Sun Safety: Vitamin A to Zinc Oxide

Posted on by Matthew Leib. This entry was posted in Staying Healthy and tagged , . Bookmark the permalink.

One in five Americans will get skin cancer in their lifetimes. The deadliest form, melanoma, is actually on the rise with an estimated 90,000 new cases in 2018. It might surprise you to hear it, but Washington has some of the highest rates for melanoma anywhere (4th in the U.S.)—and that includes the part of the state living near Puget Sound.

On Friday, May 18, Dr. Jennifer Gardner shared her insights about skin cancer prevention in a Whole U Speaker Series seminar at the HUB, including information about dispelling common sun- and sunscreen-related myths and misconceptions as well as updates about recent news and research developments.

Here’s a breakdown of what she had to say along with video of her full talk below. So, when you do go out in the sun this spring, summer, and year round, you can stay healthy, protected, and prepared to enjoy your time outdoors to the fullest.

Ultraviolet light is a known carcinogen.

The World Health Organization has declared ultraviolet (UV) light from the sun or from artificial sources such as tanning beds to be a known carcinogen—it causes cancer. Today, tanning beds are required to carry a Surgeon General’s warning that they will cause cancer. UVB rays (B for burning) are the ones that make the skin’s epidermis (outer layer of skin) red.

UVA rays penetrate deeper into a person’s second layer of skin—the dermis—and damage the structure-giving collagen in the skin, causing premature wrinkling and signs of aging. These rays are responsible for causing skin cancer, including the deadliest form of skin cancer, melanoma. Sun-protecting clothing and sunscreens either block or absorb these rays.

Don’t avoid the sun—just be smart about accumulation over time.

“You have to be smart, but you shouldn’t shy away from doing what you love,” says Gardner. “You just have to be smart and prepared about how you do it.” Everyday sun exposure does accumulate over time, she says, adding that the difference can be seen by comparing the top and underside of one’s arms. The more exposure you get, the higher your risk for skin cancers as you age.

“Frequent sunburn as a child or young adult does increase your risk for skin cancer,” Garner says. “Prevention is so much easier than treatment.”

There is no such thing as a “base tan.”

Intermittent sunburn is no joke. Occurring most frequently in instances of vacation or travel, “intermittent sun burn occurs when unprotected skin sees a lot of sun at once,” says Gardner. “Those are really bad for us, even if it’s just happening every year or so. That increases the risk for melanoma especially. There’s no such thing as a safe tan—tan on the skin is your cells’ way of telling you they are getting DNA damage from too much sun exposure.”

Tanning beds. Just don’t.

“We’re really learning this is not a good thing to do,” Gardner says.

Checking for melanoma is as easy as A-B-C-D-E.

  • Asymmetrical spots should get checked.
  • Border areas on skin that appear “scalloped” also beg getting checked.
  • Color, often designated by darkening of skin cells or appearance of multiple colors, is another sign to get checked.
  • Diameter indicates you should get checked when spots on the skin grow larger with time—anything larger than the size of a pencil eraser.
  • Evolution. Pay attention to changes on your skin and get checked when one is observed.

PNW clouds do not make it safe.

“We live in a very deceptive part of the world,” Gardner says. “Sunscreen has to be a year-round commitment if you’re looking to avoid some of that exposure.” Snow, sand, water and high elevations are particular culprits when it comes to reflecting UV lights from all angles.

Sunglasses and shade are your friends.

“Sunglasses should be blocking UV light at 99-100%” Gardner says, also recommending taking care to apply sunscreen as close to one’s eyes as possible as skin cancer near one’s eyes is “not fun” to deal with as you age.

Another easy daily sun-protection ritual Gardner recommends is to find the shade and use it. Wearing sun-protective clothing is another of the surest ways to protect your body from the sun. Wide-brimmed hats go a long way when you’re on the move, says Gardner, who adds, “little decisions made over the course of a lifetime really matter.”

There’s no such thing as “waterproof” sunscreen.

Sunscreens are no longer permitted to print “water proof,” so instead now bear the labels “water-resistant” or “very water-resistant.” That allows you between 40-80 minutes to use the product before you need to reapply, Gardner says. The best bet? To reapply every couple hours.

Use an SPF of 30 or above.

SPF 30 absorbs 97% of UV light. “You may want to think about upping that [SPF] number if you are going to be going to an intensely sunny place,” Gardner says. A 1 oz “shot glass full” of sunscreen is the amount you want to use to cover most of your exposed areas.

Is sunscreen safe?

Yes. No matter what the internet might say, sunscreen won’t give you cancer based on current data. There is currently a legislative debate in Hawaii to prohibit the distribution of sunscreens containing the chemicals oxybenzone and octinoxate, spurred on by their possible impact on sea-dwelling organisms and coral reefs. In the future, there may be bans on how “nano” the nanoparticle sunscreens can get to be deemed “reef safe” but this isn’t currently on the table.

Vitamin D: eat it.

