate with the skin in order for it to function correctly.  This is why labels recommend applying to the skin “at least 30 minutes before activity”.  We have all applied or reapplied sunscreen after we are already out and about, like after 9 holes of golf, only to find it immediately “sweats” off the skin.  I recommend applying a sunscreen to your face and neck everyday in the morning as a part of your routine when your skin is still cool.  For women it can be applied as a primer for makeup and for men as the last thing they do to their face after they shave.  For reapplying during activities, I recommend using spray-can sunscreens because they don’t have to be rubbed in completely and you can keep your hands from getting greasy.  Regarding “waterproof” and “water resistant”, I will just tell you that these are tested in a laboratory environment where sunscreen is on an arm and it is gently placed underwater for a set amount of time.  In the real world where kids are playing in a pool or we are sweating and wiping our forehead, some of the potency of the sunscreens is certainly hampered.  My recommendation is to reapply sunscreen every two hours during water activities, but that a daily application in the morning will minimize damage the most.

Help your skin fight the damage with antioxidants

Sunlight produces an array of damage that end up causing DNA mutations and cell injury with free radicals.  Antioxidants such as green tea, vitamin C, and vitamin E are utilized in your body’s natural defense against oxidative damage from radiation.  Applying antioxidants to the skin and also eating a health diet rich in antioxidants can help your body to repair damage the quickest. 

Visible-Light, Infrared-Light and Heat

New research shows that the visible light and infrared light are a big concern with regard to aging. These wavelengths penetrate deeper than ultraviolet light and are not only produced by the sun, but also by our computer monitors and other man-made sources.  A good tinted sunscreen can help protect your skin from the visible radiation and with Skin Medica’s SOL-IR technology we now can be protected from infrared rays.


These are my favorite sunscreens for your face:

EltaMD UV Physical Broad-Spectrum SPF 41.  Lightly tinted with a matte finish, this has been my go-to sunscreen for people who just need the best protection from skin cancer and also want an elegant formulation.  This is oil-free and good for sensitive skin types.  If you don’t wear makeup or you don’t want to look or feel like you have anything on your face, this is your sunscreen.  This is available in a 3oz tube for $29. 

EltaMD UV Clear Broad-Spectrum SPF 46.  This elegant formulation comes in tinted and white,  and has antioxidants and niacinamide (vitamin B3) to repair damage in the skin and calm and protect acne-prone or rosacea-prone skin.  This daily sunscreen also contains hyaluronic acid and lactic acid which gives a very silky and smooth quality which many women love as a makeup primer. This is available in a convenient 1.7oz pump for $29.

Skin Medica’s Total Defense + Repair Broad-Spectrum SPF34 Tinted SUPERscreen. Powered by SOL-IR™ Advanced Antioxidant Complex , thisproduct adds visible and unprecedented infrared coverage to an excellent physical-based sunscreen.  This is more than just an excellent sunscreen.  Without utilizing any other products, 91% of users said 8 weeks after starting this product, they saw improvement in their skin’s overall health and overall appearance and 90% said they saw improvement in skin firmness, tightness, and elasticity. For minimalists who want a single product to give them proven anti-aging benefits in addition to the most advanced protection, this is the best and is available in a 2.3oz airless pump for $65.