July 8. By Will Atwater/NC Health News. From the EnoFest in Durham to Christmas in July in Ashe County, from Topsail Beach to Grandfather Mountain, North Carolinians are gearing up for active, sun-drenched days. But as shorts-and-T-shirt weather heats up, experts warn: Don’t forget to apply sunscreen.
The Environmental Working Group, which has published its annual Sunscreen Guide since 2007, recently released its 19th edition. In this update, the organization found that of 2,204 products tested, only 498 — roughly 23 percent — met its criteria.
While the group’s findings may lead some to question the value of those bottles of sunblock collecting in their bathroom drawers and cabinets, David Andrews, EWG’s acting chief science officer, said, “Wearing any sunscreen is much more important and offers better sun protection for your skin than not applying anything.”
Six million adults are treated for nonmelanoma skin cancers each year, Andrews estimated. Those cases include basal cell and squamous cell carcinomas, two of the most common forms, according to the Centers for Disease Control and Prevention.
Dermatologists and researchers agree that — regardless of skin complexion — regular sunscreen use benefits everyone.
Natural sunblock
In the United States, non-Hispanic white people are more susceptible than other racial groups to developing sun-related skin cancer.
For example, non-Hispanic white people have about a 3 percent lifetime chance of developing melanoma, an invasive skin cancer. If detected early, melanoma is highly treatable, according to the American Academy of Dermatology. However, left untreated, it can spread to the lymph nodes and internal organs, which can be fatal.
By comparison, the lifetime risk of melanoma is about 0.5 percent for Hispanics and 0.1 percent for Black Americans.
“The way that melanin works, and why it’s protective, is that it basically sits over a cell’s nucleus,” said Dr. Puneet Jolly, a professor of dermatology at the University of North Carolina School of Medicine. “The nucleus is where your DNA lives, and it’s when your DNA gets damaged that you get skin cancer.”
Jolly continued, “[Having] dark skin [is] like having a thick, really good umbrella sitting on top of the nucleus, versus someone who is fair-skinned having a thinner umbrella, or an umbrella that is not opaque, where sunlight can get through. That’s the way melanin, a pigment, works and why people who have more pigment have a much lower risk of sun-related skin cancer.”
Although people with darker skin — including Black Americans and other people of color — have more natural protection against the sun’s ultraviolet rays due to higher levels of melanin, data show they have a higher risk than white Americans of actually dying from melanoma when they develop it. Between 2011 and 2019, the five-year survival rate for Black people with melanoma was 66 percent, compared with 90 percent for white people, according to a 2019 CDC report.
Experts say there is a range of factors behind this disparity, including delayed detection of suspicious spots that may be harder to recognize on darker skin, limited or infrequent visits to a dermatologist and extended exposure to ultraviolet radiation without consistent sunscreen use.
From that CDC report, the highest number of Black people developing skin cancer during that time period were in the South, although they didn’t have the highest rate. This reflects the relatively large Black population in the South, compared with other regions.
An ounce of prevention
Scientists at EWG emphasize that not all sunscreens are created equal.
Sunscreens come in various forms — including lotions, sprays, sticks, gels, powders and foams — but EWG researchers found that four out of five products they tested provided insufficient protection. Some could even be harmful, with the danger from chemicals in the product outweighing the benefits of protecting one’s skin.
With thousands of sunscreen products on the market, making a wise choice can feel overwhelming for consumers. EWG’s annual sunscreen guide is meant to make the purchasing process less daunting, Andrews said.
“Our goal is to simplify this space for people,” Andrews said. “We want people to go outside and have fun in the sun, but also realize that sunscreen is an important tool — one that helps reduce overexposure and potential long-term health harms.
Know your numbers and letter
SPF, or sun protection factor, measures how well a sunscreen product protects skin from burning when exposed to the sun. To determine a product’s SPF, researchers apply a standard amount of sunscreen to multiple spots on a volunteer’s back, then expose those areas to high-intensity ultraviolet B lamp light — the portion of sunlight that causes sunburn and contributes to skin cancer.
They then observe how long it takes to produce mild redness on protected skin compared with unprotected skin. The ratio of these exposures determines the SPF value.
