The New Rules of Sunscreen: 5 Dermatologists Answer Your 10 Top Sunscreen Questions

thenewrulesofsunscreen

“I can’t. I have a baby.”

One of the most useful phrases, ever. “I can’t hike/swim/play catch on this 100 degree day, because I have a baby, so if you need me, I’ll be inside where it’s cool, counting her tiny toes and drinking tea.” Aaahhh.

My girls are 7 and 9, so my days of “I can’t. I have a baby” are done, which is tragic, because they were so good for my skin. Am I ashamed that I used my precious babies as an excuse to avoid anything involving hot weather, cold weather, and, well, any weather? No. Not really. I like to think I protected their skin, too. And sure, my abs could have benefitted from the exercise, but I can conceal those. This is not to say that I’m not outdoorsy. I adore the outdoors, especially when I can view it from the couch, while drinking tea.

Honestly, you don’t get any medals for going outside, getting sweaty and then having to shower and do your hair again. I checked. All you get is wrinkles.

But let’s just say, hypothetically, that you actually enjoy venturing outdoors, and that my lifelong policy of extreme sun avoidance is not for you. Then you’re going to need sunscreen. Yes, I know that sunscreen is a hot topic right now, and as fraught with danger as a trip down the cereal aisle (are those GMO-laden Corn Flakes?). And that’s why I’m here. I’ve consulted 5 top dermatologists for the real scoop on what works, what doesn’t, and most of all, what’s safe for your family. Check out this star-studded panel of doctors:

  • Dr. Craig Kraffert, MD, Board Certified Dermatologist and President of Amarte skincare
  • Dr. Kavita Mariwalla, , MD, Yale-trained dermatologist practicing in New York
  • Dr. Dimitry Rabkin M.D., F.A.C.S, of Esthetica MD
  • Dr. Janet Prystowsky, MD. Board Certified Dermatologist practicing in New York City
  • Dr. Julia Tzu, MD, Founder of Wall Street Dermatology in New York City

With a lineup like this, I think we’ve got your sunscreen questions covered. So if you’re thinking of venturing outdoors this summer, read on, brave souls, read on. Here, your top 10 sunscreen questions answered.

thenewrulesofsunscreen

  1. Is a higher SPF better?

Dr. Mariwalla: “It’s not that higher numbers ‘don’t matter’ it’s just that the incremental protection they give is less than the number implies. For example an SPF 100 does not block rays twice as much as an SPF of 50. So if a 50 blocks 98% of harmful UV, an SPF of 100 will block 99% (for example). That’s why the FDA came out with their new guidelines – to help prevent consumer confusion… You want to make sure the sunscreen you are using is at least an SPF of 30 and in Florida over the summer, I recommend a 50.”

Dr. Kraffert: “SPF of 30 or higher.  SPF 50+ is the highest recognized by the FDA. Be cautious of package and marketing claims for products with a listed SPF greater than 50+.”

  1. Which sunscreen ingredients should I avoid?

Dr. Tzu: “Ingredients such as Padimate O and oxybenzone are chemical sunscreens that have a higher chance of causing allergic reactions to the skin. Not everyone is allergic to it (in fact, most people are not), but those with sensitive skin may want to avoid these chemical sunscreens.”

Dr. Prystowsky: “Look for mineral sunscreens that use zinc oxide and/or titanium oxide. Chemical sunscreens can soak into our skin and may cause hormone imbalances. While some had concerns about retinyl palmitate reacting with UV radiation, that was debunked. Retinyl palmitate is the main storage form of vitamin A in the liver.  A&D ointment has been a staple for years to treat diaper rash and other irritations of the skin. It has traditionally been made from cod liver oil which has a lot of retinyl palmitate in it. It is safe to use on the skin. Do NOT avoid asunscreen because it has retinyl palmitate in it. It is good for skin. Also do not be lured into herbal and botanical sunscreens as meaning they are safe.  Botanicals and herbs can cause skin allergies so why put them on when they are not necessary! Avoid botanicals and herbal products.”

Dr. Kraffert: “Many less expensive and mass market sunscreens… use homosalate. This ingredient is often used in large percentages and, aside from having a discernable lingering odor, can contribute to a heavy and greasy product feel. It may be better off for those with oily skin and/or breakout tendencies to avoid homosalate containing formulations.”

