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An Expert's Guide to Sun Safety
An Expert's Guide to Sun Safety
An Expert's Guide to Sun Safety
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During the summer months, you may be actively planning to spend time outdoors with family and friends. But before you head out into the sun, there are precautions to take to protect your skin.
The most immediate danger of time in the sun is sunburn. However, exposure to the sun can also increase your risk of skin cancer – which, according to the American Academy of Dermatology, is now the most common form of cancer in the United States. In fact, one in five Americans will develop skin cancer in their lifetime, and one person dies from melanoma every hour, the deadliest form of skin cancer.
As a board-certified dermatologist, I am here to help you and your family better understand what you can do to prevent skin damage, skin cancer, and stay safe in the sun.
What are the dangers of too much sun exposure?
While there are many benefits of outdoor activities, being outdoors does expose one to the sun, therefore it’s important to understand the risks. The sun’s light includes invisible ultraviolet (UV) rays. When these rays reach the skin, they react with DNA to cause sunburn and skin damage, and with a chemical called melanin that results in tanning. Yes, tanning is a sign of skin damage. The risk of damage increases with the amount (e.g., how long) and intensity of exposure (e.g., the time of day) to the sun. People of all skin colors are at risk for sun damage, and the sun’s rays can cause damage even on cool, cloudy days!
There are two types of UV rays you should know about:
- UVA rays pass easily through the earth’s ozone layer, making them the most common form of sun exposure. UVA rays cause our skin to age and wrinkle, as well as contribute to skin cancer.
- UVB rays make up less sun exposure than UVA rays, but are more intense. UVB rays cause sunburns, cataracts (clouding of the eye lens), and affect our immune systems. These types of rays also contribute to skin cancer.
I tell my patients to follow a few basic rules when it comes to keeping their skin healthy and protected from sun exposure:
- Seek shade. The sun's rays are strongest between 10 a.m. and 2 p.m. A good rule of thumb: if your shadow is shorter than you are, it's time to find shade.
- Cover up. Wear protective clothing when you can, like a lightweight long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses with UV protection. Don't forget your lips. Use a lip balm with a sun protection factor (SPF) of 30 or higher, since lips burn easily and are often missed. This goes double for babies and kids, whose skin is more sensitive to the sun.
- Use sunscreen. Choose a broad-spectrum, water-resistant sunscreen with SPF 30 or higher. Broad-spectrum means it protects against both UVA and UVB rays. Apply it generously before you head outside and follow the label for timing (some sunscreens need about 15 minutes to absorb before sun exposure). Most adults need about one ounce, roughly a shot-glass amount, to fully cover exposed skin. Reapply at least every two hours, and sooner if you've been swimming, sweating, or toweling off.
- Skip tanning beds. Tanning beds and sun lamps give off high amounts of UV rays and are linked to a higher risk of skin cancer, including melanoma.
We saw that in September 2021 the U.S. Food and Drug Administration (FDA) issued a proposed order that would update regulatory requirements for common sunscreen products sold in the United States. What does this mean for the public?
FDA’s proposed order asked sunscreen manufacturers to provide more safety data on several sunscreen ingredients – ones that have been used in the United States for years. Specifically, FDA wants to find out to what extent our skin absorbs certain sunscreen ingredients, and whether absorbing these ingredients has effects on our skin and bodies.
In its proposed order, FDA classifies two sunscreen ingredients as “generally recognized as safe and effective” (GRASE) – titanium dioxide and zinc oxide. FDA also proposes that two other sunscreen ingredients are not GRASE: PABA and trolamine salicylate. But, not to worry. You won’t find either of these ingredients in sunscreen legally sold in the United States. FDA also called for more safety data on 12 ingredients before issuing a final determination on how they are classified:
- Ingredients commonly used in the United States: ensulizole, octisalate, homosalate, octocrylene, octinoxate, oxybenzone, avobenzone
- Ingredients not frequently used in the United States: cinoxate, dioxybenzone, meradimate, padimate O, sulisobenzone
While FDA is asking for more data on these 12 ingredients, it’s important to note that it has not said these ingredients are unsafe. Furthermore, FDA confirms the effectiveness of sunscreen as one of the important ways to protect your skin from the sun. In fact, FDA recommends the public continue to follow sun safety guidelines – including seeking shade, wearing clothing, hats, and sunglasses, and using broad-spectrum sunscreen with an SPF of 30 or greater.
Important Update: Acetaminophen
There’s been a lot of talk recently about misleading claims that taking acetaminophen during pregnancy can cause autism. We’ve pulled together some FAQs and answers to help families.
Learn more and get the facts about acetaminophenHow do I know if I’m using the right sunscreen?
