United States
Environmental Protection
Agency
Air and Radiation
(6205J)
EPA430-F-01-015
May 2001
Ithough the sun is necessary for life, too much
sun exposure can lead to adverse health effects,
including skin cancer. More than 1 million people in
the United States are diagnosed with skin cancer
each year, making it the most common form of can-
cer in the country, but it is largely preventable
through a broad sun protection program. Ninety per-
cent of skin cancers are linked to sun exposure.
By themselves, sunscreens might not be effective in
protecting you from the most dangerous forms of
skin cancer. However, sunscreen use is an important
part of your sun protection program. Used properly,
certain sunscreens help protect human skin from
some of the sun's damaging ultraviolet (UV) radia-
tion. But according to recent surveys, most people are
confused about the proper use and effectiveness of
sunscreens. The purpose of this fact sheet is to edu-
cate you about sunscreens and other important sun
protection measures so that you can protect yourself
from the sun's damaging rays.
) Printed on paper that contains at least 50 percent postconsumer fiber.
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How Does UV Radiation Affect My Skin?
What Are the Risks?
V rays can have a number of harmful effects on the skin. The two types of UV radia-
tion that can affect the skin, UVA and DVB, have both been linked to skin cancer and a
weakening of the immune system. They also contribute to both premature aging of the
skin and cataracts (a condition that impairs eyesight), and cause skin color
changes.
UVA
UVB
Keratinocytes
Melanocytes
Basal Cell
Langerhans Cells
Capillaries
Fibroblasts
Lymphocytes
Macrophages
Mast Cells
Granulocytes
Collagen, Vessels
Elastic Fibers
GAGs, Fibronectin
UVA Rays
UVA rays, which are not absorbed by the ozone layer,
penetrate deep into the skin and heavily contribute to
premature aging. Up to 90 percent of the visible skin
changes commonly attributed to aging are caused by
sun exposure.
UVB Rays
These powerful rays, which are partially absorbed
by the ozone layer, mostly impact the surface of
the skin and are the primary cause of sunburn.
Because of the thinning of the ozone layer, the
effects of UVB radiation will pose an increased threat
until the layer is restored in approximately 50 years.
Penetration of UV Into the Skin
1 American Cancer Society, "Cancer
Facts and Figures 1999."
2 IARC Working Group (2001)
Sunscreens (IARC Handbooks of
Cancer Prevention, Vol. 5), Lyon,
International Agency for Research
on Cancer, pp. 23-52.
'Taylor, C.R. etal, Photoaging/
Photodamage and Photopmtection,
J Am Acad Dermatol, 1990: 22: 1-15.
"Stern RS, Weinstein MC,
Baker SG. Risk reduction for
nonmelanoma skin cancer with
childhood sunscreen use. Arch
Dermatol. 1986: 122: 537-545.
56 American Academy of Pediatrics,
Ultraviolet Light: A Hazard to Children,
Pediatrics, 1999: 104:
328-333.
7 IARC Working Group (2001)
Sunscreens (IARC Handbooks of
Cancer Prevention, Vol. 5), Lyon,
International Agency for Research
on Cancer, pp. 148-149.
•ch
II
Are Some People Predisposed to Adverse Health E
Lverybody, regardless of race or ethnicity, is subject to the potential adverse
effects of overexposure to the sun. Some people might be
more vulnerable to certain conditions, however.
Skin Type
Skin type affects the degree to which some peo-
ple burn and the time it takes them to burn.
The Food and Drug Administration (FDA)
classifies skin type on a scale from 1 to 6.
Individuals with lower number skin types (1 and
2) have fair skin and tend to burn rapidly and
more severely. Individuals with higher number skin
types (5 and 6), though capable of burning, have darker
skin and do not burn as easily.
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100 r
How Do Sunscreens Work?
What Is the Sun Protection Factor (SPF)?
unscreens protect your skin by absorbing and/or reflecting UVA and DVB
rays. The FDA requires that all sunscreens contain a Sun Protection Factor
(SPF) label. The SPF reveals the relative amount of sunburn protection that
a sunscreen can provide an average user (tested on skin types 1, 2, and 3)
when correctly used.
Sunscreens with an SPF of at least 15 are recommended. You should be
aware that an SPF of 30 is not twice as protective as an SPF of 15; rather,
when properly used, an SPF of 15 protects the skin from 93 percent of UVB
radiation, and an SPF 30 sunscreen provides 97 percent protection (see chart
to the right).
Although the SPF ratings found on sunscreen packages apply mainly to UVB rays, many
sunscreen manufacturers include ingredients that protect the skin from some UVA rays as
well. These "broad-spectrum" sunscreens are highly recommended.
SPF vs. UVB protection
80
5 10 15 20 25 30 35 40 45 50 55 60 65
SPF
ffects Resulting From Sun Exposure?
The same individuals who are most likely to burn are also most vulnerable to skin cancer. Studies
have shown that individuals with large numbers of freckles and moles also have a higher risk
of developing skin cancer. Although individuals with higher-number skin types are less
likely to develop skin cancer, they should still take action to protect their skin and eyes
from overexposure to the sun. Some dark-skinned individuals can and do get skin cancer.
Additional factors
Certain diseases, such as lupus, can also make a person more sensitive to sun expo-
sure. Some medications, such as antibiotics and antihistamines and even certain
herbal remedies, can cause extra sensitivity to the sun's rays. Discuss these issues with
your physician.
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What Are the Active
Ingredients in Sunscreen?