While SPF reflects protection against UVB rays, it does not tell the full story. Ultraviolet A rays penetrate deeper into the skin and cause invisible damage such as premature aging and DNA changes, and they contribute to skin cancer risk.
Some key points contained in the report:
Mineral-based sunscreens that include zinc oxide and titanium dioxide “are the only active sunscreen filters generally recognized as safe and effective by the FDA.”
Choose a broad-spectrum sunscreen with an SPF between 30 and 50. Higher SPF values may encourage overexposure and leave skin vulnerable to damage.
SPF measures UVB protection (which prevents sunburn), but many sunscreens fail to reliably block UVA rays, which penetrate deeper and can contribute to aging and increased cancer risk.
Apply sunscreen generously — about an ounce, or roughly a palmful — to all exposed skin, and reapply at least every two hours, or more often if swimming or sweating.
Choose a lotion or stick that you can gently rub directly onto your skin.
Be cautious with spray sunscreens. They pose inhalation risks and can be applied unevenly.
Watch for products with undisclosed fragrances, which may pose health risks.
Use sunscreen and bug repellent separately. Apply repellent first to avoid overexposure to its chemicals when reapplying sunscreen.
Andrews noted that “tanning beds were designed to provide UVA exposure to promote tanning, and use of tanning beds is associated with increased melanoma rates in young women in particular.”
Dermatologists recommend choosing broad-spectrum sunscreens with an SPF between 30 and 50, which protect against both UVB and UVA rays. Broad-spectrum products are specifically formulated to block or absorb a wider range of ultraviolet radiation and provide a more comprehensive defense.
“Broad-spectrum products provide protection from UVA rays that are associated with skin cancer, free radical generation and immune harm,” Andrews said in a 2021 news release.
Sun protective clothing
If possible, Jolly recommends wearing clothing specifically designed to shield the skin from the sun’s ultraviolet rays, noting it can offer advantages over sunscreen. Such garments are rated using an ultraviolet protection factor, or UPF, scale, which measures how effectively they block UV radiation. Jolly favors the clothing option because, he said, “you don’t have to worry about reapplying sunscreen [and] you don’t have to worry about, ‘Did I put the right amount on?’”
He explained that a device called a spectrophotometer measures how much light is transmitted through a garment. “In general, when they give you a UPF scale, anything over 25 is very, very good. That means it’s blocking about 96 percent of the sun’s rays,” he said.
Jolly also noted that sun-protective garments have improved over time and, like mineral sunscreens, many now incorporate zinc oxide and titanium dioxide. As for whether cost might be a barrier, he said one need not purchase several garments, for instance, because the material is durable.
“When you wash them, the way the fabric is woven, it becomes tighter, so it starts to actually work even better,” Andrews said.
He recommended investing in “a couple of high-quality [shirts] that don’t break the bank. The technology is improving, so it’s going to get better and less expensive over time.”
Andrews agrees that clothing offers uniform protection from the sun — even non UPF garments
“In most situations, any clothing will provide adequate, or at the very least, significant protection that’s completely uniform, completely balanced.” He also recommends utilizing shade such as umbrellas, tents or North Carolina’s own Shibumi Shades “as part of the overall strategy to reduce your probability of being overexposed.”
Apply and reapply
Experts agree it’s not uncommon to find bottles of partially used sunscreen from previous years in American households. According to Andrews, most sunscreens (unless otherwise noted) “should remain effective for three years.” However, he emphasized, “you should likely be using more sunscreen when you apply it.”
Jolly agreed that the amount is critical. “I get this question all the time: ‘What SPF sunscreen should I buy?’ I tell them anything over 30, I’m happy with. But what’s more important is to put on the right amount — about a teaspoon, then reapply,” he said.
Experts generally recommend applying about an ounce of sunscreen every two hours while you’re outdoors. However, depending on body size, it may take more to cover exposed areas, according to the American Academy of Dermatology.
Andrews summed it up: “Use up the sunscreen and don’t carry it over for too many years.”
For more information about sunscreen — including which brands earned the highest marks — check out the Environmental Working Group’s 2025 Guide to Sunscreens: https://www.ewg.org/sunscreen/.