There are a variety of sunscreens that contain different ingredients and levels of protection available to consumers. But to protect your skin from the sun’s harmful rays, make sure you always wear a sunscreen that offers the following:
- SPF 30 (or higher)
- Broad-spectrum protection (UVA/UVB)
- Water resistant (if needed)
Make sure you look for a sunscreen that provides all three of these benefits. On some products, you may see the words “broad spectrum” or “UVA/UVB.” Studies show that daily use can reduce your risk of skin cancer and signs of premature aging like wrinkles and age spots.
A NOTE ABOUT DYE-FREE PRODUCTS: Dye-free medications and supplements are a great option for individuals who prefer or require products without dyes, such as those with allergies, sensitivities, or personal preferences. Importantly, both dye-containing and dye-free options are held to the same rigorous safety and quality standards. If you’re unsure which is right for you or your family, talk to your pharmacist or healthcare provider. They can help you choose the option that best suits your needs.
What should parents keep in mind when applying sunscreen on young children?
For babies younger than six months, shade and clothing should do most of the work. Dress them in lightweight long sleeves, pants, a wide-brimmed hat, and sunglasses, and keep them out of direct sunlight during peak hours. If shade and protective clothing aren't available, it's okay to apply a small amount of sunscreen to exposed areas like the face and backs of the hands. Also, watch for signs of overheating, since babies can get too warm quickly in hot weather.
For babies and toddlers six months and older, broad-spectrum sunscreen with SPF 30 or higher is safe to use. A formula with zinc oxide or titanium dioxide tends to be the gentlest choice for sensitive skin. Even with sunscreen on, keep little ones in the shade and in sun-protective clothing whenever you can.
References:
- http://www.washingtonpost.com/wp-dyn/content/article/2005/09/30/AR2005093001998.html
- http://www.mayoclinic.com/health/drug-information/DR602285/DSECTION=precautions-
- http://www.drugs.com/drug-interactions/multivitamin.html
- http://www.naturemade.com/resource-center/articles-and-videos/immune-health/timing-your-vitamins
- http://www.nlm.nih.gov/medlineplus/druginfo/natural/912.html
- http://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/
- http://www.prevention.com/food/healthy-eating-tips/your-breakfast-giving-you-cancer
- http://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
- http://www.ag.ndsu.edu/pubs/yf/foods/fn1607.pdf
- http://www.fda.gov/Food/DietarySupplements/UsingDietarySupplements/ucm110567.htm
Safe Use Tips & Takeaways
Heart Health Takeaways
If your baby is younger than 1 year old and gets a sunburn, call their pediatrician right away. For older children, be sure to reach out if you notice blistering, pain, or fever.
What is fluoride?
Fluoride is a natural mineral found in water, soil, and some foods. It strengthens your enamel, repairs early signs of damage, and makes teeth more resistant to acids from bacteria and sugar.
Is fluoride toothpaste still the most effective option, or are fluoride-free formulas just as good?
Fluoride is still the gold standard for cavity protection. Fluoride-free options can clean your teeth, but they don’t offer the same enamel-strengthening power.
Is fluoride safe for daily use?
Yes. When used as directed, fluoride is safe and effective. It’s been trusted and recommended by major health organizations for over 70 years.
How does fluoride actually protect teeth?
It strengthens enamel, repairs early signs of decay through remineralization, and makes teeth more resistant to acids from bacteria and sugary foods.
Are there any risks to using fluoride long-term?
The main risk—especially for young kids—is swallowing too much, which can lead to mild fluorosis (faint white streaks on teeth). Using the right amount prevents this. For parents, supervise brushing to ensure kids spit out the toothpaste and don't swallow it.
At what age should kids start using fluoride toothpaste?
As soon as the first tooth appears!
* Under 3 years: a tiny rice-sized smear
* Ages 3–6+: a pea-sized amount
Supervise brushing so they don’t swallow it.
* Under 3 years: a tiny rice-sized smear
* Ages 3–6+: a pea-sized amount
Supervise brushing so they don’t swallow it.
Is fluoride still safe and recommended for kids with all the claims online?
Yes. A lot of online claims can be confusing, but decades of research show fluoride is safe and strongly recommended for cavity prevention when used properly.
How much fluoride should my child get from toothpaste?
Use age-appropriate amounts and brush twice a day. If your water isn’t fluoridated, ask your dentist about additional options.
How do I know which kids’ toothpaste claims are real and not just marketing?
Check for the ADA Seal of Acceptance and choose brands your dentist recommends.
Do fluoride-free or “natural” toothpastes protect kids from cavities?
They can help clean teeth, but they don’t provide the same cavity protection as fluoride toothpastes.
Are fluoride-free toothpastes just as effective for adults?
Not for cavity prevention. Fluoride-free toothpastes can help with cleaning and freshening breath, but they do not protect against cavities the way fluoride does. For adults, or anyone who is prone to cavities, fluoride toothpaste remains the most effective option for preventing tooth decay.
