Skin Cancer Foundation Statement: It’s estimated that 86 percent of all melanomas are caused by exposure to ultraviolet (UV) radiation from the sun. While genetics and family heritage also play a role, sun exposure, or more specifically the pattern of sun exposure, is of prime importance in the majority of melanomas.

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Intense, intermittent UV radiation exposure (the kind you may get on a sun-drenched holiday after spending many months indoors) is linked with an increased risk of melanoma, recent research has shown. Intense, intermittent UV exposure often causes sunburn, and just one blistering burn in childhood or adolescence (or a total of five sunburns sustained by any age) more than doubles a person's chances of developing melanoma later in life.

Related Reading and Evidence-Based Research Studies:

Parkin DM, Mesher D, P Sasieni. Cancers attributable to solar (ultraviolet) radiation exposure in the UK in 2010. Br J Cancer 2011; 105:566-69.

Pleasance ED, Cheetham RK, Stephens PJ, et al. A comprehensive catalogue of somatic mutations from a human cancer genome. Nature 2010; 463:191-96.

Chang YM, Barrett JH, Bishop DT, et al. Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls. Int J Epidemiol 2009; 38(3):814-30. Epub 2009 Apr 8.

Gandini S, Sera F, Cattaruzza MS, et al. Meta-analysis of risk factors for cutaneous melanoma: II. sun exposure. Eur J Cancer 2005; 41(1):45-60.

Pfahlberg A, Kolmel KF, Gefeller O. Timing of excessive ultraviolet radiation and melanoma: epidemiology does not support the existence of a critical period of high susceptibility to solar ultraviolet radiation-induced melanoma. Brit J Dermatol 2001; 144:3:471.

Lew RA, Sober AJ, Cook N, Marvell R, Fitzpatrick TB. Sun exposure habits in patients with cutaneous melanoma: a case study. J Dermatol Surg Onc 1983; 12:981-6.

Skin Cancer Foundation Statement: Studies offer dramatic evidence that indoor tanning bed use increases the risk of melanoma, the deadliest form of skin cancer. Just one indoor UV tanning session increases users’ chances of developing melanoma by 20 percent, and each additional session during the same year boosts the risk almost another two percent. Those who begin tanning before age 35 increase their risk by almost 90 percent. Any suggestion that tanning beds are safe is putting people’s lives in danger.

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The International Agency for Research on Cancer, affiliated with the World Health Organization, has determined that UV radiation-emitting tanning devices are cancer-causing in humans. While many members of the medical community had long believed that UV radiation from indoor tanning is carcinogenic, it had been difficult to verify the association between indoor tanning and melanoma incidence until recently. Earlier research had already shown that indoor UV tanning increases the risk of non-melanoma skin cancers. In fact, people who use tanning beds are 2.5 times more likely to develop squamous cell carcinoma and 1.5 times more likely to develop basal cell carcinoma, the two most common forms of skin cancer.

Related Reading and Evidence-Based Research Studies:

Boniol M, Autier P, Boyle P, Gandini S. Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis. Brit Med J 2012; 345:e4757. Doi: 10.1136/bmj.e4757.

Zhang M, Qureshi AA, Geller AC, Frazier L, Hunter DJ, Han J. Use of tanning beds and incidence of skin cancer. J Clin Oncol 2012; 30(14):1588-93.

National Toxicology Program. Report on Carcinogens, Twelfth Edition. U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program. 2011: 429-430. Accessed February 12, 2012.

Cust AE, Armstrong BK, Goumas C, et al. Sunbed use during adolescence and early adulthood is associated with increased risk of early-onset melanoma. Int J Cancer 2011; 128(10):2425-35. doi: 10.1002/ijc.25576.

Lazovich D, Vogel RI, Berwick M, Weinstock MA, Anderson KE, Warshaw EM. Indoor tanning and risk of melanoma: a case-control study in a highly exposed population. Cancer Epidem Biomar Prev 2010; 19(6):1557-68. Epub 2010 May 26.

World Health Organization. Sunbeds, tanning and UV exposure Fact sheet N°287. Interim revision April 2010. Accessed Oct 7, 2011.

El Ghissassi F, Baan R, Straif K, et al. WHO International Agency for Research on Cancer Monograph Working Group. A review of human carcinogens--part D: radiation. Lancet Oncol 2009; 10(8):751-2.

Karagas MR, Stannard VA, Mott LA, Slattery MJ, Spencer SK, and Weinstock MA. Use of tanning devices and risk of basal cell and squamous cell skin cancers. J Natl Cancer Inst 2002; 94:224. doi:10.1093/jnci/94.3.224.

Swerdlow AJ, Weinstock, MA. Do tanning lamps cause melanoma? An epidemiologic assessment J Am Acad Derm 1998; 38(1):89-98.

Skin Cancer Foundation Statement: There are three sources of vitamin D: exposure to the sun’s UVB radiation, certain foods, and supplements. The Skin Cancer Foundation recommends that everyone obtain the recommended daily 600 International Units (IU) through a combination of diet and supplements. The limited benefits of exposure to UVB radiation cannot be separated from the sun’s harmful effects, including an increased risk of skin cancers, premature skin aging and a weakened immune system.

