I have a friend who has instructions from one of her various doctors to slather on SPF 45 sunscreen. Every day. All over.
Apparently physical blocking like hats, shirts, long sleeves, etc. is insufficient due to his diagnosis of autoimmune disease. Her doctor also said that she should plan to get all of her vitamin D from a bottle for the foreseeable future, as she needs to stay completely out of the sun.
She asked: how do I choose a sun protection product that I feel confident in every day?
As a holistic practitioner, I get questions all the time about what might be a healthier option for food, water, cleaning products, skin care products, etc. Enter the Environmental Working Group, or EWG.org. The Environmental Working Group is an organization that provides education and research on toxic chemicals, agriculture, and public lands. They offer consumer guides on skin care, pesticides on fruits and vegetables, household cleaning products, and more, with safety and hazard ratings for ingredients in each category.
Check the ingredients in sunscreen products
Taking my friend’s doctor’s recommendations at face value, let’s take a look at the ingredients in the sunscreen she’s used in the past. Sunblock “X” contains the following:
Octinoxate 7.5%, Octisalate 5%, Octocrylene 10% and zinc oxide 7%.
EWG indicates that this product has a low score – 7/10 – and that the SPF of this product is probably much lower than the advertised value of 50. Also, that the UVA/UVB blocking properties are not well balanced and, oddly enough, , one of the “inactive” ingredients, propylparaben, raises more concern than any of the above active ingredients. Concerning characteristics of this inactive ingredient include allergies, immunotoxicity, endocrine disruption, and it’s just plain bad for the non-human environment.
I told her she should pass on the “X” sunblock.
Optimizing sun protection can be a bit trickier. According to a 2012 article on CNN.com (https://www.cnn.com/2012/07/10/living/guide-to-sun-safety/index.html), optimal sun protection may involve a topical ( one that you apply to your skin) sunscreen, and physical protection in the form of clothing, wide-brimmed hats, beach umbrellas, tinted windows, and more.
As EWG recommends, try to take physical protection/avoidance as much as possible before slathering exposed areas of skin with sunscreen. Sunscreen should be your last resort, not your first*.
7 tips for healthy sun protection
1. Find the shadow or make it.
2. Wear loose-fitting, lightweight clothing: Covering your skin in loose-fitting clothing that can breathe but still protect (tightly woven fabric) is the way to go before reaching for sunscreen. Many stores now sell lightweight clothing designed for protection from the sun.
3. Plan activities around the sun: Try to play and work outside before 10 am or after 3 pm, when the rays are less strong.
4. Don’t get burned: If you get red, tender, or blistered, you’ve gone too far!
5. Check UV Index1which gives a forecast of the expected risk of overexposure to UV radiation from the sun.
6. Sunglasses are essential: What you need are good-quality sunglasses that are labeled for ultraviolet (UV) protection, not the random $10 pair from a curbside sale. The literature at my ophthalmologist’s office recommends 99% UV blockage.
7. There is increasing evidence that sun protection can be obtained from certain foods and natural supplements. Nicotinamide, a type of vitamin B3 (niacin), has been shown to have photoprotective effects that benefit from the inside out2
Information on sunscreen and other personal products is just one of the many reasons I refer patients to EWG.org. The more information you have, the better informed you will be to make healthier decisions for preventive health!
*Recommendations in this blog apply to those at average risk of developing skin cancer, and not to those at increased risk due to systemic or skin disorders, specific genetic disorders, or those taking medications that increase sensitivity to the sun .
Dr. Dawn Cannon, MD, MS, is an integrative physician with National Integrative Health Associates, serving the Washington, DC metropolitan area. her focus is adult primary care and preventive medicine, approached holistically. Her special interests include detoxification from the damaging effects of environmental exposures and toxins, women’s health, and a functional medicine approach to finding the root cause of disease or imbalance in the body.
1. https://www.epa.gov/sunsafety/uv-index-1 Last updated May 8, 2023. Accessed June 26, 2023.
2. Chen AC, Martin AJ, Choy B, et al. A randomized phase 3 trial of nicotinamide for chemoprevention of skin cancer. N Engl J Med. 2015;373(17):1618-26.