Hundreds of sunscreens under the sun

Ah, summer! Swimming, biking, gardening, fishing, boating, ball games, beach-sitting . . . and - ouch! - sunburn.

So you reach for the sunscreen. But which one? The selection at most stores is gargantuan and baffling.

A national environmental health advocacy organization, the Environmental Working Group (EWG), annually evaluates sunscreens. This year, its researchers analyzed 1,700 sunscreen products, including lotions, sprays, moisturizers, and lip balms. Their conclusion: 80 percent offer inadequate protection or contain ingredients the group considers harmful.

Indeed, experts of every stripe advise that your first line of defense should be shade, a wide-brimmed hat, and long sleeves. But, get real.

The American Academy of Dermatology and the U.S. Food and Drug Administration, which regulates sunscreens, like to keep the message simple: Wear sunscreen.

For those who want to delve a little deeper, the EWG report (at www.ewg.org) provides detailed information on the chemicals in sunscreens, a database of products, information about how to read labels, and a "hall of shame" of products it says make misleading claims or have other problems.

Among the sunscreen sins, the report says, companies exaggerate the protection their products offer.

The EWG also has long criticized the use of two chemicals: oxybenzone, which can disrupt the hormone system, and retinyl palmitate, a form of Vitamin A that some studies have suggested can make the skin more sensitive to the sun's rays.

Both are chemical sunscreens. The EWG favors the use of products that are physical barriers - "mineral" sunscreens that contain zinc and titanium. Years ago, those were the products that gave lifeguards their signature white noses. But now, they contain nanoparticles of the chemicals that reduce or eliminate that white tint. Then again, the properties of nanoparticles may vary from product to product, and manufacturers are not required to disclose them, according to the EWG.

So, yes, use sunscreen. "But you need to remember that it has a lot of deficiencies. It's not a perfect product," said EWG senior analyst Sonya Lunder. "It's not a magic shield. Ingredients break down. Some are allergenic. Some are hormone disrupters."

The EWG goes so far as to say our use of sunscreen may actually be causing more skin damage. That's not because of anything intrinsic to the product, but because we place too much trust in it. We slap on a coating in the morning and then spend hours in the sun, never reapplying it.

A study published online Tuesday in the Journal of the American Academy of Dermatology found only 30 percent of women - and even worse, 14 percent of men - said they regularly used sunscreen when they were going to be out in the sun for more than an hour.

Among those who did, 40 percent were unsure whether the product they used provided broad-spectrum protection, meaning protection from both the UVB rays that cause sunburn and the UVA rays that penetrate the skin more deeply and are thought to be more damaging.

Others are misled by claims of high SPF - sun protection factor - values. Critics claim SPF values of, say, 75 or 100 are difficult to verify and offer only marginally better protection, if that. Although the FDA once proposed not allowing labeling that claims the highest SPF values (50-plus would be the cap), that rule was never finalized.

All this is important because skin cancer is the most commonly diagnosed cancer in the U.S. The American Cancer Society projects 3.5 million cases of nonmelanoma skin cancer will be diagnosed this year, compared with roughly 220,000 to 235,000 cases each of prostate, lung, and breast cancer. One in five Americans will be diagnosed with skin cancer in his or her lifetime. Rates of melanoma, the deadliest skin cancer, are particularly on the rise.

Better products may be on the horizon.

In November, Congress roused itself from systemic stalemate to pass the Sunscreen Innovation Act, aimed at getting the FDA to clear a backlog of new sunscreen products awaiting evaluation - in some cases for years.

Lunder and others have high hopes for two classes of chemicals now used in Canada, Europe, and other countries. (If you're traveling and want to find them, look for products containing Tinosorbs and Mexoryl.)

"We are most excited about these because they offer something that isn't part of the tool chest for U.S. companies now, which is a strong, stable UVA filter," Lunder said. "We can't argue against FDA doing a careful review. But we feel that urgency, that they could improve the protectiveness of U.S. sunscreens."

Joseph Sobanko, a Penn Medicine skin-cancer specialist and dermatologic surgeon, applies sunscreen every day. It's a part of his routine.

He advises his patients to do the same. It's simple: "SPF in a daily moisturizer is certainly going to reduce the signs of aging and reduce the risk of skin cancer. . . . Protection from the UV rays is really paramount."

He recommends products with an SPF of 30.

Beyond that, choosing a product also is simple, he said. All other issues aside, the best one is the one you'll actually use. Regularly. And don't forget to reapply it.

"Any one," Sobanko said, "is better than none."