Nashville Dermatologist -- Picking a Sunscreen, Part Two

Nashville Dermatologist -- Picking a Sunscreen, Part Two

OK. So we know we need a sunscreen with SPF 30+ and it needs broad-spectrum coverage. But we all know that when we walk into the drugstore or up to the cosmetics counter, there seem to be a BA-JILLION different sunscreens, and they all have different price points. How do you even start to choose?

Here are a few pointers that we have picked up along the way.

1. First, with sunscreen, you generally get what you pay for. You don't want to pick a sunscreen from the dollar store, nor do you want to buy the absolute cheapest sunscreen at the pharmacy. Generally speaking, we have found that the brand-name sunscreens are less irritating and more effective than the off-brand or store-brands. Aveeno, Neutrogena, Vanicream, La Roche Posay, and California Baby Super Sensitive are all easily available brands with great track records for performance.

2. Second, the mid-range sunscreens generally all do a great job at exactly what they are supposed to do -- block the sun's harmful rays. However, they may not be cosmetically elegant or they may not be appropriate for certain special situations.

3. At the higher price points, sunscreens are being designed to solve a specific problem for a special situation. They are cosmetically more elegant and therefore are more appealing for everyday use. They may be designed for sensitive skin, or acne-prone skin, or for children. So although the mid-priced sunscreens and higher-priced sunscreens generally have the same efficacy (are equally effective at blocking the sun), the specialty brands often offer particular advantages for special situations. 

4. And then of course you have to choose whether you want a lotion, a cream, a spray, a sport stick, etc.

So, what should you pick? And the answer, of course, is that it depends. You need to choose your sunscreen based on how you are going to use it. Here are a few common scenarios:

You are going on a beach vacation. You don't have any particular concerns (no allergies or sensitivities, for example), but you need something that is water-resistant that you can reapply frequently throughout the day.

We would recommend an SPF 50 or higher in this situation, as the sun at the beach can be particularly intense. Choose a broad-spectrum sunscreen and choose a large quantity. Each person needs 1 ounce for each application for full-body coverage. For one person spending 8 hours at the beach, you need approximately a 6 ounce bottle! Look for water-resistance and consider whether a lotion or a spray will be easier for you to apply. (Sprays should not be used on young children). In this situation, a Neutrogena Sport or Coppertone Sport would be a great choice, as would Blue Lizard.

You have acne-prone skin but you know you need a sunscreen to wear every day on your face, neck, and hands. You are a working professional, so you don't want something greasy or something that smells like coconut. You also are approaching mid-life so anti-aging is a concern.

This is a scenario in which it would be worth considering a higher-end sunscreen that has a smooth, dry finish, won't clog your pores, has a pleasing fragrance, layers well under make-up, and has anti-aging properties as well. Our favorite skincare lines have answered this particular need well -- EltaMD is a skincare line with many elegant sunscreens that are perfect for blemish-prone and sensitive skin. They also contain niacinamide for its calming properties.

You have really sensitive skin and you cannot tolerate chemical sunscreens -- in fact, you have broken out in an itchy rash that lasted for days the last time you tried a drugstore sunscreen. But you have fair skin and blue eyes and know you need good protection. What are your options?

Thankfully, there are many sunscreens available for people with sensitive skin. Blue Lizard is a sunscreen brand out of Australia that uses physical blockers and is great for people with sensitive skin who are on vacation or who exercise outdoors and need reliable, consistent protection. For patients who need a product for every day usage, SkinCeuticals Physical Fusion and EltaMD Pure are two great options. Vanicream and California Baby Super Sensitive are two drugstore options that are great for children with sensitive skin.

You know you need to wear sunscreen on your face every day, but you hate skincare products. You want to apply one thing only to your skin every morning. What is one product that will take care of everything?

You need a BB Cream! While we prefer that patients apply a dedicated sunscreen first, then apply their cosmetic coverage, we understand "product fatigue" and the need to simplify our daily routines. In this situation, we recommend EltaMD Elements or EltaMD UV Daily Tinted. Both of these products have excellent spf, are tinted, and provide great coverage. You can then set the product with a mineral powder and you are ready to go!

Nashville Dermatologist -- Picking a Sunscreen, Part One

Nashville Dermatologist -- Picking a Sunscreen, Part One

So last week we talked about common-sense ways to protect your skin from the sun and we learned that sunscreen is preferably your last line of defense against sun damage.

BUT . . . we all go outside and we all need sunscreen, so let's talk about how to pick the best one for you.

