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As the weather gets warmer and the days get longer, it’s tempting to rush outside to soak up the sun. But without proper protection, catching rays on the regular can substantially increase the risk of developing skin cancer.
Anyone can get skin cancer, regardless of age, gender, race, or skin color. In fact, one in five people will develop skin cancer by age 70. Babies, older people, and anyone who works outdoors should take special precautions against the sun’s harmful ultraviolet rays.
Not only can sunburn accelerate skin aging, it’s the main cause of most cases of skin cancer such as basal cell carcinoma, squamous cell carcinoma, and melanoma. While most skin cancers are treatable if detected early, melanoma is very dangerous and can spread to other organs if it isn’t caught right away.
The good news is, there is a simple and cost-effective cancer prevention tool to significantly reduce skin cancer risk: sunscreen. Patients often ask, “What is the best type of sunscreen for my family?” The quick answer is, the best sunscreen is one you’ll use regularly and reapply often.
There are several brands and formulations of sunscreen with various ingredients that work well for all types of fun in the sun. But most people don’t use sunscreen properly—or reapply it often enough.
Let’s discuss the common types of sunscreen, best practices for making the most of sun protection, and what to do if you spot something unusual when checking your skin.
Two types of sunscreen: Chemical and physical.
There are two main categories of sunscreens: chemical and physical. Differences in active ingredients impact how each type behaves on the skin.
Both types will offer protection from the sun if the sunscreen is:
- Broad-spectrum, protecting against both UVA and UVB rays
- Sun Protection Factor (SPF) of 30 or higher. SPF 30 blocks 97% of the sun’s rays—I recommend SPF 50
- Water-resistant
Chemical sunscreen.
Like a sponge on the skin, chemical sunscreens work by absorbing the sun’s rays and converting them to heat. This type of sunscreen tends to be easier to apply and doesn’t leave much white residue. Remember to reapply—chemical sunscreens should be used every two hours, even when your skin is not wet.
The U.S. Food and Drug Administration (FDA) has noted that some ingredients in chemical sunscreens can be absorbed into the bloodstream. It’s important to note that these findings do not mean the FDA has concluded that any of the ingredients tested are unsafe for use in sunscreens.
Reports have indicated that benzene, a carcinogen, was found in some sunscreens. This was due to manufacturing contamination, which was limited and contained. Benzene is not an ingredient in sunscreen. Oxybenzone, found in chemical sunscreen, is different from benzene and has been approved for use by most countries, including the U.S.
We know that exposure to UVA and UVB rays can cause cancer. If you are concerned about the ingredients in chemical sunscreens, choose a physical sunscreen instead.
Physical sunscreen.
Physical sunscreens work like a shield, covering the surface of the skin and deflecting the sun’s rays. They are not absorbed and can leave a white residue on the skin. That’s because their active ingredients, like zinc oxide and titanium oxide, contain molecules far too big to penetrate the skin.
These sunscreens are ideal for toddlers and those with sensitive skin or acne. Their mineral-based, natural ingredients are gentler on the skin than chemicals and less likely to irritate the eyes. Physical sunscreens tend to feel heavier because they are more moisturizing and can be difficult to blend into the skin. Modern formulations offer matte and tinted versions to give a more even appearance and are easier to apply and wear.
Whether physical or chemical, it’s important to use sunscreen when you go outdoors, and reapply it often—particularly for people at increased risk of skin cancer.
Extra precautions for people at higher risk.
While everyone needs protection from the sun, some people need to take special care to protect against skin damage.
Toddlers and Young Children: Limit exposure.
Young skin is sensitive and requires special care. Resist the urge to take baby to the beach right away, as anyone under six months of age should not be directly exposed to the sun for extended periods.
After your child is six months old, choose a physical sunscreen that offers broad-spectrum protection, is water-resistant, and is rated SPF 30 or higher. Some companies produce special sunscreens for infants and toddlers that may be gentler on their sensitive skin.
In general:
- Keep young children in the shade as much as possible.
- Dress them in long sleeves, pants, a wide-brimmed hat, and sunglasses.
- Make sure they drink plenty of fluids to avoid overheating.
- Reapply sunscreen every two hours or a little more frequently if they’re playing in water or getting toweled off often.
- Take your child indoors if they are fussy, crying, or have redness on exposed skin.
Older people: Compounding effects.
Spending more years in the sun can increase seniors’ risk for skin cancer. Long-forgotten sunburns add up, as damaged cells can multiply—in fact, most cases of skin cancer are identified in people older than 65.
A survey by the Centers for Disease Control Preventionfound that only about 15% of older adults regularly use all five ways of protecting themselves from the sun. These include:
- Stay in the shade
- Wear sunscreen
- Wear a wide-brimmed hat
- Wear long pants to the ankles
- Wear a long-sleeved shirt
Shield yourself from the sun with sunscreen and protective clothing whenever you go outside to reduce your risk. You’re never “too old” to protect your skin from damage.