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Vitamin D is essential for strong bones and a healthy immune system, and Institute of Medicine recommends that people ages 1-70 receive 600 IU a day. There has been much speculation on the other benefits vitamin D may offer, but after a review of more than 1,000 studies, in 2010 the Institute determined that evidence about the vitamin’s ability to prevent other health problems was inconclusive.

Vitamin D can be obtained from oily fish (salmon, mackerel, sardines) and cod liver oil as well as from fortified orange juice and milk, yogurts, and cereals such as Kashi® U™, Grape-Nuts and Total®. Supplements are readily available and inexpensive.

While obtaining vitamin D from the sun’s UVB rays may at first sound simpler, in fact it is not. Overexposure to UVB actually contributes to the breakdownof vitamin D in the body. After limited UVB exposure (determined by season, time of day, skin type and latitude; approximately five minutes daily for a Caucasian in New York City at 12 PM in the summer), the body’s vitamin D production reaches its maximum. Further UV exposure will not result in more vitamin D, but will instead prompt its disintegration into inactive compounds.

Related Reading and Evidence-Based Research Studies:

Office of Dietary Supplements. Dietary supplement fact sheet: vitamin D. National Institutes of Health. Reviewed June 24, 2011. Accessed Oct. 24, 2011.

Balk SJ. Council on Environmental Health; Section on Dermatology. Ultraviolet radiation: a hazard to children and adolescents. Pediatrics 2011; 127(3):e791-817. Epub 2011 Feb 28.

Institute of Medicine of the National Academies. Report brief: dietary reference intakes for calcium and vitamin D. Nov. 30, 2010. Accessed Oct. 10, 2011.

Brightman L, Hamann G, Geronemus R. The vitamin D dilemma. The Skin Cancer Foundation J 2008; (26):29-31.

Skin Cancer Foundation Statement: Landmark research has provided convincing evidence of the value of sunscreen use in preventing melanoma and other skin cancers. The Skin Cancer Foundation considers sunscreen one vital part of a comprehensive sun safety program, along with shade and sun-protective clothing, including long-sleeved shirts, long pants, a wide-brimmed hat and UV-blocking sunglasses.

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Years of scientific research have provided compelling evidence that the daily use of sunscreen helps lower the risk of non-melanoma skin cancers. Most recently, in a rigorous study of more than 1,600 adults over the course of a decade, researchers determined that subjects applying sunscreen with an SPF of 16 daily reduced their risk of melanoma by 50 percent.

Related Reading and Evidence-Based Research Studies:

Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol 2011; 29(3):257-63.

Green AC, Williams GM. Point: sunscreen use is a safe and effective approach to skin cancer prevention. Cancer Epidem Biomar Prev 2007; 16(10):1921-22.

van der Pols JC, Williams GM, Pandeya N, Logan V, Green AC. Prolonged prevention of squamous cell carcinoma of the skin by regular sunscreen use. Cancer Epidemiol Biomarkers Prev 2006; 15(12):2546-8. Epub 2006 Nov 28.

Green A, Williams G, Neale R, et al. Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet 1999; 354(9180):723-9.

Skin Cancer Foundation Statement: The Skin Cancer Foundation applauds the FDA for issuing its final regulations on sunscreens in 2011. The FDA’s announcement is a boon for consumers, drawing attention to and acknowledging the importance of UVA protection in the prevention of skin cancer.

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Sun protection is an important public health issue, with more than 3.5 million skin cancers in over two million people diagnosed annually in the US. The vast majority of skin cancers are associated with exposure to UV radiation from the sun, and sunscreen is an integral part of a comprehensive sun protection regimen. Although science and technology have advanced over the past several years to dramatically improve the efficacy of sunscreens, there has long been a need to update the governmental regulations associated with them — particularly in the areas of ultraviolet A (UVA) radiation protection and product labeling.

UVA rays, along with ultraviolet B (UVB) rays, are the sun’s wavelengths that reach the earth; protection from both is essential. A sunscreen’s sun protection factor (SPF) measures protection from UVB rays, but until the FDA released its final regulations, which include requirements for the testing and labeling of UVA-screening products, there were no official, standardized methods for measuring or indicating UVA protection. Under the new guidelines, consumers are assured that sunscreens labeled as both “Broad Spectrum” and “SPF 15” (or higher) not only protect against sunburn, but, if used as directed with other sun protection measures, can reduce the risk of skin cancer and early skin aging.

We hope that these new FDA rules, along with the recently updated standards set by The Skin Cancer Foundation’s Seal of Recommendationprogram, will enable consumers to easily choose appropriate sunscreen products.

Related Reading and Evidence-Based Research Studies:

US Food and Drug Administration. Questions and answers: FDA announces new requirements for over-the-counter (OTC) sunscreen products marketed in the U.S. Updated June 27, 2011. Accessed Oct. 10, 2011.