Before we go on, we need to mention that this blog is intended for educational purposes only and cannot nor should not replace the recommendations of your own personal physician. There are many factors that affect which sunscreen you choose, and we are going to try to simplify that process for you.

First things first, sunscreen is meant to protect you from the sun's damaging rays. How does it do that? Well, sunscreen utilizes either chemical blockers (which absorb the damaging rays) OR physical blockers (which reflect the damaging rays), OR a combination of both. These days, most effective sunscreens use a combination.

Chemical blockers that are commonly used include avobenzone, octinoxate, oxybenzone, octisalate, octocrylene, homosalate, and mexoryl.

Zinc dioxide and titanium dioxide are the two physical blockers that are used. Because zinc and titanium do not rub in and instead leave a white, chalky paste sitting on the surface of your skin, often these particles are "micronized" or basically are made super, super tiny so that they do not leave a chalky coating on your skin.

So how do you know whether you want a physical sunscreen, a chemical sunscreen, or both -- and when you are reading the label of ingredients, how do you know if your chosen sunscreen is effective?

There are two things you really need to know regarding the efficacy of your sunscreen -- first is the SPF, or sun protection factor, and second is the spectrum (is it "broad spectrum" or not).

SPF is the numerical rating that describes the relative strength of the sunscreen at blocking UVB rays. Dermatologists generally agree that you want to choose an SPF 30 or higher. SPF DOES NOT imply the duration that a sunscreen will last, but rather the amount of UVB rays that it will block. So choosing a higher SPF DOES NOT mean that you can reapply less frequently. Above SPF 50, the increase in sun protection is small, however for people who have a history of melanoma or are particularly prone to burning, an SPF higher than 50 is often a good choice. At Traceside, our family members are wearing an SPF 70 at the beach.

The SPECTRUM of the sunscreen indicates whether it covers both UVA and UVB rays. As we discussed above, the SPF tells you how well the sunscreen blocks UVB. But what about UVA? The sunscreeen also needs a UVA blocker. The physical blockers will both block UVA. The chemical sunscreen Mexoryl also blocks UVA.

So, in summary, when you are reading the label on a sunscreen you want to choose a sunscreen with:

1. SPF 30 or higher

2. Broad-spectrum (UVA and UVB) coverage

3. to achieve that, you need to either have picked:

* a completely physical sunscreen (zinc and titanium only)

* a chemical sunscreen that contains Mexoryl

* or a chemical sunscreen that ALSO has at least one of the physical blockers


Stay tuned! On our next post we will cover choosing the actual brand and special considerations for people with specific concerns (aka an allergy, sensitive skin, acne-prone skin, etc.).


Nashville Dermatologist -- Sun Protection 101

Nashville Dermatologist -- Sun Protection 101

School's almost out here in Nashville and naturally we are all turning our eyes towards summer -- days at the pool, weekends at the lake, afternoons at the ball park, and perhaps a little work around the yard.

Given that our active lifestyles keep many of us outdoors, what are the smartest ways to protect your skin? And did you know that sunscreen is actually your last line of defense against sun damage? Follow these four simple rules to enjoy the outdoors and minimize sun damage.

1. Avoid Sun Exposure Between 10 and 2

The sun's rays are at the most intense during the middle of the day. It is best to stay indoors during these hot hours with direct overhead sunlight. Work on a project, run some errands, eat lunch with the kids, read a book -- it's your choice, but try to not be outdoors during these hours.

2. Wear Sun-Protective Clothing

Clothing is a GREAT way to protect your skin from the sun! Did you know that there are many comfortable, lightweight, cool, and even attractive options for sun-protective wear? Dr. Valet's personal favorite is Coolibar, a company out of Australia (find them at  Most people are familiar with rash guards, but did you know you can find swim tights as well as surf-style suits? Don't forget the little ones who need sun protection and also, don't forget your scalp and eyes! Hats and sunglassses are critical.

3. Actively Seek Shade

When you have to be outside during sunny hours, try to sit in the shade -- the shade of a tree, an umbrella, a porch awning (you get the idea!). Any shade you can find will protect your skin from the sun's most intense rays.

4. And Lastly . . . Wear Sunscreen on Exposed Skin

You knew we would recommend it. Most dermatologists recommend an spf of 30 or higher re-applied every 60-90 minutes during active sun exposure. Stay tuned for another blog post soon on HOW to choose a sunscreen. (It can be overwhelming, we know).

Until then, enjoy the last days of school and stay cool!