  1. Does the application method (spray, powder, lotion) matter?

Dr. Mariwalla: “To be honest, powders and towelettes have not been tested as extensively as other vehicles. I also think most people don’t use enough spray to adequately coat their children, though as a mom, I do know how convenient they are! I advise the first layer of sunscreen of the day to be a cream. You can then reapply using a spray when outdoors every 3 hours or every 80 minutes during heavy activity/swimming/sweating. I like the sticks for reapplication on the face.”

Dr Tzu: “All sunscreens minimize the extent of UV exposures. The different vehicles that sunscreens can come in simply reflect personal and aesthetic preference. Spray sunscreen is easier to apply over large surface areas but tend to provide uneven coverage.  It should also be used in well ventilated areas to avoid risk of inhalation. Mineral powder sunscreens may be aesthetically pleasing but may not stay on as long or provide even coverage.  There is also the health risks of inhaling the powder (since it is usually applied to the face).   Stick sunscreens are great for sports because it tends to come off less easily and will not “drip” into the eyes causing irritation.

Technically, the FDA banned powder sunscreens from the US market, although it appears that these products exist. There were safety concerns over inhalation of powder sunscreens and uneven application of powder sunscreens. I would still stick with traditional lotion/cream based sunscreens for the best efficacy.”

Dr. Kraffert:Spray sunscreens are under FDA scrutiny because they often do not deliver the degree of SPF protection indicated on the label and may create hazards such as breathing problems and asthma attacks. The FDA no longer allows marketing of powder sunscreens under its revised (2012) sunscreen rules. The concerns with powder sunscreens are related to nano-sized and micronized zinc and titanium inhalation as well as the possibility that typical application techniques do not result in enough product being applied to achieve the label SPF.  I am not a big fan of powdered sunscreens for three reasons:  1) inhalation associated risks appear real 2) the delivered SPF does not always appear to correlate with the label SPF 3) powder sunscreen products do not provide a uniformly favorable skin aesthetic. As always, there are situations where powdered sunscreens can serve otherwise unmet sun protection/skin care regimen needs. Nevertheless, I do not advocate powdered sunscreens. I have experienced gel sunscreens during my career and do not recommend them. There is no obvious consumer benefit related to the gel formulation.  Gel sunscreens frequently contain high alcohol content, are often runny and greasy, and have a tendency to ball up on the skin.  Furthermore, the durability of protection from gel sunscreens seems more inconsistent than other sunscreen types.”

Dr. Prystowsky: “Keep in mind that you can inhale sprays, have to rub them in, and spray more than you think you need. One pass with a stick isn’t enough. You need to make at least 3 passes to get good coverage. I would recommend it for the face, but otherwise it’s cumbersome. Lotion may not be the most fun option, but it’s the standard and the best I’ve seen so far. A shot glass amount for your body is all you need.”

  1. Are sunscreens safe for children?

Dr. Mariwalla: “Sunscreens are safe in children. Data suggests it is also safe in children under 6 months but most of us tell parents with newborns to protect them with clothing and in shade rather than rely on sunscreen for protection of that delicate newborn skin.”

Dr. Tzu: “… It is important to remember that sunscreen is to be used in children 6 months and older.  Younger children have more sensitive skin and should simply use physical protection and avoid excessive sun exposure. Spray sunscreens should be avoided in young children because of inhalational risk.”

Dr. Prystowsky: “Sunscreen should not be used on children under 6 months of age.  Their skin is very porous and chemicals can penetrate more easily.  Young babies should be kept in the shade.”

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  1. Any tricks to applying sunscreen to young kids?

Dr. Mariwalla: “Just get it on them! For any parent who has tried to put sunscreen on a squirming child, it is difficult and there is unfortunately no trick to it, but I do recommend that you do it before you get to your destination. It should be applied 30 minutes before going outdoors. Also, much easier to not have to compete with the lure of the ocean or park to get kids to stand still. Also recommend that when applying spray, you hold it 6 inches from the skin, spray and then rub it in. You don’t want to create a spray plume that can be accidentally inhaled. I would not rely on [mineral powder sunscreens] for children. You can use them in the scalp because there are limited options for sunscreen on this area of the body.”

