A tsunami of grief washed over Margaritaville earlier this year, and it had nothing to do with that lost shaker of salt. Musician Jimmy Buffett, who for countless fans was the embodiment of beach sun and fun, died Sept. 1 of skin cancer.
And while the specific cancer that killed him, Merkel cell carcinoma, is quite rare, skin cancer in general is the most common of cancers, with the basal and squamous types affecting about 3.3 million Americans a year, according to the American Cancer Society.
Thankfully, skin cancer is usually treatable when caught early, but lately, one of the most popular ways to protect yourself — sunscreen — has come under fire. Which is not good news if you live in perpetually sunny Southern California.
Safety issues
Specifically, the product under fire is chemical sunscreen, the lotion (or spray) you apply to your skin and let absorb before going outside. This is opposed to mineral sunscreen, which does not absorb, but sits on top, in some cases making the wearer look like they’re wearing a mask.
In 2021, the Food and Drug Administration flagged 12 active ingredients, including oxybenzone and octinoxate, commonly used in chemical sunscreens, after studies showed that they get into the bloodstream, with sometimes high levels found in a variety of bodily fluids, including breast milk and semen.
Whether these compounds truly harm your health is still not clear. However, the concern is that they may disrupt the endocrine system, the network of glands in our bodies that produce the hormones that regulate our vital functions.
A year earlier, a study by researchers at UC Irvine looked at 29 smaller studies on the subject, and found that none could confirm that these ingredients caused harm. Still, the UCI researchers concluded it would be wise to do a larger and more comprehensive study.
Your various glands, however, are not the only worry. Several environmental studies, including one in 2008, and another in 2016, showed that oxybenzone and octinoxate hurt marine life, particularly by bleaching coral, leading the state of Hawaii and Key West in Florida to ban chemical sunscreens with those ingredients.
Yet other environmental researchers have said those studies may not be correct. In a rebuttal in The Conversation, an online magazine, Australian coral reef researcher Terry Hughes points out that the coral in the studies were exposed to far more of these compounds than it would be in a natural environment. More damning, he says, is that the coral in the Great Barrier Reef continued to bleach in 2020 when tourism shut down completely due to COVID-19.
If that’s the case, why bother banning sunscreen?
“It’s banned by governments that want to appear to be doing ‘something’ about coral bleaching. Despite the evidence that bleaching is caused by anthropogenic heating,” Hughes responded via X (formerly Twitter).
As for the FDA imposing its own nationwide ban on chemical sunscreen, that is not what’s happening here.
“It is important to emphasize that the FDA is not saying don’t use them,” says Dr. Kerry Hanson, a research chemist and sunscreen expert with the Bardeen Research Group at UC Riverside. “They are asking for more data, so consumers have the best information to make informed decisions.”
Hanson, like the UCI researchers, agrees further study is a good idea.
The question, though, is what do you, the consumer, do while all of this is being sorted out? Stay inside? Resign yourself to using products that make you uncomfortable?
Or, should you just take the advice of social media influencers across the political spectrum, who maintain that sunscreen is terrible overall and encourage its non-use — and, in some cases, even advise that everyone tan areas that, ahem, you usually wouldn’t show to the sun?
Taking health advice from Instagram or TikTok, said Dr. Caroline Opene, a dermatologist and director of UCLA Health’s Skin of Color Clinic, may not be the best idea.
“Essentially, the general population needs to check credentials,” she said. “Who is giving the advice?”
Opene’s advice, which echoes that of the vast majority of credentialed experts, is to do what you can to protect your skin, and not just from a painful sunburn.
“There is no such thing as a healthy tan,” she says.
The ‘healthy tan’ myth
This may come as a surprise to generations who grew up in a sun-worshiping culture where it wasn’t uncommon to slather oneself in baby oil, then spend the summer baking on the beach or near a pool.
Then there were the tanning salons — which started appearing in the early 1980s and were available year-round — that advertised tans without that pesky sunburn.
Western culture’s sunbathing craze started in the 1920s. Some say it should be blamed on French fashion designer Coco Chanel, who, after spending a vacation cruising the Mediterranean, impressed her friends and fans upon her return with her sun-kissed glow. Soon, the wealthy and the famous (and all those who aspired to be) were soaking up the sun.
This was quite the contrast to previous generations, which considered having a tan to be the mark of a lower class (not to mention the issues of entrenched racism and colorism).
Unfortunately, all that sun soaking came with a price: leathery skin, wrinkles and, even worse, skin cancer. Then, tanning salons were found to be not all that safe, given the alarming uptick in cancers among users in the ’90s and early aughts. (Still, they continue to be popular, even as doctors and scientists scold.)
The culprit in all of this? Ultraviolet light.
Blind to the light
Human beings can’t see ultraviolet light, which is why scientists may be forgiven for not knowing it even existed until German scientist Johann Wilhelm Ritter discovered it in 1801. It would take another 88 years for Swede Erik M.P. Widmark to prove it was UV light that causes burns and aging.
There are, in fact, several kinds of UV light — all affecting the skin differently, Hanson explains.
