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Choosing a Sunscreen to Combat Photoaging

 By Calvin Lee, MD and Tammy Wu, MD

Sunscreen is one of the most effective anti-aging skin care products available.  According to the Skin Cancer Foundation, the sun is responsible for 90% of the visible changes associated with skin aging.  It is often overlooked because sunscreen doesn't seem exciting since it doesn't involve exotic ingredients from the ocean or enzymes from fetal cells. This article attempts to shed light on the complex world of sunscreens, discusses some safety concerns regarding some of the sunscreen ingredients, and offers our recommendations on what we consider the best combination of ingredients.  We rank sunscreen above Botox when it comes to anti-aging efforts!

Picture by Calvin Lee, MD

SPF only tells 5 % of the story, instead read the ingredients

The ultraviolet light that reaches the earth's surface can be divided into two types:  UVA and UVB.  Both ranges of ultraviolet light can be harmful to our skin.  However UVA is mostly responsible for aging related changes to our skin:  wrinkles, diminished collagen, leathery texture, sun spots, and skin cancers.  UVA is a longer and more penetrating ray:  It penetrates deeper than UVB in our skin, and it penetrates easily through clouds and most windows.  Because of UVA's better penetrating ability, it accounts for 95 percent of the UV radiation reaching the earth's surface.  UVB rays causes sunburn and sunscreens were initially designed to reduce sunburns.  Thus, the SPF rating only addresses UVB part of the spectrum.  There is no UVA information within the SPF system.  In order to figure out the more important UVA blocking ability of your sunscreen, you must consider reading the ingredients.  The "broad spectrum" part of the labeling in the front of the sunscreen is often misleading.  In fact, most sunblocks on the market do not cover UVA rays adequately.  Currently in the US, there is no regulation on the UVA protection ability of sunscreens.

SPF is important, but it only reports the UVB side of the spectrum, and we now know that UVA plays a much bigger role in suppressing our repair mechanisms in our skin thus causing skin aging and cancers. 

Physical vs. Chemical Sunscreen

Physical sunscreens reflect and scatter light and can be considered like a mirror blocking the entry of UV light into the skin.  These work right away upon application.  Zinc oxide and titanium dioxide are minerals which are the two ingredients used in physical sunscreens.  Sometimes physical sunscreens are called mineral sunscreens.

Currently, most of the sunscreens on the market are chemical sunscreens.  Chemical sunscreens form a chemical compound with the skin and mostly work by absorbing the light rays.  Usually one has to wait about 20 minutes for the chemical compounding to take effect.  Examples of chemical sunscreens are avobenzone, octylcrylene, octinoxate, octisalate, oxybenzone, homosalate, heliopex, and Mexoryl.

There are also hybrid sunscreens that contain both physical and chemical elements.  The chemical and physical mechanisms work synergistically to protect from the sun and to protect the physical and chemical ingredients themselves from ultraviolet degradation.

Previously physical mineral sunscreens were called "sunblocks" and chemical ones were called "sunscreens".  Currently the term "sunblock" is considered somewhat misleading and has been replaced with the term “sunscreen”.   Sometimes chemical sunscreens are called “organic” sunscreens as opposed to physical sunscreens which are called “inorganic”, “natural”, or “mineral” sunscreens. 

We prefer physical sunscreens over chemical ones

In general we prefer physical sunscreens (zinc oxide and titanium dioxide) over chemical sunscreens because they are less irritating to the skin and doesn't get through intact skin.  Of zinc oxide vs. titanium dioxide, we prefer zinc oxide because of its broader coverage of UVA light, and of the two, zinc oxide is even less of a skin irritant.  In fact it is the main ingredient in diaper rash cream.  Thus, it is excellent for delicate skin.  Of all the ingredients in sunblock, Zinc Oxide offers the broadest spectrum of coverage of both UVA and UVB light.  However, zinc and titanium can feel like a paste and have a pale appearance.  But there are some formulations which have really improved the feel and the look of zinc and titanium sunscreens.  In fact some of them feel very close to a hydrating lotion.  