Dr. Tzu: “Avoid using spray sunscreens. Use the traditional cream/lotion based sunscreens and spread it evenly to cover sun exposed areas for children.”

Dr. Prystowsky: “Use your hands to apply a lotion sunscreen to the body. Note that sprays run the risk of inhalation. For the face, the sticks work well.”

Dr. Rabkin: “Sunscreens should be applied 20 minutes to a half hour before sun exposure for optimal protection. When it comes to sunscreen, ‘a little dab won’t do ya’. The average adult should apply between 2.5 and 3 ounces (about a shot glass full) for adequate protection.”

  1. Should you use a different sunscreen for the face than you do for the body?

Dr Tzu: “I tend to be more selective and look for higher quality products when it comes to facial sunscreens (it is, after all, your face!). Facial sunscreens should be noncomedogenic to prevent clogging of the pores. Also, I look for products that either come in a matte, tinted finish or contain micronized physical sunscreens so that it does can be applied to the skin without leaving a white frosty residue.”

Dr. Kraffert:Until recently there has been a fairly consistent inverse relationship between SPF levels and the use experience/resultant aesthetic.  This led people to want to use higher SPF products only when absolutely necessary and rely on lower SPF products with better elegance for day to day use.  That inverse relationship is breaking down as seen with newer products like Amarte Ultra Veil.  The biggest product selection reality today relates to the correlation of price and elegance.  More elegant sunscreens really are substantially more expensive to manufacture and thus must be sold at a higher price point.  Elegance and price thus trend together.  Many people these days are opting to choose a more elegant product for daily use on face/neck/décolleté along with a mass market product for outdoor activities requiring widespread use on the body and extremities.”

Dr. Prystowsky: “It is best to use sunscreen that is less likely to run into the eyes or cause complexion problems. Mineral based stick sunscreen is less likely to run into the eyes with sweating. A sweatband worn just above the eyebrows will also block the sun rays and prevent forehead sunscreen from getting into the eyes.”

Dr. Rabkin: “Cosmetics with built-in SPF alone aren’t enough to do the job (and are bound leave you with plenty of unprotected spots, unless you’re into the kabuki look). Treat makeup as an added layer of protection, not your main source.”

  1. What if my skin is breakout-prone? Dry?

Dr. Kraffert: “Sunscreen should feel so good that it becomes part of a pleasurable daily ritual. There should be immediate absorption without visual or tactile residue. There should be a pleasant transient fragrance or no odor at all. There should be no stickiness, greasiness, or shininess. A sunscreen should look and feel good alone, with other skin care, and with makeup. A sunscreen should not cause clogged pores, acne, or rashes. If a sunscreen causes breakout an attempt might be made to figure out which ingredients or what about the formula has caused the breakout.  This may not be possible in many cases but can be helpful when selecting a necessary alternate product. If the breakout is particularly severe it may require treatment as well as an alternate sunscreen. There are combination sunscreen moisturizers. Some are quite good but many are ordinary.  The best way to deal with dry skin is to apply preferred moisturizing products before sunscreen. The oilier a person’s skin, the more they will want to avoid heavier and greasier sunscreen products. The degree of oiliness and greasy feel that a sunscreen produces can be often difficult to ascertain from simply reading the label. Trial of several products may be required. As far as acne goes, most mass market and luxury sunscreen products do not block pores or cause breakouts. Good formulating practices and a competitive marketplace have made products that are prone to causing breakouts surprisingly rare. For those with oily skin and those prone to breakouts, there is no substitute for trying different products to find the ‘perfect’ choice. Look for lighter lotions, liquids and fluids as these tend to be the least greasy in feel and performance.”

Dr. Prystowsky: “For acne prone teenagers, or adults with sensitive skin, the Elta MD UV Clear Broad-Spectrum SPF 46 sunscreen is great for the face. I use [the Avene] Haute Protection Tinted compact that is broad spectrum spf 50 and water resistant.  It is non-comedogenic and is recommended by the Skin Cancer Foundation. It holds up very well in the pool or on the golf course and prevents sunburn. It is not recommended for children, however.”

