1EPA

United States Environmental Protection Agency

Air and Radiation (6205J)

EPA 430-F-06-013 September 2006

Sun screen:
The Burning Facts

A
lthough the sun is necessary for life, too much sun exposure can lead to adverse health effects, including skin cancer. More than 1 million people in the United States are diagnosed with skin cancer each year, making it the most common form of cancer in the country, but program. It is estimated that 90 percent of nonit is largely preventable through a broad sun protection melanoma skin cancers and 65 percent of melanoma skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun.
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By themselves, sunscreens might not be effective in pro tecting you from the most dangerous forms of skin cancer. However, sunscreen use is an important part of your sun protection program. Used properly, certain sun screens help protect human skin from some of the suns damaging UV radiation. But according to recent surveys, most people are confused about the proper use and effectiveness of sunscreens. The purpose of this fact sheet is to educate you about sunscreens and other important sun protection measures so that you can pro tect yourself from the suns damaging rays.
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2 Recycled/RecyclablePrinted with Vegetable Oil Based Inks on 100% Postconsumer, Process Chlorine Free Recycled Paper

How Does UV Radiation Affect My Skin? What Are the Risks?

radiation, a known carcinogen, can have a number of harmful effects on the skin. The two types of UV radiation that can affect the skinUVA and UVBhave both been linked to skin cancer and a weakening of the immune system. They also contribute to premature aging of the skin and cataracts (a condition that impairs eyesight), and cause skin color changes.

UV

UVA Rays
UVA rays, which are not absorbed by the ozone layer, penetrate deep into the skin and heavily
contribute to premature aging. Up to 90 percent
of the visible skin changes commonly attributed
3 to aging are caused by sun exposure.

UVB Rays
These powerful rays, which are partially absorbed by the ozone layer, mostly affect the surface of the skin and are the primary cause of sunburn. Because of the thinning of the ozone layer, the effects of UVB radiation will pose an increased threat until the layer is restored in the latter half of the 21st century.

Armstrong,
B.K., and A.
Kricker, How much melanoma is caused by sun exposure?, Melanoma Research, 1993: 3:395-401.
1 2

Penetration of UV Into the Skin

IARC Working Group (2001)

Sunscreens (IARC Handbooks of Cancer
Prevention, Vol. 5), Lyon, International Agency
for Research on Cancer, pp. 23-52.
Taylor, C.R. et al, Photoaging/Photodamage
and Photoprotection, J Am Acad Dermatol,
1990: 22: 1-15.

3 4,7 American Academy of Pediatrics, Ultraviolet

Light: A Hazard to Children, Pediatrics,
1999:104: 328-333.
5 Ries, L.A.G, D. Harkins, M. Krapcho, A. Mariotto, B.A. Miller, N. Howlander, M. Hayat, B.F. Hankey, B.K. Edwards (eds), SEER Cancer Statistics Review, 1975-2003, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2003/, based on November 2005 SEER data submission, posted to the SEER Web site, 2006.

Are Some People Predisposed to Adverse Health Ef

verybody, regardless of race or ethnicity, is subject to the potential adverse
effects of overexposure to the sun. However, some people are more vulnerable
than others to the harmful effects of the sun.

Skin Type
Skin type affects the degree to which some people burn and the time it takes them to
burn. The Food and Drug Administration
(FDA) classifies skin type on a scale from 1
to 6. Individuals with lower number skin
types (1 and 2) have fair skin and tend to burn
rapidly and more severely. Individuals with high
er number skin types (5 and 6), though capable of
burning, have darker skin and do not burn as easily.

Strouse, J., T. Fears, M. Tucker, A. Wayne, Pediatric Melanoma: Risk Factor and Survival Analysis of the Surveillance, Epidemiology and End Results Database. Journal of Clinical Oncology. 2005; 23: 4735-4741.
6 8 Wolpowitz, D. and B.A. Gilchrest, The vita min D questions: How much do you need and how should you get it?, J Am Acad Dermatol, 2006: 54:301-317.

IARC Working Group (2001) Sunscreens (IARC Handbooks of Cancer Prevention, Vol. 5), Lyon, International Agency for Research on Cancer, pp. 148-149.
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How Do Sunscreens Work?

What Is the Sun Protection Factor (SPF)?

SPF vs. UVB protection

unscreens protect your skin by absorbing and/or reflecting UVA and UVB rays. The FDA requires that all sunscreens contain a Sun Protection Factor (SPF) label. The SPF reveals the relative amount of sunburn protection that a sunscreen can provide an average user (tested on skin types 1, 2, and 3) when correctly used. Sunscreens with an SPF of at least 15 are recommended. You should be aware that an SPF of 30 is not twice as protective as an SPF of 15; rather, when properly used, an SPF of 15 protects the skin from 93 percent of UVB radiation, and an SPF 30 sunscreen provides 97 percent protection (see chart to the right). Although the SPF ratings found on sunscreen packages apply mainly to UVB rays, many sunscreen manufacturers include ingredients that protect the skin from some UVA rays as well. These broad-spectrum sunscreens are highly recommended.

ffects Resulting From Sun Exposure?