Besides the broad spectrum of UVA and UVB coverage, we also prefer physical sunscreens because some chemical sunscreens are currently under scrutiny for possibly causing harmful side effects.  The chemical that has been most commonly brought up as having possibly adverse effects such as hormone disruption is the chemical that is prevalent in most readily available sunscreens – oxybenzone.  Conclusions haven't been fully drawn.  While the medical community is debating the safety of chemical sunscreen ingredients, physical sunscreens already offer an alternative.  Hybrid physical/chemical sunblocks make sense too, because the amount and type of chemicals used in the hybrid sunblocks can be made in lower levels. 

However, there is one more wrinkle  - while we do recommend the physical sunscreen ingredients zinc and titanium, we have some hesitation regarding nanoparticle sized zinc or titanium.  These are extremely small particles, created in the attempt to improve the look and feel of the product.  There’s some thought that they can become unstable when exposed to sunlight and can possibly penetrate through our skin.  For now, as the experts debate this issue, we recommend watchful waiting on these new products. There are many sizes of zinc and titanium which are used, particles over 100 nm in size seem safe with current research in regards to bloodstream absorption.  Furthermore skin care companies are taking steps to coat the particles to ensure that they avoid absorption into the bloodstream.

Zinc or Titanium choices for your safer, physical sunscreen

Of the two ingredients that are used in physical sunblocks, which one is better?  Titanium has a whiter look on the face compared to zinc, is less effective at blocking the long end of the UVA spectrum, and has a higher probability of irritating the skin; however, it is more stable.  We are very happy with the sun protection ability and safety of both ingredients found in physical sunscreens.  However, it will be your choice on the way the sunblock looks and feels with titanium.  Most of our patients prefer the Zinc oxide because of its broader protection within the UVA spectrums (both long UVA rays and short UVA rays - covering the entire spectrum) and its gentleness on the skin.  Because of its greater opacity and tackier feel, they are willing to overlook titanium's better stability (which translates to a higher SPF compared to zinc alone).  If you can't decide, there are sunscreens which combine both zinc and titanium. 

18.5% Zinc Oxide in this product!

But my makeup and moisturizer contains SPF!

Most of these combination products are not made with zinc or titanium.  Even if they contain these physical sunscreen minerals, we feel that an additional layer of sunscreen applied separately allow for more of the sunscreen to be applied to the face.  The sun protection from these sunscreen are dose dependent, meaning that the more you use, the better the protection.  We generally recommend using a nickel to quarter sized dallop for facial coverage.  We are usually not using this much makeup.  About reapplication, powered tinted mineral (physical) sunscreens exist.  These are perfect for reapplication over makeup.  We recommend reapplication of sunscreen every two hours, regardless of SPF. 

But I want my Vitamin D!

We don’t believe in lying out in the sun for extended periods of time to get vitamin D.  It is possible to get adequate vitamin D from outdoor summer sun in Modesto in only 15 minutes or less daily.  This time varies with the season, our latitude on earth, and our skin tone.  If prevention of premature photoaging is your goal, we would recommend continued photo-protection of your face while capturing the sun’s rays on other parts.

Final Thoughts

Keep in mind that even the best medical grade sunscreens applied properly will only offer partial protection from the sun.  Our recommendation to reduce the effects of facial photoaging is to apply daily, a nickel to quarter sized dollop of a sunblock with zinc oxide 3% or more with an SPF of 30 or more.  Use hats and sunglasses in conjunction to sunscreens.  Sunlight bounces off the ground and walls of buildings, and thus hats and sunglasses alone are usually not enough.  And if considering a hybrid physical/chemical sunscreen, consider one without the chemical oxybenzone which might cause hormone disruption.  Try to get a zinc and/or titanium sunblock which feels and looks right to you (without nanoparticles) so that you will use it often and consider reapplication every 2 hours.  Also consider using sunscreen on your neck and hands.  Because UVA penetrates easily through clouds and glass, use sunscreen every day, even when it's cloudy or even if you plan to stay indoors. 

About the authors:

Our Plastic Surgery Reviews |  Botox Face Muscles  |  What's Great About Modesto, CA

Cost of Plastic Surgery in Modesto, CA  |  Creation of Surgical Artistry History

Surgical Artistry webpage is for information only, not medical advice. Dr. Calvin Lee on Google+
www.surgerytoday.com homemade website by Calvin Lee, MD and Tzuying Tammy Wu, MD, Modesto, CA
  Date of edit: 03/30/2013

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