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By Dr. Fang-Yu Li

Still getting tanned with SPF50? Dermatologist shares secrets on choosing effective sunscreen in Taiwan

All dermatologists are obsessed with sun protection, because we know all too well how UV ray affects our skin. In summer time when UV ray stays constantly at a harmful level, we may encounter problems that are more severe than tans, such as spots, wrinkles, and sagginess. Many people wonder why they still get tans even after using sunscreen of high SPF rating, such as SPF50, and this is actually attributed to common confusions and misuses of sunscreen.  

SPF alone is not enough; there is more to sun protection than UVB

So why do we still get tans even with SPF50? Actually, SPF rating does not tell the full story about sun protection, because it only measures how well a product protects against UVB. In the early days, manufacturers used to emphasize and advertise high SPF rating of their products, and although these sunscreens are indeed effective at mitigating sun burns and redness, they do nothing about UVA, which is the main culprit behind tans and aging. For this reason, choosing sunscreens by their SPF ratings alone does not provide complete protection, and tans will still develop inevitably. Today, new products would label their protection strength against UVA using standards such as PA, Boots Star Rating, Broad Spectrum etc. Only by taking into consideration several different standards at the same time may consumers gain total protection against tans.  

UV ray can be distinguished between three different wavelengths: UVC, UVB, and UVA; a shorter wavelength causes more harm but is less effective at penetrating through obstacles. UVC has the shortest wavelength of the three; it is almost entirely absorbed at the ozone layer, and its effects on humans can be neglected. However, ozone depletion in the southern hemisphere does put the residents at higher risk of UV ray exposure. UVB has a medium wavelength that penetrates up to the epidermis, causing sun burns and redness. UVA is the main culprit of the three UV rays; it has the longest wavelength that enables it to penetrate through deeper layers of the epidermis and the dermis, wreaking havoc to collagen fiber and elastin while causing wrinkles and aging. About 95% of UVA reaches the Earth's surface, which can be further distinguished by wavelength into short-wave UVA (UVA2) and long-wave UVA (UVA1). Many sunscreens advertise very high SPF ratings but lack protection against wavelengths of 360nm and above (UVA1), which therefore puts the wearer at risk of UV harm.    

5 key points to choosing the best sunscreen

Having covered the basics about UV rays, we can now proceed to choose the sunscreen that offers the best protection, and we recommend taking note of the key points below:

1. Protection strength: SPF measures protection from UVB rays. Read PA or PPD for UVA protection. The latter two measurements indicate the product's ability to delay tans, and a higher value suggests better UVA protection and therefore takes longer time to develop tans. The plus (+) sign after PA is converted from PPD value. Do take note that people generally put on less sunscreen than is ideal, so we recommend SPF rating of 50 or above against UVB and PA+++ or above (Dr. Li recommends 4 +'s while some of DR.WU's products recommend 3 +'s) against UVA to effectively delay development of tans. 

2. Protection spectrum: As explained above, there are different wavelengths of UV ray, and a sunscreen is considered to offer more complete protection if it covers a broader spectrum. UVA of longer wavelength poses the greatest threat to the skin, but many sunscreens fail to offer protection against wavelengths of 360nm and longer. A product's protection spectrum is usually determined by the critical wavelength value. Products that offer protection against wavelengths of 370mn and higher, i.e. the long wave (UVA1), can be labeled Broad Spectrum. 

3. Evenness of protection: A sunscreen that offers very good protection against UVB but modest protection against UVA, for example, exhibits poor evenness of protection. Some regions of the world do label the evenness of protection, and the EU, for example, uses the UVA Label to indicate that a product protects against UVA for at least one-third the strength of protection against UVB. Meanwhile, UK implements the Boots Star Rating (★★★-★★★★★) and uses more stars to indicate high UVA protection relative to UVB, and therefore better evenness.

4. Endurance: For most sunscreens, protection strength tends to diminish approximately after two hours in two different ways. For a chemical sunscreen, the structure begins to break down after absorbing UV ray; and for a physical sunscreen, electric charges start to build up and attract physical elements such titanium dioxide and zinc oxide, causing the powder to form clusters that result in uneven distribution and degraded performance. The latter shortcoming can be overcome with improved formula design, and consumers may use functional test data produced by reputable institutions to serve as reference. 

5. Refreshing texture: Greasiness is something we all want to avoid when choosing sunscreen. Summers in Taiwan are too hot and humid that even a slightly greasy texture would feel too stuffy to wear. This is why we recommend choosing sunscreens that have a refreshing texture for comfort and better prevention of acne. Summer is the season when our skin is most prone to acnes due to excess sebum secretion, which is why choosing a refreshing sunscreen is especially important during this time. For people who have acne-prone skin, it is recommended to try out new sunscreens for one week on a smaller area of the skin before applying to the entire body. 

The proper way to use sunscreen and the areas most prone to exposure

Besides choosing the right sunscreen, it is just as important to apply proper techniques to ensure the best protection. Many people make the mistake of using inadequate amount of sunscreen. We generally recommend 2mg of sunscreen per square centimeter of skin area, which equates to about the size of a NT$10 coin for the entire face. Alternatively, measure a volume equal to the entire tip of the index finger for one side of the face, and use about half the volume applied to face onto the neck area, covering at least the collar bones. Make sure to cover the back of the hand, because spot removal procedures are difficult to perform on the hands and feet, and the skins are especially prone to darkening after laser surgery. Furthermore, spots on the back of hand adds extra years to a person's appearance. I, for example, would rub a thick layer of sunscreen on the back of my hands whenever I go outdoors, and I generally use sunscreen like hand lotions. Do take note that children are especially prone to sun burn because their skins are not fully developed like adults. Make sure to use sunscreen on children when going outdoors, and cover their neck and skin behind the knees, because these are the areas that are often neglected and prone to sun burn.   

Truth be told, we can not depend on sunscreen as the only way to prevent tans, but should also try to avoid exposure to the sun between 10am and 4pm when UV ray is at its strongest. If it is absolutely necessary to go outdoors, use accessories such as umbrella, hat, and sunglasses for protection. Whenever I go outdoors, I would always apply sunscreen to my face, neck, and back of hand and carry an umbrella with me. When taking children to the park, I would bring sleeve covers to quickly protect myself from UV ray. There is also a common misconception among people that wearing masks can exempt them from sun protection, but end up developing spots as a result. Face masks have no SPF rating and do not undergo rigorous certification like sunscreens do. The misconception about face mask's ability to block UV ray often lead people to neglect sun protection on areas under mask, such as nose bridge and cheek bones, causing spots to develop on the exact areas they try to avoid.  

Lastly, a reminder for females who wear makeup: never neglect sun protection even if the foundation is SPF-rated, because it is impractical and too heavy to apply 2mg of foundation per square centimeter of facial skin. Instead, we recommend wearing sunscreen first followed by light makeup to cater for skin health and appearance at the same time.