United States
Environmental Protection
Agency
The Burning Facts
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 cancer in the country, but
it is largely preventable through a broad sun protection
program. It is estimated that 90 percent of non-
melanoma skin cancers and 65 percent of melanoma
skin cancers are associated with exposure to ultraviolet
(UV) radiation from the sun.
By themselves, sunscreens might not be effective in pro-
tecting you from the most dangerous forms of skin can-
cer. However, sunscreen use is an important part of your
sun protection program. Used properly, certain sun-
screens help protect human skin from some of the sun's
damaging UV radiation. 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 educate you about sunscreens and other
important sun protection measures so that you can pro-
tect yourself from the sun's damaging rays.
> Recycled/Recyclable—Printed with Vegetable Oil Based Inks on 100% Postconsumer, Process Chlorine Free Recycled Paper
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How Does UV Radiation Affect My Skin?
What Are the Risks?
UV,
radiation, a known carcinogen, can have a number of harmful effects on the
skin. The two types of UV radiation that can affect the skin—UVA and UVB—have
both been linked to skin cancer and a weakening of the immune system.
They also contribute to premature aging of the skin and cataracts
(a condition that impairs eyesight), and cause skin color
changes.
UVA
UVB
Keratinocytes
Melanocytes -|
Basal Cell te.
Langerhans Cells a.
Capillaries
Fibroblasts
Lymphocytes
Macrophages
Mast Cells
Granulocytes
Collagen, Vessels
Elastic Fibers
GAGs, Fibronectin
1 Armstrong,
B.K., and A.
Kricker, How
much melanoma
is caused by sun
exposure?. Melanoma
Research, 1993: 3:395-401.
2 IARC Working Group (2001)
Sunscreens (IARC Handbooks of Cancer
Prevention, Vol. 5), Lyon, International Agency
for Research on Cancer, pp. 23-52.
3 Taylor, C.R. et al, Photoaging/Photodamage
and Photoprotection, 1 Am Acad Dermatol,
1990: 22: 1-15.
v American Academy of Pediatrics, Ultraviolet
Light: A Hazard to Children, Pediatrics,
1999:104: 328-333.
5 Ries, L.A.G, D. Harkins, M. Krapcho, A. Mariotto,
B.A. Miller, N. Howlander, M. Hayat, B.F. Hankfcy.
B.K. Edwards (eds), SEER Cancer Statistics Review,
1975-2003, National Cancer Institute. Bethesda,
MD, http://seer.cancer.goV/csr/1975_2003/, based
on November 2005 SEER data submission,
posted to the SEER Web site, 2006.
s Strouse, J., T. Fears, M. Tucker, A.
Wayne, Pediatric Melanoma: Risk Factor
and Survival Analysis of the
Surveillance, Epidemiology and End
Results Database. Journal of Clinical
Oncology. 2005; 23: 4735-4741.
8 Wolpowitz, D. and B.A. Gilchrest, The vita-
min D questions: How much do you need and
how should you get it?, 1 Am Acad Dermatol,
2006: 54:301-317.
s IARC Working Group (2001) Sunscreens (IARC
Handbooks of Cancer Prevention, Vol. 5), Lyon,
International Agency for Research on Cancer,
pp. 148-149.
Subcutaneous Tissue
I I
Penetration of UV Into the Skin
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 affect 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 the latter half of the 21st century.
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. However, some people are more vulnerable
than others to the harmful effects of the sun.
Skin Type
Skin type affects the degree to which some
people 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 high-
er number skin types (5 and 6), though capable of
burning, have darker skin and do not burn as easily.
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How Do Sunscreens Work?
What Is the Sun Protection Factor (SPF)?
unscreens protect your skin by absorbing and/or reflecting UVA and UVB
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
SPF
ffects Resulting From Sun Exposure?
The same people 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 people with higher-number skin types have a lower inci-
dence of skin cancer, they should still take action to protect their skin and eyes from over-
exposure to the sun, since cases of skin cancer in people with darker skin are often not
detected until later stages when it is more dangerous.
Additional factors
Certain diseases, such as lupus, can also make a person more sensitive to sun exposure.
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 Ingredients
Broad-spectrum sunscreens often contain a number of
chemical ingredients that absorb UVA and UVB radia-
tion. Many sunscreens contain UVA-absorbing
avobenzone or a benzophenone (such as dioxybenzone,
oxybenzone, or sulisobenzone), in addition to UVB-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, redness, stinging, swelling, and tightening of the skin.
