Crystal Lake, Illinois' Peggy Lim has a healthy respect for the sun's powerful ultraviolet rays, and on a recent shopping trip she agonized over choosing a sunscreen for her three children.
"I've always heard the higher the SPF (sun protection factor) the better, until you get to SPF 45," said Lim, who finally bought whatever happened to be in front of her. "Now my husband says the SPF doesn't matter as much as how much you use. What's the right amount? Do I have to apply it under their clothes? And how bad of a mother am I if I forget to reapply it?"
Like many people, Lim wants reliable sunscreen information to help sort fact from fiction. But although the U.S. Food and Drug Administration drafted guidelines three decades ago governing the safety, efficacy and labeling of sunscreen, official rules have yet to be implemented.
Critics of the agency say the lack of formal regulations has spawned misleading claims on products and put consumers at risk by encouraging them to rely too heavily on sunscreen for protection.
The FDA expects to finalize the rules in October; they would take effect by 2012.
In the meantime, to help consumers make decisions — and light a fire under the FDA — the Environmental Working Group on Monday released its annual Sunscreen Safety Guide, which rates sunscreens, lip balms and moisturizers, and features a database searchable by brand name. On Tuesday, Consumer Reports will issue its sunscreen guide.
The EWG, an advocacy group that has waged a four-year campaign promoting strict sun-safety standards, slammed the majority of the 1,400 products it tested. It recommends only 39 of 500 beach and sport sunscreens, primarily because of what it called "a surge in exaggerated SPF claims above 50" and concerns about ingredients in the products.
"Hats, clothing and shade are still the only completely reliable sun protection," said Jane Houlihan, EWG's vice president for research.
In fact, the long-delayed FDA rules would update labels to stress the importance of a comprehensive approach to sun protection that encourages seeking shade and covering up.
Sunscreen can help protect against sunburn, but contrary to what many people think, it hasn't yet been shown to prevent skin cancer or premature skin aging, according to the FDA.
Research has found that people who use sunscreen tend to stay in the sun longer than they might otherwise. That is particularly true if a product has a high SPF number, ratings the Environmental Working Group says "sell a false sense of security."
The group reported a 33 percent increase from last year in the number of products labeled with an SPF higher than 50. But the new federal guidelines would cap SPF claims at 50+ because there's little evidence that higher SPF products offer more protection.
SPF numbers, a familiar but baffling system for consumers, primarily measure protection from the UVB (ultraviolet light with a shorter wavelength) rays that cause sunburn.
A product labeled SPF 15 blocks about 93 percent of the sun's UVB rays; an SPF 50 protects against about 98 percent, said Dr. Henry Lim, chairman of the department of dermatology at Henry Ford Hospital in Detroit.
Because 100 percent blockage isn't possible, products labeled SPF 70 or 100 don't make much sense, said Lim.
"Rather than increasing SPF factor, the push now is to make a sunscreen product cover both UVA and UVB — how to make it broader," he said.
UVA (ultraviolet light with a longer wavelength) radiation facilitates tanning but also can damage the DNA of cells deep within the skin, contributing to skin cancer and premature aging.
Though many products are labeled "broad spectrum," consumers can't currently tell how much protection a sunscreen provides against UVA rays. The Environmental Working Group reported it found that one popular children's sunscreen marketed as SPF 100 had a UVA protection factor of 9, which is lower that you might expect.
Under the proposed guidelines, labeling would be expanded to include a four-star system that tells consumers how well the product protects against UVA rays.
The term "waterproof" would be prohibited, and labels on water-resistant sunscreens would have to state how often the products need to be reapplied.
The FDA also wants to tweak SPF testing procedures and allow new combinations of active ingredients. In Europe, 30 active ingredients are approved for use, compared with 16 in the U.S., according to Dr. Patricia Agin, a fellow in skin care research and development at Merck Consumer Care, a division of Merck & Co. Inc. that manufactures Coppertone.
One sunscreen ingredient flagged as risky by the Environmental Working Group is oxybenzone, which boosts UVA protection and is FDA approved. The group cites lab studies suggesting it has an estrogenic effect and can be absorbed into the bloodstream.
"It's very preliminary but troubling," said Houlihan.
Others say absorption alone isn't enough to raise an alarm. "I'm not closing my mind on the issue, but based on the data I don't see any concern with oxybenzone," said Dr. Lim.
The EWG's top-rated sunscreen products, which include the brands All Terrain, Badger, Beyond Coastal and California Baby, all contain either zinc or titanium minerals, which offer more UVA protection than products with a different ingredient called avobenzone, Houlihan said.
Peggy Lim ultimately chose two SPF 50 products marked as "pediatrician tested" for her three children, Ruth, 9, Paul, 7, and Samuel, 5, though she acknowledged she didn't know what that might mean. Both products were scored poorly by the EWG, which used an algorithm to analyze safety and effectiveness.
"When I was a kid, my mom tossed us outside for the summer and told us a healthy tan was a good thing," said Lim with a sigh. "It was easier then."
How much sunscreen should you use? Enough to fill a shot glass, according to the American Academy of Dermatology, though larger people should adjust accordingly. Most people apply a quarter to half of the recommended amount of sunscreen, which lowers the advertised SPF factor.
Spread it on liberally 15 to 30 minutes before going outside and reapply every two hours or after swimming, sweating or towel drying.
Some other factors to consider when using sunscreen:
Sprays and Powders: The Environmental Working Group recommends against these products, which can be accidentally inhaled. Others say there's little risk of harm. "I wouldn't recommend spraying sunscreen into your nose, but the amount you'll inhale is no worse than walking behind a diesel bus," said Dr. David Leffell, chief of dermatologic surgery and cutaneous oncology at the Yale School of Medicine and a consultant for Coppertone.
Vitamin D: Don't forget, the body needs sunlight to make this vital chemical. The National Institutes of Health suggests 5 to 30 minutes of sun exposure between 10 a.m. and 3 p.m. several times a week on the face, arms, legs and back during the warmer months. After that, seek shade, cover up, wear a hat and sunglasses and use sunscreen. Speaking of covering up, the FDA has not advised using sunscreen under regular clothing. It also doesn't regulate clothing that claims to offer UV protection.
Nanoparticles: Sunscreen labels don't say whether the products contain nanoparticles. Studies have shown that nano-scale ingredients don't penetrate healthy skin, so consumer use should be minimal. But if you want to avoid them until more is known, look for the white-colored zinc or titanium oxide products. If mineral-based sunscreens are clear, they likely have nanoparticles.
Combo Products: Insect repellants aren't necessarily safe for frequent application. But you do have to keep reapplying sunscreen. So you may want to avoid combination products.
Retinyl Palmitate: The EWG recommends avoiding products with a vitamin A derivative called retinyl palmitate. Preliminary data suggest topical applications can enhance the rate of UV-induced skin tumor formation in lab mice, said Dr. Allan Conney, director of the Susan Lehman Cullman Laboratory for Cancer Research at Rutgers University. Epidemiological studies would be needed to determine whether humans are at risk.