Sunscreen Recommendations

An ounce of prevention is worth a pound of cure.

If you're headed outside, it's always best to apply some sunscreen to protect your skin. But how does sunscreen work and why is it so important to make sure you're protected?

Here are eight of the top recommendations offered by dermatologists to patients, along with how and why they can help you avoid a sunburn and reduce your risk of developing skin cancer.

Stay out of the sun during peak hours.

Typically, the sun's rays are strongest between the hours of 10 a.m. and 2 p.m., so during those hours, head indoors or seek shade. Any time you're outside, cover your skin with clothing or a wide-brimmed hat, and be sure to use plenty of sunscreen.

It's also important to note the sun's rays can reflect off surfaces and cause burning even if you're partially covered. Even on cloudy days, you can still get burned because 70% to 80% of the sun's rays filter through the clouds, so use a sunscreen daily, no matter the weather.

Always use sunscreen or sunblock.

Dr. Brian Toy, a board-certified dermatologist with a private practice in Mission Viejo, California, and an attending dermatologist at Providence Mission Hospital in Orange County, California, says that the terms "sunblock and sunscreen are often used interchangeably, but there are key difference between the two."

Sunblocks typically contain titanium dioxide, zinc oxide or sometimes both. "These ingredients are actually minerals that reflect light off the skin like millions of tiny mirrors. As a result, they're oftentimes called physical blockers (or mineral sunblocks), since they block ultraviolet rays from penetrating the skin."

Sunscreen, on the other hand, refers to chemical protection. "When applied to the skin, chemical sunscreens act like a sponge, absorbing ultraviolet light and chemically converting it into something less dangerous," Toy says. "This filtering process results in the screening of harmful ultraviolet light. You can recognize a chemical sunscreen because it will contain ingredients that are hard to pronounce like oxybenzone, avobenzone, octisalate, octocrylene, homosalate and octinoxate."

Dr. Susan Massick, associate professor of dermatology at the Ohio State University Wexner Medical Center in Columbus, notes that "chemical sunscreens, such as oxybenzone and avobenzone, cover specific UVA and UVB ranges (specific wavelengths of light) so they often need a combination or mixture of chemical ingredients to provide broad-spectrum coverage."

Both sunblocks and sunscreens can work, but "in general, sunblocks provide the best protection because they don't allow UV radiation to penetrate the skin," says Dr. Cheri Frey, a board-certified dermatologist and assistant clinical professor in the department of dermatology at Howard University in Washington, D.C. "Sunblocks provide broad coverage and are less likely to cause (skin) irritation."

Plus, "given the mineral ingredients, sunblocks are more environmentally friendly than chemical sunscreens, Massick adds.

But sunscreens are popular because they're typically lighter weight, easier to rub in and are useful for layering under makeup or other skin care products. "Ultimately, the best sunscreen is the one you'll wear," Frey says.

Read the label.

There are a ton of sun protection products to choose from these days, and deciphering which is the best for you can be challenging. You have to read the label to make sure you're getting a good product that offers enough protection for your needs.

Researchers with the Environmental Working Group recently released the 15th annual Guide to Sunscreens and noted that of more than 1,800 products that advertise sun protection, only 25% offer adequate protection with no "worrisome ingredients, such as oxybenzone, a potential hormone-disrupting chemical that is readily absorbed by the body."

Still, there are plenty of products that offer great protection, and the EWG rates their top picks in the guide.

"Both physical and chemical blockers can be formulated these days to protect against harmful UVA and UVB (rays), but you want to double check on the packaging that this is the case," says Dr. Ata Moshiri, assistant professor of dermatology and dermatopathology at the University of Washington in Seattle.

Choose a broad-spectrum sunscreen.

When looking for a sunscreen or sunblock, you'll also be faced with an SPF number, or sun protection factor, on the label. This can be confusing or misleading about the level of protection offered.

Toy explains: "If you normally burn in one hour without sunscreen, applying an SPF 30 will theoretically allow 30 hours of sun exposure before burning. Unfortunately, these numbers are derived in the laboratory under perfect conditions." Most of us don't actually apply enough to achieve the advertised SPF. "As a result, an SPF 30 product typically translates into an actual SPF of only five hours."

SPF also only refers to protection against UVB rays that cause burning of the skin, not the UVA rays that can cause the skin to age faster. UVB rays are responsible for most skin cancers, but UVA rays can also cause cellular damage and lead to skin cancer. This is why you need to look for a product that's labeled as offering "broad-spectrum" protection.

"Broad spectrum is important because you want to make sure to cover the full range of ultraviolet light," Massick says. "UVB causes more tanning of skin and potential for sunburn, whereas UVA causes more photodamage, premature aging and wrinkling of skin. Neither are healthy for you and worse with frequent and long-term sun exposure."

When choosing a sunscreen, think about your preferences, Moshiri says. "The best sunscreens are the ones you will actually use. It's no good having a fancy sunscreen if it just sits in the bottle."

Massick recommends using an SPF 30+ for daily use and 50+ for "active or prolonged outdoor exposure."

