Dermatologist always prefer and recommend physical blockade versus sunscreen for ultraviolet UV protection.Clothing in the form of hats, shirts, or pants as well as and overhead screens or coverings are much more effective than any applied sunscreen particularly because their efficacy does not decrease over time like all topically applied UV products. Since this is not always possible we have recommendations on current commercially availble skin applied products.

Sunscreens

Sunscreens can be divided into two basic types. “Mineral” or “Barrier” based sunscreens sit on the surface of the skin and block ultraviolet radiation from coming in contact with the underlying structures. The “Chemical” based sunscreens absorb into the skin and are able to absorb ultraviolet radiation within the atomic bonds of their chemical structure.

Recent literature has suggested that some of the chemical based sunscreen active ingredients are able to pass through the skin and become absorbed in the bloodstream to measurable levels. Studies are ongoing to determine the significance, if any, of these measurable levels of chemical active ingredients.

We are currently recommending only Mineral (Barrier) based sunscreens while this aspect of UV radiation preventive care is researched and consensus finalized. The active ingredients that we currently recommend are Zinc Oxide (ZnO) and Titanium DiOxide (TnO2).

In selecting a sunscreen we recommend to review the “active ingredients” on the product label to ensure that only the two above Mineral (Barrier) ingredients are present. Some products may have one of these, some may have both, but either alone or in combination they are recommended. Some specific examples of products meeting these criteria are listed below:

• Cetaphil Sheer SPF50 mineral sunscreen
• Neutrogena Sensitive skin Mineral
• Blue Lizard Sensitive skin 30
• CeraVe Hydrating Sunscreen 50 for Sensitive skin
• Coppertone Pure Simple Baby 50

This list is not intended to be comprehensive. Almost all major brands of sunscreen will have a product line that is only mineral based. They are often packaged or marked as the “sensitive skin” or “baby” product as their ingredients are usually less irritating to the skin.

Additionally, current evidence based medicine strongly supports the use of sunscreens to prevent skin cancers. Please review the CMAJ journal article:

CMAJ. “The efficacy and safety of sunscreen use for the prevention of skin cancer” CMAJ 2020 December 14;192:E1802-8. doi: 10.1503/cmaj.201085.

It can be found at the CMAJ website: https://www.cmaj.ca/content/192/50/E1802