I have a friend who has instructions from one of her several physicians to slather herself with SPF 45 sunblock. Every day. All over.
Apparently physical blocking like hats, shirts, long sleeves, etc. is insufficient, because of her autoimmune disease diagnosis. Her physician also said that she should plan to get all of her vitamin D from a bottle for the foreseeable future, since she needs to stay completely out of the sun.
She asked: how do I pick a sunscreen product I feel safe using every day, all over?
As a holistic physician, I get questions all the time about what may be a healthier option for food, water, cleaning products, skin care products, etc. Enter Environmental Working Group, or EWG.org. The Environmental Working Group is an organization that provides education and research on toxic chemicals, agriculture and public land. They offer Consumer Guides to skin care, pesticides in fruits and vegetables, home cleaning products and more with safety and hazard ratings for ingredients in each category.
Check Ingredients in Sunscreen Products
Taking my friend’s doctor’s advice recommendations at face value, let’s look at the ingredients in the sunscreen she has used in the past. Sun block "X" contains the following:
Octinoxate 7.5%, Octisalate 5%, Octocrylene 10%, and zinc oxide 7%.
EWG indicates that this product scores poorly - 7/10 - and that the SPF of this product is likely much less than the advertised value of 50. Also, that the UVA/UVB blocking properties are not well balanced, and, interestingly, one of the “inactive” ingredients, propylparaben, generates more concern than any of the above active ingredients. Worrisome characteristics of this inactive ingredient include allergies, immunotoxicity, endocrine disruption, and it’s just plain bad for the non-human environment.
I told her she should pass on Sun block “X”.
Optimizing sun protection can be a little more complicated. According to a 2012 article at CNN.com (https://www.cnn.com/2012/07/10/living/guide-to-sun-safety/index.html), optimum sun protection may involve a topical (one that you apply to the skin) sun block and physical protection in the form of clothing, wide-brimmed hats, beach umbrellas, tinted car windows and more.
As EWG recommends, try to take physical protection/ avoidance as far as you feasibly can before slathering your exposed skin areas with sun block. Sun block should be your last, not first* resort.
7 Tips for Healthy Sun Protection
1. Find shade or make it.
2. Wear loose, lightweight clothing – covering up your skin with loose-fitting clothes that can breathe but still protect (tightly woven fabric) is the way to go before reaching for the sunblock. Many stores now carry lightweight clothing designed for sun protection.
3. Plan activities around the sun – try outside play and work before 10 am or after 3 pm when rays are less strong.
4. Don’t get burned – if you get red, tender or blistered, you’ve gone too far!
5. Check the UV index1, which gives a forecast of the expected risk of overexposure to UV radiation from the sun.
6. Sunglasses are essential – good quality sunglasses that are labeled according to ultraviolet (UV) ray protection are what you need, not the random $10 pair from a sidewalk sale. Literature at my ophthalmologist’s office recommends 99% UV blocking.
7. There is increasing evidence that it may be possible to get sun protection from certain foods and natural supplements. Nicotinamide, a kind of vitamin B3 (niacin) has been shown to have photo-protectant effects that benefit from the inside out2
Information on sun block and other personal products is only one of a dozen reasons I refer patients to EWG.org. The more information you have, the better informed you are to make healthier choices for preventive health!
*the recommendations in this blog apply to those with average risk of developing skin cancers, and not to those with increased risk because of systemic or skin disorders, specific genetic disorders, or those who take medication known to increase sun sensitivity.
Dr. Dawn Cannon, MD, MS, is an integrative physician at National Integrative Health Associates, serving the metropolitan Washington, D.C. area. Her focus is adult primary care and preventive medicine, approached holistically. Her special interests include detoxification for the damaging effects of environmental exposures and toxins, women's health, and a functional medicine approach to finding the root cause of disease or imbalance in the body.
1. https://www.epa.gov/sunsafety/uv-index-1 Last updated May 8, 2023. Accessed June 26, 2023.
2. Chen AC, Martin AJ, Choy B, et al. A Phase 3 randomized trial of nicotinamide for skin-cancer chemoprevention. N Engl J Med. 2015;373(17):1618-26.