Dr. Mariwalla: “For acne prone skin I like Neutrogena Clear Skin and Bullfrog gel.”

  1. What if I have allergy-prone skin or rosacea?

Dr. Kraffert: “Sun exposure tends to worsen rosacea so sunscreen is beneficial for rosacea-prone individuals.  There is some anecdotal information suggesting that zinc oxide may be especially beneficial as a sunscreen ingredient for those with reactive and rosacea-prone skin.  Look for zinc oxide in the active ingredient list if you suffer from rosacea tendencies. True allergies to sunscreen products are related to an allergic response to one of the ingredients.  Allergies can occur to any of the ingredients in sunscreen including active sunscreen ingredients.  Allergies to zinc oxide and titanium dioxide, however, are extremely rare.  Sun”screen ingredient allergies in general are also quite rare and most people who develop such a reaction can, with or without the help of a dermatologist, eventually identify their particular problem ingredient.  Once that is done, people with allergies to a particular sunscreen ingredient can simply select from sunscreen products that do not contain that particular ingredient.”

coola-mineral-sunscreen-spf-30Ultra Veilelta-md-physical-sunscreen-spf-41

  1. Which sunscreens do you recommend?

Dr. Mariwalla: “For children, I like Blue Lizard, Badger, Neutrogena Pure and Free and Coola. I would avoid anything that is less than an SPF 30. I also like La Roche Posay Anthelios spray because it sprays like a cream (no plume for kids to inhale).”

Dr Tzu: “The best sunscreen is the one that you will tend to use on a daily basis.  I like the EltaMD and TiZo line of sunscreens because they are aesthetically pleasing sunscreens that I can apply on a daily basis as both cover up (tinted versions are available) and sunscreen. I don’t think I can think of sunscreen brands that I would avoid.  Any sunscreen is better than not using any sunscreen.” 

Dr. Prystowsky: “I have had good experience with over the counter Neutrogena and Aveeno sunscreens and Elta MD sunscreens bought in the doctor’s office. Also the [Avene] Haute make-up sunscreen mentioned above is excellent.”

Dr. Kraffert: “The… main positive sunscreen attributes can be… characterized as follows:

  1. a)            SPF of 30 or higher.  SPF 50+ is the highest recognized by the FDA.  Be cautious of package and marketing claims for products with a listed SPF greater than 50+.
  2. b)            Broad Spectrum rating.  This indicates meaningful protection against both UVB and UVA rays.
  3. c)            Water resistance.  This is important if swimming, excessive perspiration, or repeated wiping of exposed skin is likely.
  4. d)            Anti-oxidants and other bio-active/protective ingredients may be beneficial.
  5. d)            Experience:  Quick absorption.  Pleasant and transient fragrance/odor only.
  6. e)            Aesthetic: Lack of chalky residue.  Lack of greasy texture or stickiness.  Semi-matte finish that is virtually invisible but provides a subtle aesthetic improvement.

Amarte Ultra Veil defines the three main points and six bullet points above.”

  1. What is the best way to treat sunburn?

Dr. Mariwalla: “Cool compresses, topical steroid creams and lots of moisturizer. Remember that a sunburn is a radiation burn so that skin will continue to be sensitive for the rest of the summer.”

Dr. Prystowsky: “If the sunburn is not blistered, it should be treated with topical Aloe or A & D ointment.   An over the counter topical steroid cream or lotion such as 1% hydrocortisone is helpful also. If the person is not allergic to Advil or Aleve (or too young to take these products) these will help minimize the general unwell feeling of a sunburn. If the sunburn is severe and/or there are blisters, medical attention should be sought.”

The bottom line? There is no substitute for an old-fashioned sunscreen lotion (with a physical, not chemical, sunblock) applied to the entire body half an hour before heading outside, and a sunscreen stick for the face. Other sunscreen methods are best saved for reapplication. My favorite trick? Use a foundation brush (its synthetic materials won’t absorb product – I like the brushes from Paula Dorf and Smashbox) to “paint” sunscreen lotion onto your child’s face. The shape makes it easy to cover hard to reach areas (such as under the eye and the earlobes).

I hope you learned something new about sunscreen to better protect yourself and your family this summer!

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