Chemical (Organic) Ingredients
Broad-spectrum sunscreens often contain a number of
chemical ingredients that absorb UVA and DVB radia-
tion. Many sunscreens contain UVA-absorbing avobenzone
or a benzophenone (such as dixoybenzone, oxybenzone, or sulisoben-
zone), in addition to DVB-absorbing chemical ingredients (some of which
also contribute to UVA protection). In rare cases, chemical ingredients cause
skin reactions, including acne, burning, blisters, dryness, itching, rash, red-
ness, stinging, swelling, and tightening of the skin. Consult a physician if
these symptoms occur. These reactions are most commonly associated with
para-aminobenzoic acid (PABA)-based sunscreens and those containing ben-
zophenones. Some sunscreens also contain alcohol, fragrances, or preserva-
tives, and should be avoided if you have skin allergies.
Physical (Inorganic) Ingredients
The physical compounds titanium dioxide and zinc oxide reflect, scatter,
and absorb both UVA and UVB rays. These ingredients, produced through
chemical processes, do not typically cause allergic reactions. Using new
technology, the particle sizes of zinc oxide and titanium dioxide have been
reduced, making them more transparent.
Summary
All of the previously mentioned chemical and physical ingredients have
been approved by the FDA. The following table lists these ingredients and
includes information regarding the type and amount of ray protection that
they provide and their class.
How Can I Maximize
My Sun Protection?
ecause the active sunscreen ingre-
dients will not usually block out the
complete spectrum of UVA and UVB
rays, sunscreens by themselves might
not offer enough protection to pre-
vent skin cancer and some of the other
sun-related ailments. To thoroughly
protect yourself, you should take as
many of the following action steps as
you can:
• Limit time in the strong, midday sun
between 10 a.m. and 4 p.m.
• Seek shade.
• Wear sunglasses with 99-100 percent
UVA and UVB protection.
• Wear tightly woven, long-sleeve
clothing.
• Wear a wide brim hat.
• Apply broad-spectrum sunscreen
rated SPF 15 or higher.
Can I Get a Tan
Without the Sun?
FDA Monograph
Sunscreen Ingredients
Aminobenzoic acid (PABA)
Avobenzone
Cinoxate
Dioxybenzone
Homosalate
Menthyl anthranilate
Octocrylene
Octyl methoxycinnamate
Octyl salicylate
Oxybenzone
Padimate O
Phenylbenzimidazole
Sulisobenzone
Titanium dioxide
Trolamine salicylate
Zinc Oxide
Amount of
Ray Protection
UVA
O
•
©
€
O
C
©
©
O
€
O
O
C
€
O
•
UVB
•
©
Chemical (C)
or Physical (P)
C
C
C
C
C
C
C
C
C
C
C
C
C
P
C
P
Protection Level: • = extensive C) = considerable © = limited O = minimal
./unless tanners and bronzers are
applied to the skin like a cream and
can provide a temporary, artificial tan.
The only color additive currently
approved by FDA for this purpose is
dihydroxyacetone (DMA). Application
can be difficult, and areas of the skin
can react differently, resulting in an
uneven appearance.
Bronzers stain the skin temporarily,
and they can generally be removed
with soap and water. They may streak
after application and can stain clothes.
Sunless tanners and bronzers might
not contain active sunscreen ingredi-
ents. Read their labels to find out if
they provide any sun protection.
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How Can I Protect My Kids?
Children
An estimated 80 percent of a person's sun exposure occurs
before age 18.4 For this reason, it is important that children
be protected from overexposure. Many parents do not prop-
erly apply sunscreen on their children. Sunscreen should be
applied and reapplied to all exposed areas. Blistering sun-
burns during childhood significantly increase the risk of
developing skin cancer later in life.5 Encourage your chil-
dren to take all sun safety action steps.
Babies
Keep babies out of direct sunlight. The American Academy
of Pediatrics recommends using sunscreen on infants for
small areas such as the face and back of hands where pro-
tection from clothing is inadequate.6
SunWise School Program
v I / In response to the serious
v I /
y^^v
v public health threat raised
a school program that raJlalas good ideas by OVereXpOSUTe tO UV radi-
ation, EPA is working with schools and communities across
the nation through the SunWise School Program. SunWise
aims to teach children in elementary and middle school
and their caregivers how to protect themselves from over-
exposure to the sun. For more information, go to the
SunWise Web site at .
-
Is a Suntan Healthy?
10 such thing as a
healthy suntan. Any change in your
natural skin color is a sign of skin
damage. Every time your skin color
changes after sun exposure, your
risk of developing sun-related ail-
ments increases.
/ill Sun Protection
Jeprive Me of
Vitamin D?
un exposure is not required to
get a sufficient amount of vitamin
D. Most people get an adequate
amount of vitamin D in their diets.
If you are concerned about not get-
ting enough vitamin D, consider
taking a multivitamin or drinking
vitamin D-fortified milk daily.
Are Tanning Lotions
Safe?
he FDA considers it an important
public health issue that users of sun-
tanning products be told when the
products do not contain a sunscreen
and thus, do not protect against sun-
burn or other harmful effects to the
skin. The FDA requires that all such
products carry the following label:
"Warning-This product does not
contain a sunscreen and does not
protect against sunburn. Repeated
exposure of unprotected skin while
tanning may increase the risk of
skin aging, skin cancer, and other
harmful effects to the skin even if
you do not burn."
(Title 21 of the Code of Federal Regulations,
Section 740.19)
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How Does the Outside
Environment Influence Exposure?
I he intensity of the sun's UV rays reaching the Earth's
surface varies and should be considered when you plan
outdoor activities. The National Weather Service issues the
UV Index, a daily forecast of UV intensity.
The UV Index
You can obtain your
local UV Index fore-
cast daily from local
weather stations or
newspapers. The U.S.
Environmental
Protection Agency's
Web site provides
daily local UV fore-
casts for your ZIP
code. The address is
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