“UVB is higher in energy, and causes sunburn. Think ‘b’ for burning,” she says. “UVA is lower in energy and causes many of the visible signs of aging, like wrinkles and age spots. Think ‘a’ for aging.”
Although human eyes can’t see either UVA or UVB, the skin can sense it. The reason there is no such thing as a healthy tan is that it’s actually the skin’s stress response when subjected to too much radiation.
Raise the melanin umbrellas!
Tanning happens in the top layer of skin, known as the epidermis, which is composed of four types of skin cells:
- Merkel cells (responsible for being able to sense touch);
- Langerhans cells (part of the immune system, they tackle bacteria and other invaders);
- melanocytes (they dictate skin color, as well as eye and hair color); and
- keratinocytes (containing a protein called keratin, also the building block for your hair and nails).
Keratinocytes are the most abundant skin cells, constantly reproducing and shedding, which means that the average human grows a whole new epidermis about every month.
When exposed to too much UV, the keratinocytes send an SOS to the melanocytes, which produce melanin. Melanin, or specifically, eumelanin, is a dark brown pigment that is quite effective at blocking radiation. (Redheads can thank pheomelanin for their coloring.)
The melanocytes transfer pigment packets, called melanosomes, to the keratinocytes. The keratinocytes arrange their new melanosomes over their nuclei (which is where cells keep their precious DNA) into a little melanin umbrella.
So, when you look at your freshly tanned arm, what you’re really seeing is millions of tiny melanin umbrellas.
Sunscreen, revisited
Why worry, then, about wearing sunscreen, when the human body effectively produces its own with eumelanin?
It’s all about the sun protection factor, or SPF.
“The SPF value represents how long a person can stay in the sun without getting sunburned,” Hanson explains, adding that SPF only applies to UVB radiation.
“So, for example, if you burn within 10 minutes of UVB exposure, then an SPF 15 should protect you for 15 times 10 minutes, or 150 minutes, before you get burned. Melanin can provide an SPF of up to about 13 depending on your level of melanin in your cells.”
There’s the catch: Melanin is useless against UVA radiation.
“Melanin blocks UVB, but does not block UVA,” Hanson said. “People who have more melanin may not burn as quickly as those with less melanin, but sunburn occurs in people with all skin types.”
This is why Opene, at her UCLA clinic, advises patients with darker skin to always use sun protection, preferably a broad-spectrum UVA and UVB product with an SPF of at least 30.
“In general, people dramatically overestimate the amount of protection that melanin offers,” she says. “People with the darkest skin tones have an SPF that is less than 15. So, while they may rarely or never burn, they can still accumulate DNA damage in their skin cells when they tan. Over time, this leads to the very common findings of white freckling on the arms and legs, brown spots, and a leathery texture of the arms and legs.”
But how, exactly, does that recommended sunscreen work?
Again, the mineral kind sits on top of the skin, much like a mask. The chemical kind, though, contains chemicals that form an internal mask. That mask, though, acts less like a shield and more like a raft of little sponges, each absorbing either UVA and UVB radiation, then breaking it down, then releasing it, usually as heat.
Neutralizing UV radiation, however, quickly destroys the sponges, which is why consumers are encouraged to reapply sunscreen every two hours (more often if they swim or sweat a lot).
Both Hanson and Opene say neither of those types of sunscreen will help if not applied properly. Since mineral sunscreen is easier to see, make sure you coat your skin evenly and thoroughly.
Chemical sunscreen can be trickier. Experts recommend a shot glass worth, but it really depends on your size. Hanson recommends applying chemical sunscreen after you’ve done your skin routine, including makeup, so that the protective layer is on top. When you apply also makes a difference. It’s best if you apply about 10 minutes before you go into the sun, Hanson said, and make sure it dries into a nice film.
Finally, check the expiration dates. No sunscreen lasts forever. If your favorite lotion has separated or clumped, throw it out.
Smart sun protection, without shame
There are ways to enjoy the sun without slathering on sunscreen. Here are some tips from the experts:
- Get a parasol, a nice big hat with a wide brim, long sleeves, and long pants or skirts. All help, but just make sure the material is tightly woven. Darker colors are also better, even if they tend to absorb the heat. That doesn’t mean, though, that you can escape the need for sunscreen entirely. You should still apply it to exposed skin. More clothes just mean less need for creams.
- Check the daily UV index (a feature available on most weather widgets these days). If it’s high, don’t stay out too long, and if you can, avoid going out between 10 a.m. and 4 p.m.
- If you are older, and take certain medications, you may be more sun-sensitive, Hanson said, and burn even while taking precautions. Statins and anti-inflammatories, for example, are on the FDA’s list of drugs that make you photo-sensitive.
- Ditch the guilt over the bad old days. Opene reports many of her older patients are ashamed about past sunbathing habits. It’s never too late to be careful. Remember, sun damage builds up over time. Just do your best to avoid more!
- Get very familiar with your skin. Not everyone has access to a dermatologist, so keeping track of changes, like a mole growing or changing colors, patches that keep peeling, or injuries that won’t heal, is crucial. And that means ALL skin, Opene stressed. That includes palms and soles, between fingers and toes, eyelids, ears — even the inside of your mouth and your genitals. It may feel terrifying at first, but it pays to catch problems early.
