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Keep using that sunscreen, but don't assume it's foolproof

  Like a lot of blond-haired, fair-skinned people, 34-year-old Jonjon Baus slathers on sunscreen before he heads outdoors. As a bicyclist and runner, he opts for the sweatproof formulas, and because he rarely gets sunburned, he figures he's safe.

"That's really how I gauge how effective my sun protection is," says Baus, a manager for an Orlando, Fla., running store.

But in the wake of a class-action lawsuit filed recently in California against sunscreen manufacturers — claiming they have fraudulently exaggerated the effectiveness of their products — Baus has started to wonder.

In fact, although dermatologists still recommend the liberal use of sunscreen, they warn that it's entirely possible for the sun to damage skin without burning it, and that most of the sunscreens currently on the market do a better job preventing sunburn than they do at preventing other problems — including premature wrinkles, age spots and even skin cancer.

And neither sun protection factor (SPF) ratings nor the labeling of a product as "broad-spectrum" gives consumers any information on how much they'll be shielded against ultraviolet A rays, which don't cause burning but do cause aging of the skin and potentially cancer.

"I wish sunscreens were better. That would be terrific. But they're not," says Dr. James Spencer, a St. Petersburg, Fla., dermatologist and clinical professor of dermatology for Mount Sinai School of Medicine. "But they are a useful tool, and like any tool, if you don't use it properly, it doesn't work."

The problem is that many people may expect too much from a sunscreen, Spencer says, putting themselves at risk for skin cancer by spending too much time in the sun.

The confusion comes in part because there are different types of sunlight responsible for skin damage — mainly UVA and UVB. Because UVB is what causes sunburn and has a well-established link with skin cancer, it is generally considered more harmful. But scientists now believe UVA causes much of the premature aging of the skin and, more critically, much of the skin's genetic damage, which may also lead to skin cancer. UVA rays can even penetrate windows to reach people indoors.

So far, there's no way to measure the UVA-screening ability of a given product, and scientists don't know how much UVA contributes to the alarming rise in skin cancer. According to the Centers for Disease Control and Prevention, the death rate from melanoma in the United States has climbed about 4 percent a year since 1973.

Though researchers have discussed a rating system for UVA, so far there has been no action on the matter. And that's only part of the problem.

Some experts say that claims for UVB protection could be inflated, too. In 1999, under orders from Congress, the federal Food and Drug Administration drafted a slate of regulations on sunscreen manufacturers but never formally adopted them. Critics say the agency bowed to pressure from the sunscreen lobby.

Representatives of the FDA did not respond to requests for an interview on the subject.

The proposed rules would have prohibited "unsupported, absolute and/or misleading and confusing terms such as 'sunblock,' 'waterproof,' 'all-day protection' and 'visible and/or infrared light protection.' "

Yet doctors agree that those terms — still widely employed in sunscreen advertising — are misleading at best.

No product, experts say, is truly waterproof, sweatproof or capable of lasting all day.

"If you read the fine print," says Dr. John Meisenheimer, chief of dermatology for Orlando Regional Healthcare System, "it does say that you have to reapply them."

Meisenheimer, a competitive swimmer and occasional surfer, says that each time you dive in the water or perspire, you'll need to put on more sunscreen afterward — at least every 60 to 80 minutes. But he still recommends the waterproof variety.

"They tend to stay on a little bit better when you sweat," he says.

He also advises his patients to use products that offer an SPF rating of 30 or higher as well as those that claim broad-spectrum protection, even if there's no way to measure how much. After all, the doctor notes, some UVA protection is better than none.

Ingredients that protect against UVA radiation include avobenzone (better known under the trade name Parsol 1789), which quickly degrades in sunlight, and Mexoryl, which is longer-lasting. The latter has yet to be approved by the FDA, though it has been widely used in Canada and Europe for years.

The bottom line, dermatologists say, is that the more you can stay in the shade, cover up or liberally apply a good-but-imperfect sunscreen, the better off you'll be.

"We're not going to tell people to hide in a cave and only come out at night," Spencer says. "It's not realistic."

Meisenheimer agrees. He says he tells patients: " 'Listen, use your sunscreens, protect yourself as much as you can ... and then just enjoy. ' "