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Which sunscreen is best?

This month, my dermatology colleagues at Northwestern University published an article in JAMA Dermatology (JAMA Dermatol. Published online July 06, 2016. doi:.10.1001/jamadermatol.2016.2344) in which they looked at the most popular sunscreens purchased on Amazon.  They found that 40% did not meet the minimal standards set by the American Academy of Dermatology.  Prices varied 3000% ($0.68 an ounce to $23.47 an ounce).  They also found that in reviews of the products, the most important feature was “cosmetic elegance” followed by “product performance.”

Not all sunscreens are the same.  Be sure that the sunscreen you use meets the minimal standards recommended by the American Academy of Dermatology listed on the label.  If not, don’t use it, even if you like the way it feels on your skin.   The three features are:

  • SPF (Sun Protective Factor) of 30 or higher
  • Broad spectrum coverage
  • Water resistant (40 minutes) or Very water resistant (80 minutes).

Don’t spend a lot of money on sunscreen.  The cheaper brand that meets these 3 minimal standards is just as good as the more expensive brand.  You need to put on a “shot glass” amount every 2-3 hours to be protected, so find the least expensive sunscreen that feels good to you and the other members of your family.

Now for the dirty little secret:  No sunscreen is that good.    These 3 standards are the minimal features. Sunscreens are tested in the laboratory under perfect conditions.  The reality is that no one puts enough sunscreen on their skin.  Everyone misses areas and very few people actually reapply sunscreens every 2 hours and after swimming.

In the past few years, I have started to recommend swim shirts or rash guards, hats with wide brims, lightweight shirts, and large UV protective sunglasses.  I instruct my patients to only apply sunscreen in the areas that are still exposed after wearing these items.  I have never burned through a light weight shirt, so I do not recommend buying clothing that is SPF rated for additional protection and additional expense.

 

Harry Goldin, M.D.

 

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