Sunburn, Sunscreen or Artificial Tanning: Which is Preferable?

Is enjoying the beach or pool part of your summer plans? If so, how will you protect yourself from the UV rays put out by our sun? Conversely, how will you protect others from being blinded by the radiant whiteness of your skin? It seems that just spending time outside requires a person to make a lot of science-based decisions. Fortunately, it is our job here at AITSE to provide you with the information you need to do this in an informed manner.

First, is exposure to the sun really as bad as we are told? Yes and no. According to the World Health Organization, UV light is now classed as a Group 1 carcinogen. It is worse in those with fair skin and under 18 years of age. Over-exposure to sunlight can cause basal cell carcinoma, squamous cell carcinoma and melanoma. The prior two types of skin cancer are common, but rarely fatal (only 0.1% of these cancers end in death). In comparison, even though only <5% of skin cancers are melanoma, it is responsible for almost all skin cancer deaths.

Other effects of UV exposure include “sagging cheeks, deeper facial wrinkles, and skin discoloration,” damage to the eyes, and sun allergies, resulting in itchy red rashes and even blisters. Not so attractive and probably better avoided.

This is why the Centers for Disease Control and Prevention advise that one should avoid UV damage between 9 am and 3 pm by staying in the shade, wearing sunglasses, wearing UVA and UVB protective sunscreen, and wearing sun protective clothing.

Note that they are not recommending never going out or always wearing sunscreen. After all, there are some benefits to being out in the sun. Exposure to UV light causes our cells to make vitamin D, which is essential for bone health. Sunshine is a great treatment for psoriasis. And there is even some clinical data indicating that UV exposure may cause endorphin release–in other words sunshine may help fight depression!

In fact, moderate amounts of sunshine early or late in the day are fine–and probably a good idea.  But, extended tanning times on the beach or by the pool are definitely out, even if you “prepared” your skin by visiting a tanning salon. In fact, several peer-reviewed studies have shown that the claim that tanning beds are somehow safer than outdoor tanning because they are a controlled environment are definite scientific bunk.

But, what about suntan lotion? Won’t that allow one to spend the day at the beach or by the pool? Doesn’t faithful application reduce the risk of developing skin cancer? And, while we are asking questions, are the chemicals that block UVA and UVB safe? According to a review of the peer-reviewed literature, no, probably not and probably not.

Faithful and generous application of UVA and UVB-blocking sunscreen will reduce the chances of getting a sunburn, but does not appear to significantly reduce one’s risk of dying from skin cancer. There has only been one peer-reviewed study showing that sunscreen protects from cancer–and that was from squamous cell carcinoma. In comparison, suntan lotion offered no protection at all from basal cell carcinoma and the more deadly melanoma. Astonishingly, some studies even indicated that use of these agents increased the cancer risk! For this reason the American College of Preventive Medicine sees no reason to recommend the daily use of sunscreen (p. 85).

Nonetheless, as epidemiological data shows steadily rising skin cancer incidence, sunscreens continue to sell. Some of these creams claim to be chemical-free because they only contain the chemicals zinc oxide (ZnO) and titanium dioxide (TiO2). But, these ingredients have a definite drawback: they are usually visible as a white film. Therefore, Zno and TiO2 creams are now being manufactured as less visible nanoscale particles, concomitantly making it more likely that they will be absorbed through the skin, entering cells and the blood stream. There have not been any studies on the effect of ZnO and TiO2 in children and babies.

Other sunscreens contain chemicals like oxybenzone, OMC and 4-MBC, all of which have repeatedly been shown to be present in the plasma and urine of those using the product (an indicator that they are absorbed). In fact, a study of nursing women showed that 78.8% of them regularly used products containing sunscreen and 76.5% of their human milk samples contained the chemical that they were using. This makes sense given that fat-containing substances (creams) are readily absorbed by cells–the chemicals in sunscreen (and any other chemicals on the skin, like DEET) are given a free ride into the body. What they do there is largely unknown.

It would seem that those who would like to sport a healthy-looking tan without the UV-associated wrinkling and skin cancer and sunscreen-associated toxicity have no alternative but to use a sunless tanner. These creams and sprays have an additive that offers no protection against sun damage, but can give the illusion of a tan for 5-7 days. The active ingredient dihydroxyacetone (DHA) reacts with amino acids in dead cells to form orange-brown colored melanoidins. DHA is said to be safe, provided it is used in moderation and only applied to the skin, not the mucus membranes. But, this verdict may change in the near future. Apparently, DHA induces DNA breakage in bacteria and skin cells and of course DNA damage may lead to cancer. In addition, it appears that the chemical accelerates photo-aging by increasing free radical formation. Back to square one.

So, what is the answer? You decide. AITSE does not purport to replace the advice of your physician. Rather, our goal is to give you the balanced information that will enable you to make an informed decision. See you at the beach–I’ll be the white one in the hat and long sleeves.