US Food and Drug Administration. Sunscreen drug products for over-the-counter human use; final rules and proposed rules. Published June 17, 2011. Accessed Oct. 10, 2011.

Wang SQ, Lim HW. Current status of the sunscreen regulations in the United States: 2011 Food and Drug Administration’s final rule on labeling and effectiveness testing. J Am Acad Dermatol 2011; 65(4): 863-869.

Rogers, HW, Weinstock, MA, Harris, AR, et al. Incidence estimate of nonmelanoma skin cancer in the United States, 2006. Arch Dermatol 2010; 146(3):283-287.

Skin Cancer Foundation Statement: Despite claims about sunscreen safety, consumers should rest assured that sunscreen products, including the ingredients oxybenzone and retinyl palmitate, are safe and effective when used as directed.

More Information:

Both oxybenzone and retinyl palmitate are approved for use in sunscreens by the US Food and Drug Administration (FDA), and in fact oxybenzone has been available in this country for over 40 years.The Skin Cancer Foundation’s position is based on years of clinical data. Many of the organizations that claim to evaluate sunscreen ingredient safety and efficacy rely on computer models and questionable “experts” for measuring protection against UV radiation, which can only be classified as “pseudo-science.”

Sun protection is essential to skin cancer prevention — about 90 percent of non-melanoma skin cancers and 86 percent of melanomas are associated with exposure to UV radiation from the sun. Sunscreens should be considered a vital part of a comprehensive sun protection regimen that also includes seeking shade, covering up with clothing including a wide-brimmed hat and ultraviolet (UV) radiation-blocking sunglasses, and avoiding UV tanning and tanning booths.

Related Reading and Evidence-Based Research Studies:

Wang SQ, Burnett ME, Lim HW. Safety of oxybenzone: putting numbers into perspective. Arch Dermatol 2011; 147(7):865-6.

US Food and Drug Administration. Sunscreen drug products for over-the-counter human use; final rules and proposed rules. Published June 17, 2011. Accessed Oct. 10, 2011.

Morison WL, Wang SQ. Sunscreens: safe and effective? The Skin Cancer Foundation J 2011; (29); 55-58.

Burnett ME, Wang SQ. Current sunscreen controversies: a critical review. Photodermatol Photoimmunol Photomed 2011; 27(2):58-67. doi: 10.1111/j.1600-0781.2011.00557.x.

Wang SQ, Dusza SW, Lim HW. Safety of retinyl palmitate in sunscreens: A critical analysis.  J Am Acad Dermatol. 2010; 63(5):903-6. Epub 2010 Aug 7.

United States Environmental Protection Agency. Sunscreen The Burning Facts. EPA 430-F-06-013. Sept 2006.

Parkin DM, Mesher D, P Sasieni. Cancers attributable to solar (ultraviolet) radiation exposure in the UK in 2010. Br J Cancer 2011; 105:566-69.

Skin Cancer Foundation Statement: By reducing the particles of the sunscreen ingredients titanium dioxide and zinc oxide to tiny, “micronized” or “nanosize” particles, sunscreen manufacturers are able to eliminate the white, pasty look associated with these ingredients, making sunscreen products appear more natural on the skin. The concern is that nano-sized sunscreen particles could penetrate the skin and damage living tissue. However, this is not the case: sunscreens are applied to the outermost layer of skin, which is made up of dead skin cells. Several studies have shown that nanoparticles do not penetrate intact living skin. Therefore they pose no risk to human health.

Related Reading and Evidence-Based Research Studies:

Wang SQ, Tooley IR. Photoprotection in the era of nanotechnology. Semin Cutan Med Surg 2011; 30(4):210-3.

Mavon A, Miquel C, Lejeune O, Payre B, Moretto P. In vitro percutaneous absorption and in vivo stratum corneum distribution of an organic and a mineral sunscreen. Skin Pharmacol Physiol 2007; 20:10-20.

Gamer AO, Leibold E, van Ravenzwaay B. The in vitro absorption of microfine zinc oxide and titanium dioxide through porcine skin. Toxicol In Vitro 2006; 20:301-307.

Schulz J, Hohenberg H, Pflücker F, et al. Distribution of sunscreens on skin. Adv Drug Deliv Rev 2002; 54 (Suppl. 1): S157-S163.

Pflucker F, Wendel V, Hohenberg H, et al. The human stratum corneum layer: an effective barrier against dermal uptake of different forms of topically applied micronised titanium dioxide. Skin Pharmacol Appl Skin Physiol 2001; 14 (Suppl. 1): 92-97.

Laderman J, et al. Penetration of titanium dioxide microparticles in a sunscreen formulation into the horny layer and the follicular orifice. Skin Pharmacol Appl Skin Physiol 1999; 12:247-256.

Lansdown AB, Taylor A. Zinc and titanium oxides: promising UV-absorbers but what influence do they have on the intact skin? Int J Cosmet Sci 1997; 19:167-172.