Importance of using sunscreen

How important is sunscreen when it comes to protecting our skin? Medical and skincare experts weigh in with their opinions.

BUSINESSWOMAN Joanna Cheng panicked when a year of swimming under the sun resulted in large, dark spots on her skin.

A trip to the dermatologist confirmed permanent damage; unless she opted for laser treatment, which might erase only 90% of the problem, her mottled skin will never be the same again.

Cheng, 41, laments her decision to swim without sunblock for a “good, bronze tan”.

“There’s beauty and charm in skin that’s genetically predisposed to light freckling and pigmentation, but dark spots and heavy pigmentation indicate sun damage. Sunblock can help reduce that,” says Bobbi Brown training manager Carina Choo.

Will it really? There have been concerns, suggesting that not only do sunblocks provide little protection from UV rays, those thick, white goops of cream actually cause more harm than good.

First and foremost, it is important to understand the difference between UVA (ultraviolet-A) and UVB (ultraviolet-B).

The Skin Cancer Foundation, an international organisation dedicated to reducing the incidences of skin cancer through research and public awareness, explains that UVA comes from long-wave solar rays known to penetrate the skin deeply, and is considered the main culprit behind wrinkling, leathering and other aspects of photoaging.

UVB, on the other hand, comprises short-wave solar rays that are known to cause sunburn.

Sunlight is important for healthy skin, but just a small amount will do.

Dr Steven Chow, a senior consultant dermatologist and secretary of the General Asian Academy of Dermatology and Venereology explains that available evidence shows that in temperate countries, anything from 5 to 30 minutes of sunlight exposure between the hours of 10am and 3pm, twice a week, is sufficient to prevent vitamin D deficiency.

There are two kinds of sunblocks in the market today. First, there is the physical sunblock, which deflects or scatters UV radiation with its active ingredients titanium dioxide and zinc oxide. Then there is the chemical sunblock, which supposedly works by absorbing the energy of UV radiation before it affects the skin.

Online sources have listed several scientists who invented the concept of the SPF rating system in the 1930s.

Amongst them are Austrian scientist Professor Franz Greiter, who introduced Glacier Cream, the first commercially viable sun protection cream; Milton Blake, an Australian chemist who is credited for being the first to experiment with sunscreen formulas in his kitchen; and L’oreal Cosmetics founder Eugene Schueller who created sunscreens in his laboratory and marketed them.

Paula Begoun, an American author known for her well-researched views on skincare and cosmetics, believes that skin darkening is the natural response to sun damage and SPF is not the only guide when buying sunscreens.

“All the SPF number lets you know is how long you can stay in the sun without burning when wearing that product. However, it only refers to protection from UVB radiation, without giving you information about protection from UVA radiation,” she writes in her book, The Beauty Bible: Your Ultimate Guide To Smart Beauty, a well-received book that evaluates skincare formulations based on their ingredients and compares the company’s claims to the latest studies about that ingredient.

This sheds some light as to why skin ageing – and even cancer – happens despite wearing sunblock.

“If that SPF 15 or SPF 30 (sunblock product) doesn’t contain avobenzone, titanium dioxide or zinc oxide, you are receiving minimal protection from UVA radiation and it is a dangerous product to consider using,” she asserts in her book.

Dangerous because the user now spends more time in the sun, thinking that the product offers more protection than it does in reality.

According to Begoun, these facts about SPF are worth noting: apply sunblock liberally 20 minutes before sun exposure and reapply every 40 to 80 minutes if you are sweating or swimming. If you use an ordinary moisturiser over sunscreen, the effectiveness of the first product will be diluted; press-powder foundations make an “iffy way to get sun protection for the face, but make a great makeup touch up and sunscreen application midday”; and that SPF 15 and SPF 8 do not add up to SPF 23.

Nowadays, many sunscreens are rated as “PA+”, “PA++” or “PA+++”.

PA, which stands for Protection Grade of UVA, measures the ingredients’ protective effect against UVA.

As there is currently no standard measure of UVA absorption, the PA serves to estimate the amount of protection offered.

PA+ is sufficient for most activities but should you plan to stay in the sun for long hours, opt for PA+++ or higher, if possible.

