To Screen or Not to Screen

That was my question this morning. I was about to set out on my favorite walk along Biscayne Bay, where palms and other foliage provide only intermittent shade. After some deliberation, I elected to wear a sleeveless top and (gasp!) no sunscreen on my arms or on the back and front of my neck. On my face, I applied a 25 SPF sunblock (Clinique City Block), but only across my sensitive cheeks and nose. Hardly the makings of a Shakespearean tragedy, and yet...

Whether 'tis nobler to suffer the slings and arrows of a tropical sun or to take arms against the threat of sunburn with chemical emollients—that's a decision dermatologists and others would have us believe is indeed a matter of life and death. Dermatologists maintain that exposure to the sun, even a single sunburn, can lead to melanoma, a life-threatening cancer. I take this concern seriously. Yet to protect myself from the sun's rays, I wind up slathering on a plethora of chemicals with dreadful-sounding names—homosalate, octinoxate, octisalate, avobenzone, octocrylene, oxybenzone.

These chemicals are absorbed into my body through my skin, possibly causing ill effects. Oxybenzone, for example, disrupts hormonal activity. Having had breast cancer that was estrogen and progesterone receptor positive, I'm not sure I like that idea. The "natural" sunblocks, zinc oxide and titanium dioxide, are less likely to be absorbed, but even they can enter the body through minute cracks in the skin. None of this sounds appealing. Yet, too much sun exposure also seems like a bad idea.

To digress—I well remember when margarine became all the rage during the sixties and seventies, fueled by fear of cholesterol. Back then, when I read the list of chemicals among its ingredients, I couldn't believe margarine was better for my health than plain old butter. So I stayed with butter, but used it in moderation. Lo and behold, evidence eventually emerged that margarine of the type sold during that earlier period contained carcinogens plus hydrogenated trans fats that may have been as bad for heart health as the animal fat in regular butter.

So, what does this have to do with sunscreen? For years, dermatologists and sunscreen manufacturers have assured us of the safety of sunscreens. But perhaps time and studies will reveal that the very chemicals meant to prevent harm from sun exposure are worse than the exposure itself. Nowadays, all-natural butter substitutes are available that contain none of the chemicals or trans fats that made them such a bad choice in the past. Is there an analogy in the sunscreen world, something to protect us from the sun that won't ultimately do more harm than good?

Some people advocate the "natural" sun blocks, those which use zinc oxide and titanium dioxide, as a safer choice. Newer formulations make them less greasy, thick, and white when applied. But they can still be pretty gooey, especially if you're putting them all over your body. The better choice may be good old-fashioned clothing—long sleeves, hats, long pants. For most activities, clothing made with SPF fabrics would be overkill. Some of the garments actually have sunscreens embedded in their fabrics, defeating the idea of using clothes instead of chemical sunscreens.

Of course, long sleeves and long pants can be awfully uncomfortable on a hot day. Plus, I'd look pretty odd in such a getup on the beach or, for that matter, anywhere in let-it-all-hang-out Miami. And then there's the issue of vitamin D. It's been recognized in recent years that many of us weren't getting enough vitamin D. Fortified food couldn't supply what we weren't getting from the sun and sunscreens were blocking our ability to utilize the sun for this essential vitamin. Supplements are one answer and I now take them daily. But some doctors (usually not dermatologists) argue that a small amount of sun exposure every day is actually good for us. Hence, my unprotected walk in the Florida sun might have done more than give my skin a healthy-looking glow—it might even have improved my health.

So, how do I reach a compromise I can live with, both in the figurative and literal sense? Since I've already taken Shakespeare totally out of context, let me end with a line from Cymbeline—" Fear no more the heat o' the sun. . ." I'll try to take that advice, but worrier that I am, I'll hedge my bets—sunscreen at the beach or when taking a long walk, long-sleeved shirts when it's not unbearable, and a preference for the shadiest spot on my terrace.

After a day of body surfing in  Manzanillo, Mexico, 1965—hard to see in the photo, but it was the worst sunburn of my life.