Consider your skin type.

When choosing the right product for you, consider:

-- Whether you want to use chemical ingredients versus mineral ingredients.

-- How sensitive your skin may be to different chemicals.

-- How easy sunscreens are to rub in versus the opaque color that you may notice with mineral sunblocks.

Toy recommends choosing "a non-comedogenic product that won't clog your pores, as well as one that is PABA-free. Para-aminobenzoic acid is a common sunscreen ingredient to which many are allergic."

Frey suggests taking into account your skin type when selecting a product. "If you're prone to sunburns or have a condition that makes you sensitive to the sun, sunblock is best." Some products offer a mixture of chemical and physical protection, so try a few and see what works best for you.

If you have darker skin, "you might consider a tinted blocker or a product that is color-matched to your skin," Moshiri says.

Massick also recommends "using different products in different places." For example, you can use a stick sunblock on the ears, forehead and lips and a spray or aerosol sunblock for your scalp and other areas that have heavy hair coverage.

"Bottom line, the best one is the one that you like and you'll use and is easy to apply without causing skin irritation," Massick says.

Moshiri agrees. "The products you use are far less important than the goal they are trying to help you achieve, which is to avoid getting sunburned or having a deep tan. Burns and deep tans are all signs that your skin has seen too much harmful UV radiation, putting you at increased risk of skin cancer and photoaging."

Apply frequently.

Many people don't reapply sunblock frequently enough, and many don't use enough. Most dermatologists say you should reapply a liberal amount (about a shot glass full for the whole body and a dollop about the size of a quarter for the face and ears) every two hours. Reapply more frequently if you're "out in the sun and heat or if you're sweating or swimming," Massick says. Water-resistant sunscreens may only last 40 to 80 minutes, so it's super important to reapply if you've been in the water.

It's also important to apply sunscreen at least 15 minutes before you head outside, as it needs some time to soak into the skin before it can offer full protection.

Wear sun-protective clothing.

Covering up your skin with a t-shirt or long pants can certainly prevent some sun exposure, but depending on the material, you could still be receiving more ultraviolet radiation than you realize. Enter specially made sun-protective clothing that's designed to physically block UVA and UVB rays.

"I'm a huge fan of sun-protective clothing and recommend it regularly to all of my patients," Moshiri says. These specially designed clothes -- hats, long-sleeved shirts, shorts and pants -- block UV radiation with tightly woven fabric.

"Sun-protective clothing has its own rating system, UPF, or ultraviolet protection factor, and is a great option for added protection from the sun," Massick says.

She adds that when choosing clothing to protect the skin, "the darker the fabric or the denser the weave and type of fibers, the more protective clothing can be. A white t-shirt may only give a UPF of 4. But clothing with a designated UPF rating can provide added protection similar to sunblocks and sunscreens."

Clothing that's listed with a UPF 25 rating "will allow 1/25th or 4% of UV transmission," while clothing graded at UPF 50 "will allow only 1/50th or 2% of UV transmission," she explains.

Toy adds that "clothing marketed as sun-protective typically employs proprietary fabrics to keep you cool even while covered up," so you don't have to worry about overheating when protecting your skin.

One of the best things about sun-protective clothing, Frey says, is that "unlike with sunblocks and sunscreens, there's no need to reapply. And sun-protective clothing can cover hard to reach areas or areas that were missed when applying sunblock or sunscreen." She recommends using both clothing and sunscreen or sunblock for the best level of protection.

And Moshiri notes that sun-protective clothing is "reusable, environmentally friendly and doesn't need to be reapplied every two hours the way lotions do. If you're able to wear these items, they greatly cut down on the need for sunscreen or sunblock use, which can the be applied just to your exposed skin -- think face, ears, backs of hands, feet."

Take care of your skin.

The skin is the biggest organ in the body and its health is critical to your overall health and well-being. You need to look after the skin you're in.

"Whatever strategies you employ -- sunscreens, sunblocks and sun-protective clothing -- don't forget to be mindful of the behavioral changes that are just as important, such as avoiding the sun during peak hours, seeking shade when outdoors for prolonged periods of time, etc.," Moshiri says.

In addition to wearing sunscreen every day and taking care with how exposed you are to the sun, you should get to know your skin. If you notice any changes to the skin, such as new moles, moles that change color, size or shape or any other sores, lesions or unusual lumps and bumps, be sure to talk with your primary care provider or visit a dermatologist to get it checked out.

You should also make a point to visit your dermatologist annually for a thorough skin check. This regular screening can be especially helpful in catching new skin cancers early while they're still very treatable. "Your local friendly dermatologist would love nothing more than to talk with you about your specific needs and give their recommendations -- some will even have (sunblock) samples you can take with you," Moshiri adds.

8 sun-safety recommendations:

1. Stay out of the sun during peak hours.

2. Always use sunscreen.

3. Read the label.

4. Choose a broad-spectrum sunscreen.

5. Consider your skin type.

6. Reapply frequently.

7. Wear sun-protective clothing.

8. Take care of your skin.