The consequences of sun exposure can be grimmer than a bad case of pigmentation – there’s melanoma, a dangerous and often fatal form of skin cancer.

In 2006, the National Cancer Registry of Malaysia published statistics that revealed that skin cancer occurred in 295 people in a 100,000 population. Patients admitted that denial was the most frequent reason for putting off seeing the doctor about a suspicious lesion on the skin, accounting for 71% of all cases of skin cancer.

The illness tends to develop in old age, from the 50s onwards but unfortunately for some, from the 30s.

Linda, a cured cancer patient from Florida, shares her harrowing experience at the Skin Cancer Foundation website: “Although I never went to a tanning salon, I had a few bad sunburns when I was little, and I grew up without applying sunblock because I didn’t consciously go out in the sun to tan. However, in May last year, I was diagnosed with malignant melanoma and had a tumour removed from my leg.”

Her experience, like many others, suggests that sunscreen is necessary, after all, in reducing skin cancer risks.

“I have not heard of people who have developed cancer from wearing sunscreen. Rather, what I do see happening is people developing cancers from high exposure to the sun,” Choo says.

Contrary to these findings, alternative reports have emerged, purporting that substances used in sunblocks and sunscreens are the cancer-causing culprit.

AOL News, an American global Internet services and media company, published an article in May last year that alleges that “almost half of the 500 most popular sunscreen products may actually increase the speed at which malignant cells develop and spread skin cancer because they contain vitamin A or its derivative”.

According to researchers at Environmental Working Group, a non-profit organisation that carries out controversial research, most sunblocks may prevent sunburn, but not ultraviolet light from destroying skin cells and causing tumours (and lesions).

From these studies, a few ingredients have been identified as being potentially harmful to the human body including oxybenzone, which penetrates the skin and enters the bloodstream, while vitamin A and its derivatives – retinol and retinyl palmitate – “may speed up the cancer that sunscreen is supposed to prevent”.

“In that year-long study, tumors and lesions developed up to 21% faster in lab animals coated in a vitamin A-laced cream than animals treated with a vitamin-free cream,” the report read.

Begoun reasons, in a chapter entirely dedicated to sun exposure, sunblock and its damages, that there is little research being conducted on the harmful effects of sunscreen ingredients. Besides that, those experiments are in vitro (in test tubes) and not in vivo (on human skin).

Another study published in Environmental Health Perspective in March 2001 had based the research on rats that were fed sunscreen ingredients, not topical application to rat skin or a human’s,

“Eating pure sunscreen is not the same as applying them to the skin!” she argues. “All these issues are significant and deserve more research, but none of the findings indicate that anyone should give up using sunscreen.”

Chow offers a similar rebuttal: “Much of these alarming revelations and new sensations that you see and read in articles are a reflection of the ongoing trade war between various sunblock manufacturers. There are many claims and counter claims in the lay press; it is marketing science. The present trend is pushing for purely physical sunblocks, to avoid chemical-based sunblocks.”

“In view of unanswered controversy, stick with physical sunblocks. Most medical grade sunscreens – such as Galderma – don’t contain those ingredients,” says Dr Lim Wye Leng, a medical practitioner who runs a private skin treatment clinic in Kuala Lumpur. She feels that retinol and retinyl palmitate make excellent anti-ageing ingredients but don’t belong in a sunscreen.

“They should be used as a night cream instead,” she says.

Choo offers a simple solution – wash your face properly.

“I believe that sunblocks work, but if you’re very concerned about the chemicals they contain, cleanse your skin thoroughly when you get home at night. Who’s to say that our skin is not exposed to other toxic elements during the day just because we avoid sunblock? At least, it offers some UV protection, and you can always wash it off,” she says.

She maintains that consumers ought to enlighten themselves by reading up and, ultimately, finding a product that they are confident will suit their lifestyle.

“Of course, sunblocks do protect your skin against a certain level of sun exposure. But, ultimately, it is sensible, holistic management of sun avoidance that matters most. If one continues to expose the skin to excessive sunlight daily from a young age, the damage is cumulative and no amount of sunblock can prevent the eventual results,” Chow concludes.

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