“Getting vitamin D through your skin is not very predictable, nor is it necessarily the best way to get it,” Gardner says. “If you’re being amazing at protecting yourself from the sun, you probably have low vitamin D.” The American Academy of Dermatology has issued the following position statement: “Adequate amount of vitamin D should be obtained from a healthy diet that includes foods naturally rich or fortified with vitamin D. [It] should not be obtained from unprotected exposure to ultraviolet radiation.”


Jennifer M. Gardner, M.D. is an Assistant Professor in the Division of Dermatology at the University of Washington. She specializes in pigmented lesions, melanoma, skin cancer, skin problems associated with chemotherapy or immunotherapies used to treat cancer, as well as general dermatology issues such as acne, psoriasis, atopic dermatitis, and infections of the skin.

2 Thoughts on “Sun Safety: Vitamin A to Zinc Oxide”

On May 21, 2018 at 8:39 AM, Karen Erickson said:

You don’t mention the following: 1) Most people who live in the Seattle area have moved here from other places, and I know some move here to get away from the sun. These folks bring their sun exposure over time with them. Skin cancer arrives 10 to 40 years after exposure, so saying we have the highest rate without mentioning this fact is misleading. 2) Ingredients in sunscreen have NOT YET been proven to cause cancer, but we do know that some ingredients cause allergic reactions, and are found in the blood. Here’s an informative site on this:
https://www.ewg.org/sunscreen/report/the-trouble-with-sunscreen-chemicals/#.WwLlAkgvyUk 3) Using mineral sunscreens is safer – actually wearing clothing is even more safe. You don’t mention this. I had a horrible reaction to chemical sunscreen and it would have been nice to know about this potential before I used it. We need to educate folks on this!

    On May 22, 2018 at 12:03 PM, Matthew Leib said:

    Karen, thanks for your comment. We reached out to Jennifer for some further information, which she addresses in her own words below:

    1) The skin cancer rates are the rates. We should all be wondering why and there are lots of potential reasons on my list including of course that many people got their extensive sun exposure and childhood sunburns in Southern California or other sunny climates before moving or retiring here to the PNW where they develop or have skin cancer diagnosed. But the list of potential factors is much longer than that. We see a LOT of skin cancer in Washington / PNW. The reasons aren’t fully understood and they’re likely multifactorial, but it’s important to understand this area of the country is not “protected” from skin cancer. Understanding this helps in knowing the importance of prevention and early detection efforts, which are important for everyone. It’s important to be mindful of prevention efforts and early detection strategies.

    2) I briefly mentioned the concerns of the Environmental Working Group with regard to sunscreen and some of the controversies, though I didn’t do a deep dive into the studies behind the concern due to the scope of the talk and time constraints – I’ve reviewed all the studies brought up by the EWG. The key is really “NOT YET” – the data that currently exists has not shown there is a health risk to humans. As more studies are performed and more data is gathered, we need to keep an open mind about what it means for our health. Everything that is good for us today may be bad for us tomorrow – I tell people to keep an open mind and consider new data as it becomes available. There is very strong data that sunscreen prevents sunburn and premature aging. We also know ultraviolet light is a known carcinogen. Absolutely, people can have an allergic reaction to sunscreen – it’s generally some of the chemical blocking ingredients that have the highest risk. Sensitized patients should avoid those ingredients as you should avoid anything you’re allergic to and go with a sunscreen with alternate ingredients. I tell my patients to turn over the bottle and look at the “active ingredients” list to tell them what sunscreen ingredients a given product contains. Usually, patients with an allergy to sunscreen do better with the physical blocking sunscreens (zinc oxide or titanium dioxide) – but you can become allergic to other ingredients found in products, as well, so it’s best to test it out in a small amount of skin before applying on large areas. Sunscreen can get absorbed through the skin, but so far, there have been no data proving it’s harmful to human health. If there is a concern while awaiting more data, best to stick with non-micronized physical blocking sunscreen. With regard to oxybenzone, the American Academy of Dermatology’s current summary stance:

    “Oxybenzone: This is one of the few ingredients in sunscreen that effectively protects our skin from harmful UVA and UVB rays. Here are the facts about oxybenzone:
    Approved by the FDA in 1978. No data shows that oxybenzone causes hormonal problems in humans. No data shows that oxybenzone causes any significant health problems. FDA approved for use by people 6 months of age and older.”

    3) I LOVE sun-protective clothing and I DO mention it…before I even discuss sunscreen as a foundation of prevention strategies: wide-brimmed hats, use the shade, wear UV-protective sunglasses and use sunscreen. I also mentioned it as a way to help them take a “less is more” approach to the chemicals should they be worried about themselves (again no data supports that at this time) or for the environment (there is data that the chemicals in sunscreen may be harmful to coral reefs and marine life) – if you cover with UPF50+ clothing (blocks 98% of the sun’s rays, which is as effective as higher SPF sunscreens when used correctly), you don’t have to use as much sunscreen to cover the remaining exposed areas. I told the audience to look for UPF 50+ clothing, which should be stated on the label in garments that have been tested for this property and I told them to follow manufacturers instruction for care of the garment. I also mentioned I look like a bee keeper at the pool or beach because I love hats and sun protective clothing so much. I agree with you, Karen, 100% and I’m trying to educate people on this…I’ll try to emphasize this even more [in future talks].

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