Consult a physician if these symptoms occur. These reactions are most com-
monly associated with para-aminobenzoic acid (PABA)-based sunscreens and
those containing benzophenones. Some sunscreens also contain alcohol, fra-
grances, or preservatives, and should be avoided if you have skin allergies.
Physical Ingredients
The physical compounds titanium dioxide and zinc oxide reflect, scatter, and
absorb both UVA and UVB rays. These ingredients, produced through chem-
ical processes, do not typically cause allergic reactions. Using new technolo-
gy, the particle sizes of zinc oxide and titanium dioxide have been reduced,
making them more transparent without losing their ability to screen UV.
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.
FDA Monograph
Sunscreen Ingredients
Aminobenzoic acid (PABA)
Avobenzone
Cinoxate
Dioxybenzone
Ecamsule
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
€
©
©
O
€
O
O
€
€
O
•
UVB
•
©
Chemical (C)
or Physical (P)
C
C
C
C
C
C
C
C
C
C
C
C
C
C
P
C
P
Protection Level: • = extensive C) = considerable © = limited O = minimal
For the most up-to-date information on approved sunscreen ingredients, visit
the FDA Web site at .
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:
• Do Not Burn
• Avoid Sun Tanning and Tanning Beds
• Generously Apply Sunscreen
• Wear Protective Clothing
• Seek Shade
• Use Extra Caution Near Water, Snow,
and Sand
• Watch for the UV Index
• Get Vitamin D Safely
Can I Get a Tan
Without UV?
•Sunless 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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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 devel-
oping sun-related ailments increases.
'
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How Can I Protect My Kids?
Children
Because children will be exposed to UV radiation for their whole lives, it
is important to engrain sun safety practices at an early age. Many par-
ents do not properly 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.4 Between 1973 and 2003, cutaneous melanoma
increased by 81 percent.5 Incidence of pediatric melanoma is also on the
rise—increasing almost 3 percent per year—making it just as important
to teach children SunWise behavior.6 By teaching children about sun
safety and encouraging them to take all of SunWise's sun safety action
steps, parents will ensure that their children understand the dangers
associated with sun exposure and the ways to avoid them.
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 protection from clothing is inadequate.
SunWise Program
In response to the serious public health threat
raised by overexposure to UV radiation, EPA is
working with schools and communities across
the nation through the SunWise Program. SunWise aims to teach children
in elementary and middle school and their caregivers how to protect
themselves from overexposure to UV. For more information, go to the
SunWise Web site at .
ost people get an adequate
amount of vitamin D in their diets. If
you are concerned about not get-
ting enough vitamin D, consult your
physician and consider taking a mul-
tivitamin supplement and consum-
ing foods and beverages fortified
with vitamin D daily.8
r
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?
>
he intensity of the sun's UV rays reaching the Earth's
surface varies and should be considered when you plan out-
door activities. The National Weather Service issues the UV
Index, a daily forecast of UV intensity, for the United States.
The UV Index
Index Number
<2
3 to 5
6 to 7
8 to 10
11 +
Exposure Level
Low
Moderate
High
Very High
Extreme
You can obtain your local
UV Index forecast daily
from local weather sta-
tions or newspapers. EPA's
Web site provides daily
local UV forecasts for
your ZIP Code or city and
state at and entering your e-mail
address and ZIP Code or city and state.
In general, UV strength is greatest from 10 a.m. to 4 p.m.
during sunny summer days. Up to 80 percent of UV rays
pass through clouds, however, meaning that sunburn is
possible on cloudy days as well. UV exposure is greater at
low latitudes (nearer to the equator) and/or high alti-
tudes. Snow, water, and sand also increase sun exposure
by reflecting incoming UV rays, making it especially impor-
tant for skiers, boaters, and beachcombers to wear cloth-
ing and hats and apply sunscreen.
Is Sunscreen Fail-Safe?
/
sing sunscreen does not mean it is safe to
spend more time in the sun, especially when the
UV Index is high. Although a sunscreen with an SPF
of 15 or higher offers protection from sunburn, it
does not block all of the sun's damaging rays. In
fact, there is no evidence that sunscreens protect
you from malignant melanoma, the deadliest form
of skin cancer, even though sunburns have been
linked with the development of melanoma. There
is only limited evidence that sunscreens protect you
from several other types of skin cancer.9 To fully
protect yourself, remember to seek shade, mini-
mize peak hours of sun exposure, and wear protec-
tive clothing in addition to applying sunscreen.
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