Dr. Vliet’s Health Tip: Sunscreen Tips for Your Summer Kick-off!

© by Elizabeth Lee Vliet MD and Kathy Kresnik

As the summer season officially kicks off each Memorial Day weekend, I thought it was especially appropriate to talk about my recommendations on being in the sun, and also highlight the newly released annual sunscreen guide from the Environmental Working Group (EWG) with my medical commentary as well.  This is the EWG’s 20th report and I think this organization does a great job in their annual reports to break down the various types of sunscreens, their risks and benefits.  We will also talk about an interesting new form of sunscreen that has been in use in other countries and finally has begun the approval process for sale in the United States. Now keep in mind, I live in one of THE sunniest states in America, but as a physician, my take on sunshine, sunscreen and getting optimal levels of vitamin D may surprise you. Hint…this discussion is going focus on points about how dosing matters!

Sunshine is one of the most important forms of natural medicine we have. I cherish it and recommend being out in the sun, including if you feel sick—especially with a cold or other viral illness. Sunlight in the morning is one of the most important ways you can reset your circadian rhythm to give your mind, body and psyche a “boost” in the morning by turning off melatonin and increasing serotonin and dopamine.  Then watching the sunset in the evening signals your body to start winding down in the evening, with a decrease in dopamine and rise in melatonin, which will help you have better sleep that night.

Sunshine is an important source of vitamin D that is absolutely essential for a strong immune system.  Vitamin D precursor-conversion in the skin is blocked when you wear sunscreen, and this is one of the big reasons that so many of my own patients living in sunny Arizona are deficient in Vitamin D—even when they spend time outdoors.  They are too “covered up” with long sleeves, hats, long pants and loads of sunscreen.

The question becomes how much sunshine is enough and how much is too much? How much Vitamin D is enough, and how much is too much?  How much sunscreen is enough and how much is too much?  I will discuss all these points in today’s Health Tip to help you have a common-sense approach.  And what I am teaching here is pretty much what I do myself to stay healthy – and avoid too much sun, too much Vitamin D AND too much use of sunscreen.

KEY TAKE AWAY POINT:  AVOID BURNING YOUR SKIN IN THE SUN!

This is the most critical point I want you to keep in mind for being in the sun.  Obviously, if you are going to be out on a lake, river, or ocean fishing all day long in the bright sun, you need sunscreen, clothes and hats to prevent sunburns.  But for short walks or outdoor chores, getting some sun on your skin, especially earlier in the morning and later in the afternoon, is really good for you.  For example, when I am outside to do ball sprints for a half hour or walking with my K-9s, or feeding the chickens or other short chores, I don’t wear long sleeves or a hat, and I don’t put on sunscreen.  This is the time I boost my vitamin D via sunshine on my skin.  I want that healthy sun exposure for my skin.

On the other hand, when we were out on dive boats all day during our scuba diving liveaboard trips, I did wear a hat, had on my long sleeve wetsuit and put sunscreen on my exposed face. Remember, being around water adds to the sun exposure due to so much reflection off the bright surface. The same is true when you are at high altitude hiking in the summer or skiing in the winter.  I hope this Health Tip will guide you to make wise choices.

For two decades the EWG has empowered the public with “safer, science-backed choices for sun care”. EWG began offering this service because “twenty years ago, the sunscreen market was flooded with products formulated with potentially harmful chemicals, misleading claims about sun protection and little, if any, reliable information about the ingredients in sunscreens that people put on their skin.”

EWG is the same organization that puts out the annual “Dirty Dozen and Clean Fifteen” organic food lists that our Truth Team has also recommended each year. They started this annual sunscreen guide to review almost 2800 products with sun protection factor, or SPF, and named the top-rated options, based on ingredient safety and balanced protection from ultraviolet, or UV, radiation.  Whenever you use sunscreen, you want to make sure that your choice is based on good scientific studies, the SPF products are free from ingredients of concern and are effective at reducing the effects of UV radiation.  Read the full report EWG’s 20th annual guide to sunscreens | EWG’s Guide to Sunscreens and links to verified products.

For 2026, it is shocking that out of 2,784 SPF products reviewed:

• Only 550 out of meet their rigorous criteria. 
• Only 62 sunscreens met their strictest requirements for health and transparency. 

So, let’s look at the types of sunscreens and how they compare.  The guide points out that “for over a quarter-century, U.S. sunscreen ingredients available to formulators have remained largely unchanged. Since 1999, American families have been forced to rely on limited sunscreen options while products with potentially safer, more effective filters have become the standard across Europe and Asia.”

Types of Sunscreen

Bemotrizinol one of those safer ingredients that has been widely used in Europe, Australia, and parts of Asia for many years.  It is an oil-soluble organic UV filter which provides broad spectrum protection against both UV-A and UV-B radiation and is highly photostable. It is an organic triazine- based UV absorber and is marketed under the trade names such as Tinosorb S, Escalol S, and Parasol Shield in other countries. One of the main benefits is it is highly photostable meaning it does not significantly degrade on UV exposure and can help stabilize less stable filters in combined formulas, which have been the ways it is widely used in so many other countries.