Outdoor workers: Dress to protect.
People who work outdoors can quickly accumulate a lot of sun exposure. It is especially important to be thoughtful about clothing choice when working outside.
Clothes labeled “UPF” or “Ultraviolet Protection Factor” can significantly reduce skin cancer risk by blocking UV rays. The UPF rating indicates how much UV radiation a fabric permits to reach the skin. For example, a UPF 50 fabric allows just 2% of the sun’s rays to get through. Look for a UPF of at least 30 for the best protection.
In addition to UPF, check clothing for the following factors:
- Color: Dark and bright colors absorb more UV rays, keeping them from harming the skin.
- Construction: Densely woven cloth like denim is more protective than loosely woven fabrics like linen.
- Content: Unbleached cotton, shiny polyesters, and high-tech fabrics can all help prevent skin damage.
- Fit: Loose-fitting clothing provides more even protection.
- Coverage: The more skin under clothes, the less exposure to the sun.
- Activity: Clothes that get stretched or wet will lose some protective ability.
Beyond clothing, be sure to always wear plenty of sunscreen on all exposed skin and take a break to reapply every two hours.
Best practices for using sunscreen.
Use sunscreen whenever you go outside, even on cloudy days. As much as 80% of the sun’s UV rays can reach exposed skin when clouds are overhead. Apply sunscreen to all exposed skin 15 minutes before going outside, and pay special attention to these commonly missed areas:
- Middle of the chest
- Top of the scalp and part in the hair
- Hairline, including along the forehead
- Tops and backs of ears
- Back of the neck
- Back of the hands
- Tops of the feet
Sunscreens come in many formats, including lotions, sprays, and gels. Each have their benefits and best uses.
Lotions and sprays are easy to apply. Beware of wind when using sprays, and never use them around an open flame, as they are very flammable. Don’t forget to rub in the spray for even coverage.
Gels are great for hairy areas, as they can penetrate to reach the skin. A cream or stick may be more effective for application around the eyes.
Products that combine sunscreen with moisturizers and cosmetics are convenient but must still be reapplied often for sun protection. The American Academy of Dermatology recommends avoiding products that combine insect repellant and sunscreen, as bug spray should be used sparingly and much less often.
More tips for maximum sun protection.
Consider these additional tips to reduce the risk of skin cancer.
- Seek shade when possible. The sun is strongest from 10 a.m. to 2 p.m.
- Wear protective clothing, like a wide-brimmed hat and sunglasses.
- Use caution year-round. Snow, sand, and water all reflect the sun’s rays, increasing the chance of skin damage.
- Get vitamin D from food, not just the sun. Fish, orange juice and milk are all good sources of Vitamin D.
- Avoid tanning beds. There is no such thing as a safe tan.
How to check your skin—and when to see a doctor.
Anyone can get skin cancer, regardless of their skin pigmentation. When it’s identified early, most types of skin cancer are highly treatable. It’s important to examine your own skin regularly and talk with your doctor if you notice anything unusual.
How to check your skin.
The American Academy of Dermatology suggests that patients who are at average risk of skin cancer “check your birthday suit on your birthday”—an annual skin self-exam to look for unusual skin changes such as new or bigger moles or irritated skin patches.
Here’s how to do this:
- Use a full-length mirror to get a good look at the skin on your chest and back.
- Next check your underarms, forearms, and palms
- Examine your legs, between the toes, and the soles of your feet
- Use a hand mirror to check your scalp, including your hairline. Part your hair for a better look.
- Finally, use the hand mirror to check your back and buttocks.
- Asymmetry: One part of the spot is different from another.
- Border: The outer edges of the spot are irregular, scalloped, or poorly defined.
- Color: The spot has multiple shades of tan, brown or black or areas of white, red, or blue.
- Diameter: Though they can be smaller, most cancers are larger than 6 millimeters, or about the size of a pencil eraser.
- Evolving: The spot looks different from others or is changing in color, shape, or size.
If you find a mole that fits the ABCDE criteria, consult with a dermatologist to assess your skin.
The dermatologist will ask questions about your health history and sun exposure, including any family history of sunburns and skin cancer. Expect questions about your own history of blistering sunburns, as these are particularly damaging to the skin.
Using the naked eye or a magnifying light, the dermatologist will examine your skin for abnormalities and check for visible signs of sun damage like freckling, certain types of wrinkling, or other changes.
For those at higher risk of skin cancer, the dermatologist will check for precancerous changes present on the skin to determine whether you need to take extra precautions to avoid developing skin cancer.
As you get ready for fun in the sun, remember to protect your skin. Use proper sun protection and talk with your doctor as soon as you notice skin changes—when detected early, most skin cancers are highly treatable.
