Better Sunscreen Labels Still May Mislead

Sunscreens that Americans buy this summer should have more accurate labels. Updated rules from the Food and Drug Administration (FDA) took effect in December. But a consumer group says some labels may still be misleading. Sunscreens have a sun protection factor (SPF) to indicate how well they work. The FDA says sunscreens with an SPF of 15 to 50 can claim protection against skin cancer and early aging, as well as sunburn. The FDA says there's no proof that protection increases further for numbers above 50. But an Environmental Working Group survey found higher numbers on 1 out of 7 products. The group checked 1,400 sunscreens. Experts worry that numbers above 50 could encourage people to stay out in the sun longer. The new FDA rules require all "broad spectrum" sunscreens to protect against both UVA and UVB rays. Both can cause skin cancer. UVA rays also cause skin aging. UVB rays cause sunburns. Under the new rules, sunscreens also cannot claim to be "waterproof." They can claim to be "water resistant" for either 40 or 80 minutes. The Associated Press wrote about the rules May 20.

By Howard LeWine, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

It took more than 30 years. But finally sunscreens will need to show accurate labels.

The U.S. Food and Drug Administration (FDA) released new guidelines for sunscreen labels in 2011. The agency told the manufacturers they had a year to get their products tested to comply with the new rules and make the labels accurate. The FDA gave them extra time beyond the one year.

But now the sunscreens you buy must comply with the new rules. They must be tested for protection against ultraviolet A and B rays. UVA rays cause wrinkles. UVB rays cause sunburn. Both can cause skin cancer.

Sunscreens carry a sun protection factor (SPF) rating to show how well they protect against sunburn. SPF is a measurement of how much longer it takes for your skin to turn red from the sun after applying the sunscreen. For example, let's say your skin turns red after 10 minutes in the sun. Sunscreen with an SPF of 15 would prevent your skin from turning red for 150 minutes under the same conditions.

The SPF level must be 15 or higher for both types of rays. Products that don't meet this standard must carry a warning. The American Academy of Dermatology recommends using products with an SPF of 30, up to 50.

The FDA says there's no proof that numbers above 50 provide more protection. Despite that, 1 in 7 product labels still claims an SPF higher than 50, according to a consumer group.

The FDA also requires sunscreen labels to be more accurate with the use of terms. If a label says "broad spectrum," the product must pass tests proving that it truly protects against both UVA and UVB rays. Always choose broad spectrum sunscreens to decrease cancer risk. The rules ban the terms "sunblock," "waterproof" and "sweatproof." Sunscreens can be labeled as "water resistant." They should indicate how long they provide protection after water exposure or sweating, either 40 or 80 minutes.

What Changes Can I Make Now?

Apply sunscreen before you go out. Make sure you apply enough and apply often. Use 1 ounce of sunscreen (a shot glass full) to cover your body and face. Reapply sunscreen right away after swimming or heavy sweating. Apply every 2 hours if you don't get in the water and don't sweat.

Even the best sunscreens can't protect you from all of the sun's rays. Here are some other ways to protect yourself from skin cancers, sunburn and early aging of skin:

• Wear clothing made from tightly woven fabrics or those that absorb UV light.
• Avoid the sun from 10 a.m. to 4 p.m., when its rays are most intense.
• Wear a wide-brimmed hat to keep UV rays off your face.
• Stay in the shade.
• Pay attention to reflections from water, sand and (in the winter) snow.
• Watch for news reports that give the UV index in your area. A UV index reading of 2 or less means low danger from the sun's UV rays for the average person.
• Examine your skin regularly for any new moles or changes in moles. Ask your doctor about any changes you see.

The downside of avoiding the sun and full protection is the risk of vitamin D deficiency. Buy foods and drinks fortified with vitamin D. Or consider a vitamin D supplement. I recommend a vitamin D3 supplement at a dose of 1,000 international units (IU) daily.

What Can I Expect Looking to the Future?

Excessive sun exposure and other sources of UV rays increase the risk of the different types of skin cancer. Of these, melanoma is the one that doctors worry about most. It's the deadliest.

Current research suggests that sunburns, especially before age 19, substantially raise melanoma risk. This likely is true for burns related to indoor tanning as well.