The same people who are most likely to burn are also most vulnerable to skin cancer. Studies have shown that individuals with large numbers of freckles and moles also have a higher risk of developing skin cancer. Although people with higher-number skin types have a lower inci dence of skin cancer, they should still take action to protect their skin and eyes from over exposure to the sun, since cases of skin cancer in people with darker skin are often not detected until later stages when it is more dangerous.

Additional factors
Certain diseases, such as lupus, can also make a person more sensitive to sun exposure. Some medications, such as antibiotics and antihistamines and even certain herbal remedies, can cause extra sensitivity to the suns rays. Discuss these issues with your physician.

What Are the Active Ingredients in Sunscreen?

Chemical Ingredients
Broad-spectrum sunscreens often contain a number of chemical ingredients that absorb UVA and UVB radia tion. Many sunscreens contain UVA-absorbing avobenzone or a benzophenone (such as dioxybenzone, oxybenzone, or sulisobenzone), in addition to UVB-absorbing chemical ingredients (some of which also contribute to UVA protection). In rare cases, chemical ingredients cause skin reactions, including acne, burning, blisters, dryness, itching, rash, redness, stinging, swelling, and tightening of the skin. Consult a physician if these symptoms occur. These reactions are most com monly associated with para-aminobenzoic acid (PABA)-based sunscreens and those containing benzophenones. Some sunscreens also contain alcohol, fra grances, or preservatives, and should be avoided if you have skin allergies.

How Can I Maximize My Sun Protection?

ecause the active sunscreen ingre dients will not usually block out the complete spectrum of UVA and UVB rays, sunscreens by themselves might not offer enough protection to pre vent skin cancer and some of the other sun-related ailments. To thoroughly protect yourself, you should take as many of the following action steps as you can: Do Not Burn Avoid Sun Tanning and Tanning Beds Generously Apply Sunscreen Wear Protective Clothing Seek Shade Use Extra Caution Near Water, Snow, and Sand Watch for the UV Index Get Vitamin D Safely

Physical Ingredients
The physical compounds titanium dioxide and zinc oxide reflect, scatter, and absorb both UVA and UVB rays. These ingredients, produced through chem ical processes, do not typically cause allergic reactions. Using new technolo gy, the particle sizes of zinc oxide and titanium dioxide have been reduced, making them more transparent without losing their ability to screen UV.

Summary
All of the previously mentioned chemical and physical ingredients have been approved by the FDA. The following table lists these ingredients and includes information regarding the type and amount of ray protection that they provide and their class.
FDA Monograph Sunscreen Ingredients
Aminobenzoic acid (PABA) Avobenzone Cinoxate Dioxybenzone Ecamsule Homosalate Menthyl anthranilate Octocrylene Octyl methoxycinnamate Octyl salicylate Oxybenzone Padimate O Phenylbenzimidazole Sulisobenzone Titanium dioxide Trolamine salicylate Zinc Oxide Protection Level: = extensive = considerable = limited

Amount of Ray Protection UVA UVB

Chemical (C) or Physical (P)

C C C C C C C C C C C C C C P C P = minimal

Can I Get a Tan Without UV?

unless tanners and bronzers are applied to the skin like a cream and can provide a temporary, artificial tan. The only color additive currently approved by FDA for this purpose is dihydroxyacetone (DHA). Application can be difficult, and areas of the skin can react differently, resulting in an uneven appearance. Bronzers stain the skin temporarily, and they can generally be removed with soap and water. They may streak after application and can stain clothes. Sunless tanners and bronzers might not contain active sunscreen ingredi ents. Read their labels to find out if they provide any sun protection.

For the most up-to-date information on approved sunscreen ingredients, visit the FDA Web site at <www.fda.gov>.

Is a Suntan Healthy?
here is no such thing as a healthy suntan. Any change in your natural skin color is a sign of skin damage. Every time your skin color changes after sun exposure, your risk of devel oping sun-related ailments increases.

Will Sun Protection Deprive Me of Vitamin D?

