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Sun Protection For The Face

Do sunscreens really work?

A Consultation with Dr. Jennifer M. Segal

Dear Doctor,
I've been using sunscreen for years but, at age 40, I still seem to get “tanned” and my skin is showing signs of aging and sun damage. Do sunscreens really work?

Woman applying sunscreen to her face.

Dear Stephanie,
The harmful rays of the sun, ultraviolet A (UVA) and ultraviolet B (UVB), injure the skin by damaging cells and degrading collagen. Over time, this causes cosmetically undesirable skin changes called “photo-aging,” which include brown spots, uneven skin tone, dryness, and reduced skin elasticity and thickness. Since skin changes in response to sun damage are cumulative and determine the onset and extent of photo-aging, the effects typically appear 20 to 30 years after sun damage first occurs. It is therefore common in your 40s to see signs of early to moderate photo-aging (brown spots, dryness, wrinkles) even if you have used sunscreen in recent years.

One look at children on a beach today (wearing hats, sunscreen and sun shirts) demonstrates how increased awareness of the sun's harmful effects has prioritized sun protection early in life. But those of us who missed this opportunity need not despair — it is never too late to protect our skin from the sun, and sunscreens really do work when used correctly. Studies show that daily application of sunscreen significantly reduces pigmentation and thinning of the skin caused by sun damage. When combined with topical medications, such as antioxidants, alpha-hydroxy acids, and retinoids, sun protection improves skin texture and maintains youthful “dewiness.” Moreover, since our skin's ability to resist solar damage decreases with age, using sunscreen later in life is essential for not only cosmetic benefit, but also skin cancer prevention. Routine, correct use of sunscreen reduces the signs of photo-aging and improves the health of our skin. The true “beauty” of sun protection is that it protects against skin cancer as well as brown spots and wrinkles.

Choosing the right sunscreen matters.

As our understanding of sun damage has increased, so has the array of sunscreens to choose from. The most popular reference used when selecting a product is the Sun Protective Factor (SPF). SPF measures a sunscreen's ability to delay (not prevent) sunburn, which indicates sun-induced cellular injury. SPF 30 means that it takes 30 times longer to burn with sunscreen than without it. Since higher SPFs offer superior protection to lower SPFs, I recommend sunscreens with SPF 30 or higher for daily use, and SPF 50 or higher for more intense sun exposure. Although SPF is based mainly on UVB exposure, both UVA and UVB cause solar damage, and the best sunscreens protect against both. Therefore, in addition to high SPF, choose a sunscreen with “UVA/UVB” protection.

Whether a spray, gel, cream, or lotion, find sunscreen you like to use. Physical sunscreens, such as zinc or titanium dioxide, stay on the skin surface to block and reflect UV. They are well tolerated by sensitive skin but can sometimes appear chalky or clog pores. Chemical sunscreens absorb UV when applied to the skin, they typically feel “lighter” but can be more irritating than physical sunscreens. Antioxidants, such as Vitamin C, reduce sun damage by neutralizing UV-induced free radicals that cause cellular injury. They are useful adjuvants — agents that combine with or add to — but do not replace sunscreens.

Tanning does not substitute for sunscreen.

“Tanning” is the result of UV radiation exposure triggering the skin to make excessive pigment; it is only modestly protective against it — comparable to SPF 3! It is not recommended because the skin thereby incurs further damage. Sunless tanners (suntan in a bottle), moderately increase sun protection if used with sunscreens, but are ineffective protectants alone.

Apply sunscreen generously to the face, neck, chest and any exposed skin surfaces preferably 20 minutes before sun exposure and re-apply frequently throughout the day.

How you use sunscreen matters.

If you are tanning or burning, chances are you are not applying your sunscreen effectively. The standard amount of sunscreen used to determine SPF is greater than most people commonly apply. Consequently, the true SPF on one's skin is frequently lower than the SPF on the bottle. Insufficient application is the primary reason why a sunscreen “doesn't work,” and may even increase sun damage by causing an overestimate of protection and lead to prolonged sun exposure. Apply sunscreen generously to the face, neck, chest and any exposed skin surfaces preferably 20 minutes before sun exposure and re-apply frequently throughout the day. In high sun exposure and humidity, re-apply sunscreen every few hours, and always immediately after water contact or sweating.

I recommend “layering” sunscreens, combining a topical antioxidant with a physical or chemical sunscreen then adding a physical block in your makeup, which allows convenient reapplication. Finally, correct use of sunscreen means combining it with sun protective clothing and sun avoidance; all three are necessary for effective sun protection.



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