Skin cancer: How much protection does sunscreen buy you? Labels aren't so clear

The sunscreen aisle at your favorite drugstore stocks a mind-boggling array of promises: Waterproof. Anti-aging protection. Broad spectrum protection. Chemical free. Baby tear-free.

So the savvy consumer goes directly to the Sun Protection Factor number. The higher the SPF, the longer you can hang out in the sun without fear of burning, wrinkling or even skin cancer, right?

Think again. The fact is, you can't tell from any of those pretty labels just how much sun protection you are buying.

Bureaucrats, doctors and the sunscreen industry have spent years wrestling over sunscreen guidelines. The Food and Drug Administration, which regulates these products, had hoped to announce a new consumer-friendly labeling system by next month.

But now, as the peak sun season bears down on Florida, that guidance is still far away. Spokeswoman Rita Chappelle said that scientists "hope to have it ready sometime this year." Then it could be at least another 18 months before manufacturers must comply.

Delays and red tape don't shade over reality in the Sunshine State. Doctors have known for years that it is not enough to worry only about sunburn, the focus of the SPF system.

To guard against cancer and skin damage, people need broader protection. And consumers can't really know how much coverage they are getting until the FDA finalizes its proposed four-star ratings system for sunscreen.

"You don't know whether it's a little or a lot. That's a problem," said Dr. James Spencer, a St. Petersburg dermatologist and president of the Florida Society of Dermatology. "It's just unbelievable that it's taken this long."

Sun protection 101

Today's wild-colored sunscreen bottles trace their roots to World War II.

Soldiers sent to the tropics smeared on a primitive sunblock. They helped to popularize the concept back home, where tanning became the rage as highways, airplanes and air-conditioning lured hordes to sunny places like Florida.

But nothing ruins a beach outing faster than a sunburn. With demand growing for better sun protection, the FDA put in place the SPF system, which we have used to pick out sunscreens for the last 30 years.

Here's how it works:

Along with visible light, the sun gives off ultraviolet light that we can't see. One type, UVB, is primarily responsible for sunburn. Protection from UVB is what you're buying when you select lotion by its SPF.

An SPF 15 sunscreen filters out 93 percent of UVB rays. So SPF 30 doubles the protection, right?

Wrong. SPF 30 filters 97 percent of those rays.

"The SPF number was devised by scientists studying the skin,'' Spencer says. "It was never really meant to be a consumer-friendly thing to put on the label."

And SPF doesn't address the longer rays known as UVA light, which penetrate the skin more deeply, contributing to wrinkled and leathery skin. UVA also is linked to melanoma, the most dangerous skin cancer.

You won't get a sunburn sitting near a window, but you can still get a lot of UVA exposure, said Dr. Neil Alan Fenske, chairman of the department of dermatology at the University of South Florida. "More than a high SPF, what's really more important is that we have broad spectrum protection," he said.

Stars for sunscreen

Some day, the FDA could make sunscreen as easy to navigate as restaurant and movie reviews.

Four stars would appear on the products with the highest UVA protection. Potions that don't qualify for even a single star would be labeled "no UVA protection."

The familiar SPF figure would remain, but the FDA wants to rename it the "Sunburn Protection Factor" — and cap the maximum at 50-plus.

The agency would no longer allow sunscreens to promise "waterproof" or "sweatproof" protection. The directions would remind people to reapply at least every two hours, or after swimming and sweating.

At least, that was the plan announced two years ago.

Sunscreen manufacturers say the star system is confusing.

"Our concern was that the stars would be the immediate draw for the consumer and they would base their purchase decision solely on the stars and ignore other information on the label, such as the SPF," said Farah Ahmed, assistant general counsel for the Personal Care Products Council.

She said the labels should also be allowed to say that sunscreens can help protect against aging and skin cancer.

But the FDA has called for a new label warning: "UV exposure from the sun increases the risk of skin cancer, premature skin aging and other skin damage. It is important to decrease UV exposure by limiting time in the sun, wearing protective clothing and using a sunscreen.''

In short, sunscreen is not your best or only defense.

Navigating the risks

Think of sunscreens like a cocktail. Sun protection comes from a mix of ingredients, Fenske says.

Start by looking for "broad spectrum" protection. Ingredients like avobenzone (also known as Parsol 1789), zinc oxide and titanium dioxide shield against UVA light. Fenske advises patients to be "sun smart." Don't think that putting on sunscreen in the morning gives you license to stay outside all day. Seek shade, avoid peak sun hours and wear protective clothing.

When he hits the pool in Key West, Fenske wears a sun-protective wetsuit, a broad-brimmed hat and UV-filtering sunglasses. And he liberally applies sunscreen to his face. "I probably look like a nerd, but I enjoy the pool," he says. "And I don't get a scintilla of redness after being in the pool all day."

Times researcher John Martin contributed to this report. Letitia Stein can be reached at lstein@sptimes.com or (813) 226-3322.

Decoding the label | What to look for

Dermatologists say everyone should use sunscreen, regardless of skin type. Start by finding a sunscreen offering "broad spectrum" protection. That means it shields against both UVB and UVA light. The SPF number tells you about the UVB coverage. SPF 30 protects against 97 percent of UVB rays. So at higher numbers, the returns diminish. Until the FDA gives more guidance on UVA coverage, here are some key ingredients to look for —and examples of just a few of the many sunscreens available that provide them.

Blue Lizard
Australian
Sunscreen

Contains zinc oxide and
titanium dioxide, which help deflect UVA rays. Today these ingredients are available in forms that don't leave a thick stripe on the skin.

Neutrogena
Ultra Sheer
with Helioplex

Contains avobenzone to protect against UVA light, but it breaks down in sunlight limiting its effectiveness. Neutrogena says it has stabilized the UVA coverage with new technologies like Helioplex.

La Roche-Posay
Anthelios

Contains Mexoryl SX, also known as ecamsule, a newer ingredient on the market that protects against shorter UVA rays and is a more stable filter.



Skin cancer

• 53,792 people diagnosed in 2005 in the U.S. with melanomas, the most serious form of skin cancer.

• 8,345 people died of melanomas of the skin.

• Skin cancer is the most common form of cancer. About 65 to 90 percent of melanomas result from UV light or sunlight exposure.

• Lifetime risk of melanoma is about 1 in 50 for whites, 1 in 1,000 for blacks, and 1 in 200 for Hispanics, the American Cancer Society says.

Skin cancer: How much protection does sunscreen buy you? Labels aren't so clear 04/09/09 [Last modified: Wednesday, April 15, 2009 2:51pm]

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