SUNSCREENS—YES OR NO?

Sunscreens Yes or No for a Good Skin

Undoubtedly, wholeheartedly, without question YES! Recent controversy over the role of sunscreens in preventing melanoma and skin cancer have raised questions about the use of these agents. About one million cases of skin cancer a year are diagnosed in the United States, including 41,600 new cases of melanoma. Every hour, one American dies of skin cancer. There are more cases of skin cancer than all other cases of cancer combined. We are in an epidemic. One out of five people will get skin cancer in their lifetime. In 1980 your risk of developing melanoma was 1 in 250. By the year 2023 your risk will be 1 in 25. The Skin Cancer Foundation has emphasized that suntanning and sunburning both result from genetic damage at the cellular DNA level, and should in no way be considered helpful in skin cancer prevention. They are evidence of the body’s attempt to repair UV damage, and any lesions that cannot be repaired increase the risk of all skin cancers. The number of sunburns before age 20 increases the risk of skin cancer much more than sunburns after the age of 20, possibly because younger skin is more susceptible to UV damage. One blistering sunburn doubles your chance of developing malignant melanoma. In fact, some experts believe that sun exposure in childhood and adolescence is perhaps the most important cause of melanomas. Although melanoma is the most frequent cause of death due to skin cancer, all skin cancers can be deadly if left untreated.

Sunscreen use is ONE of the strategies to help prevent this damage. Sunscreens alone do not protect against melanoma and other skin cancers. Unfortunately, some individuals feel that sunscreen should provide enough protection, and they may ignore other sun safety behaviors that could provide additional protection. Subsequently, these individuals may ignore suspicious marks or lessons as potentially dangerous because they feel that sunscreen alone provides all the protection they need. Sun protection should begin at age six months, and continue throughout one’s lifetime. The most Important factor in selecting a sunscreen is its ability to protect the skin from both UVA and UVB ultraviolet light. All sunlight contributes to premature skin aging, wrinkling, sunburn and skin cancer.

In addition to sunscreens, sun safety should be practiced at all times. Always cover up with protective clothing and a hat—preferably one that has a four inch rim. Each inch of hat brim cuts your risk of skin cancer by ten percent, since two-thirds of all skin cancers occur on the head and neck. Avoid the midday sun between 10 A.M. and 4 P.M., and regularly use a sunscreen with an SPF of 15 or greater on all exposed skin surfaces, even on cloudy days.


Dr. Skellchock is Clinical Associate Professor of Dermatology at the University of California, San Francisco, and a dermatologist at Kaiser Permanente in South San Francisco