Do fluoride alternatives like nano-hydroxyapatite (nHAp) make a difference?
Yes—nHAp can help with sensitivity and early enamel repair. But it hasn’t matched fluoride’s cavity-prevention strength in studies.
How do I compare fluoride vs. fluoride-free options if I have sensitivity or enamel wear?
Fluoride is best for strengthening enamel and cavity prevention. nHAp may help with sensitivity and enamel repair. Some people benefit from using both in a balanced routine. Talk to your dentist about what's right for your specific needs.
Are whitening toothpastes safe to use with fluoride or fluoride-free products?
Most are safe but can be abrasive. Choose gentle formulas and avoid using them every single day—especially for kids.
What should I look for when choosing an OTC toothpaste?
Pick products with proven active ingredients (like fluoride), check for the ADA Seal of Acceptance, and avoid unnecessary additives or sweeteners.
Does fluoride affect hormones or the brain?
No credible scientific evidence shows fluoride at levels used in toothpaste or properly fluoridated water (0.7 mg/L) disrupts hormones or causes neurodevelopmental harm.
What should I do if my community stops adding fluoride to the water?
Use fluoridated toothpaste, consider fluoride rinses (for ages 6+), and talk to a dentist about fluoride supplements for kids (if needed).
Do fluoride supplements have side effects?
They’re safe when used under dental guidance and typically recommended for children in areas without fluoridated water or at high risk for cavities.
What’s the best way to make sure I’m getting enough fluoride?
Brush twice daily with fluoride toothpaste, drink fluoridated tap water if available, and ask your dentist for personalized advice if you’re cavity-prone.
Are heavy metals in supplements dangerous?
Why do plant-based protein powders tend to have more heavy metals than whey protein?
Plant-based proteins come from crops like peas and rice that absorb trace metals from soil as they grow. When concentrated into powder, those traces concentrate too. Whey comes from milk, which goes through a different biological process and shows lower heavy metal levels. This reflects a difference in source material, not a safety problem.
Is there a safe level of lead in supplements?
No known safe level of lead has been identified, so the goal is to keep exposure as low as possible. Since lead builds up in the body over time, extra care is appropriate for children and people who are pregnant. Safety limits for these groups are set very conservatively. Manufacturers are required to test their products for heavy metals, and some go a step further with independent third-party testing. Consumers can contact manufacturers directly to ask about their testing practices.
Is it safe to eat fish if it contains mercury?
Yes. Since seafood is the main source of mercury exposure, health experts, including the FDA and the Environmental Protection Agency (EPA), provide guidance to help everyone make safe and healthy choices. This advice is especially useful for people who are pregnant, breastfeeding, or feeding young children, to help them pick fish that are both nutritious and lower in mercury—such as salmon, tilapia, shrimp, and canned light tuna.
Does the FDA regulate heavy metals in supplements?
Yes, the FDA has authority over dietary supplements and can take action when a product is unsafe. For example, the FDA uses Interim Reference Levels (IRLs) for lead as benchmarks to evaluate potential health risks in food and dietary supplements.
What does a Prop 65 warning on a supplement label actually mean?
It means the product contains a listed substance above California's disclosure threshold. It is a legal notification requirement, not a safety verdict. Prop 65 thresholds are set conservatively, often 1,000 times below any level linked to observed harm. It does not mean the product violates federal safety standards.
Are organic supplements lower in heavy metals?
Not necessarily. Organic certification covers things like pesticides and fertilizers, but it doesn't control what's naturally in the soil or how a product is made. An organic plant grown in soil with arsenic or cadmium will still absorb those metals. Organic is a good farming standard, but it is not a reliable sign of lower heavy metal levels.
How do I know if my supplement has been tested for heavy metals?
By law, supplement manufacturers are required to test or verify that their products meet quality and safety specifications, including limits on contaminants such as heavy metals when appropriate. The FDA reviews these records during inspections. Some companies go a step further and use independent third-party re-testing for added assurance. You can always contact the manufacturer directly to ask about their testing and quality practices.
Should children or pregnant people avoid supplements because of heavy metals?
Not automatically, but extra care is reasonable. Safety guidelines for these groups are set very carefully because their bodies can be more sensitive to certain exposures. For lead in particular, where no amount has been shown to be safe, the goal is always to keep exposure as low as possible. Children and pregnant individuals should take only supplements recommended by a healthcare provider.
What should I look for when buying a supplement I can trust?
Start with established brands sold through reputable retailers, not unverified online sellers. Be skeptical of claims like "pure" or "heavy metal free" unless there is independent testing to back them up. When in doubt, don't hesitate to contact the manufacturer directly to ask for their heavy metals test results.