M
How Can I Protect My Kids?
Children
Because children will be exposed to UV radiation for their whole lives, it is important to engrain sun safety practices at an early age. Many par ents do not properly apply sunscreen on their children. Sunscreen should be applied and reapplied to all exposed areas. Blistering sun burns during childhood significantly increase the risk of developing skin cancer later in life.4 Between 1973 and 2003, cutaneous melanoma increased by 81 percent.5 Incidence of pediatric melanoma is also on the riseincreasing almost 3 percent per yearmaking it just as important to teach children SunWise behavior.6 By teaching children about sun safety and encouraging them to take all of SunWises sun safety action steps, parents will ensure that their children understand the dangers associated with sun exposure and the ways to avoid them.

ost people get an adequate amount of vitamin D in their diets. If you are concerned about not get ting enough vitamin D, consult your physician and consider taking a mul tivitamin supplement and consum ing foods and beverages fortified with vitamin D daily.8

Are Tanning Lotions Safe?

Babies
Keep babies out of direct sunlight. The American Academy of Pediatrics recommends using sunscreen on infants for small areas such as the face 7 and back of hands where protection from clothing is inadequate.

he FDA considers it an important public health issue that users of suntanning products be told when the products do not contain a sunscreen and thus, do not protect against sun burn or other harmful effects to the skin. The FDA requires that all such products carry the following label: WarningThis product does not contain a sunscreen and does not protect against sunburn. Repeated exposure of unprotected skin while tanning may increase the risk of skin aging, skin cancer, and other harmful effects to the skin even if you do not burn.

SunWise Program
In response to the serious public health threat raised by overexposure to UV radiation, EPA is A Partnership Program of the U.S. Environmental Protection Agency working with schools and communities across the nation through the SunWise Program. SunWise aims to teach children in elementary and middle school and their caregivers how to protect themselves from overexposure to UV. For more information, go to the SunWise Web site at <www.epa.gov/sunwise>.

(Title 21 of the Code of Federal Regulations, Section 740.19)

How Does the Outside Environment Influence Exposure?

he intensity of the suns UV rays reaching the Earths surface varies and should be considered when you plan out door activities. The National Weather Service issues the UV Index, a daily forecast of UV intensity, for the United States. You can obtain your local UV Index forecast daily <2 Low from local weather sta tions or newspapers. EPAs 3 to 5 Moderate Web site provides daily 6 to 7 High local UV forecasts for 8 to 10 Very High your ZIP Code or city and 11+ Extreme state at <www.epa.gov/ sunwise/uvindex.html>. The higher the UV Index forecast, the stronger the sun will be and the greater the need to follow all the sun protection action steps. For days when the UV Index is unseasonably high for a particular loca tion, EPA issues a UV Alert. You can sign up to receive an
Index Number Exposure Level

The UV Index

email-based UV Alert or daily UV Index forecast by going to <https://enviroflash.epa.gov> and entering your e-mail address and ZIP Code or city and state. In general, UV strength is greatest from 10 a.m. to 4 p.m. during sunny summer days. Up to 80 percent of UV rays pass through clouds, however, meaning that sunburn is possible on cloudy days as well. UV exposure is greater at low latitudes (nearer to the equator) and/or high alti tudes. Snow, water, and sand also increase sun exposure by reflecting incoming UV rays, making it especially impor tant for skiers, boaters, and beachcombers to wear cloth ing and hats and apply sunscreen.

How Do I Apply Sunscreen?

se a broad-spectrum sunscreen with an SPF rating of 15 or higher. Apply sunscreen 20 minutes before going out into the sun (or as directed by the manufacturer) to give it time to absorb into your skin. Apply it generously and regularly about 1 ounce every 2 hoursand more often if you are swimming or perspiring. A small tube containing between 3 and 5 ounces of sunscreen might only be enough for one person during a day at the beach. Do not forget about lips, ears, feet, hands, bald spots and the back of the neck. In addition, apply sunscreen to areas under bathing suit straps, necklaces, bracelets, and sunglasses. Keep sunscreen until the expiration date or for no more than 3 years, because the sunscreen ingredients might become less effective over time. According to the FDA, water resistant sunscreens must maintain their SPF after 40 minutes of water immersion, while very water resistant sunscreens must maintain their SPF after 80 minutes of water immersion. Either type of water-resistant sunscreen must be reapplied regularly, as heavy perspiration, water, and towel drying remove the sunscreens protective layer.

Is Sunscreen Fail-Safe?
sing sunscreen does not mean it is safe to spend more time in the sun, especially when the UV Index is high. Although a sunscreen with an SPF of 15 or higher offers protection from sunburn, it does not block all of the suns damaging rays. In fact, there is no evidence that sunscreens protect you from malignant melanoma, the deadliest form of skin cancer, even though sunburns have been linked with the development of melanoma. There is only limited evidence that sunscreens protect you from several other types of skin cancer.9 To fully protect yourself, remember to seek shade, mini mize peak hours of sun exposure, and wear protec tive clothing in addition to applying sunscreen.