The good news is that in late 2025, the FDA proposed re-classifying bemotrizinol as a safe and effective active sunscreen ingredient, and for the first time in decades a new filter may be allowed on the U.S. market.  The USDA is in the process of adding bemotrizinol up to 6% concentration to the list of permitted sunscreen additives sunscreen actives; current FDA communications describe it as a broad-spectrum filter with low skin absorption and rare irritation. It has a favorable safety profile with low dermal penetration, low rates of skin irritation and no intrinsic estrogenic or androgenic activity. It is described as a promising option for adults and children. Let’s hope it gets approved and comes to market soon!

Mineral sunscreens – especially those containing zinc oxide, remain EWG’s top recommendation for daily use because of that ingredient’s ability to provide balanced UVA and UVB protection.  But for many consumers, the heavy zinc oxide ointments are not very pleasant to use, so even though they are effective, many people turn to something more cosmetically appealing, even if not as effective as a sunscreen.

Chemical sunscreens – Millions of consumers prefer non-mineral formulas more for cosmetic reasons and turn to sunscreens formulated with 3% avobenzone – a chemical filter that provides good UVA protection.  But on the flip side, I want you to be aware that chemical sunscreens containing avobenzone can cause local skin reactions, generate more free radicals as they break down in UV, and contribute to systemic exposure and environmental concerns. Current human data does not show clear and clinically proven systemic harm, however, with use levels in the approved range.  But like a lot of foods and medicines that regulatory agency reviews consider “acceptable” for the general population, those with sensitive skin or adverse reactions to various chemicals may do better using the mineral-based (zinc oxide) sunscreens.

In addition, further caution is wise since more recent studies both by the FDA and some academic centers have shown that avobenzone and other chemical filters are systemically absorbed at levels above earlier “thresholds” that were used to trigger more safety testing.

• A 2020 FDA study found multiple common chemical filters (including avobenzone, octocrylene, homosalate, octisalate, and oxybenzone) reached measurable plasma levels after typical application, even after a single day’s use.
• The FDA emphasized that exceeding this threshold means “we need more safety data,” not that the ingredients are proven unsafe; nonetheless, the long‑term significance of chronic systemic exposure remains unknown.
• Some UV filters (notably oxybenzone, and to a lesser degree others) show endocrine‑disrupting activity in cell and animal models, but human data remain inconsistent and do not show clear links to cancer or major endocrine disease at current exposure levels.

Spray sunscreens – Spray sunscreens are convenient, but they pose two major concerns: inhalation of aerosolized particles and uneven coverage that can leave skin exposed. Benzene, a known human carcinogen contamination has also been found in some aerosol (spray) sunscreen products which appeared to come from manufacturing issues (the propellants) rather than from the sunscreen active ingredients, but the presence of benzene is so toxic it prompted product recalls. This is an additional reason for caution when using spray sunscreens, and it is the reason I agree with EWG recommendation to use lotion or stick sunscreen products instead of sprays.

Other Concerns I think are Important to Consider:

Fragrance:
I personally have many allergies to strong odors and especially synthetic fragrances in so many of these products, and I treat a lot of patients with multiple chemical sensitivities that include fragrances.  I am especially appreciative that EWG’s Guide addresses this fragrance issue that the majority of doctors fail to recognize can be causing significant harms for so many people. EWG reported that in 2026, 36% of sunscreens contain undisclosed “fragrance blends.” I have warned about this problem for many years and have written about it in several of my books.  This “fragrance” catch-all term, sometimes also called “natural fragrances,” can mask hundreds of undisclosed chemicals and petroleum-derived synthetic fragrances that may include allergens, hormone disruptors and carcinogens. Ingredients in fragrance are largely unregulated and inadequately or rarely ever addressed by the FDA. In 2024 the FDA missed a deadline set by Congress for addressing fragrance allergen labeling, leaving consumers to act as their own watchdogs.

For daily users of all products with added fragrance (not just sunscreens), these chemical exposures accumulate over time, and contribute to headaches, brain fog, lethargy, diminished concentration, coughing sneezing, wheezing, nausea, and even palpitations and heart arrythmias.  The symptoms of adverse reactions to synthetic fragrances can be so varied and potentially serious that it may take years and multiple doctor visits to arrive at the culprit.  A simple solution, if you experience puzzling vague symptoms such as I just listed, is to eliminate every single product with added fragrance from your home and observe changes in your health over about a month.  You may be amazed at how chronic daily headaches or nagging coughs disappear!

Sunscreen Protection Factor – SPF:
EWG’s Guide points out that more isn’t always better when it comes to SPF. Manufacturers continue to push SPF 70, 80 and 100+, often using “boosters” that inflate the number without actually improving UVA protection.  If higher isn’t always better, then what DO you need to consider is the SPF target for appropriate protection?

The difference is actually minimal. Marketing people clearly don’t want YOU to know that!  For example:  SPF 50 blocks 98% of UVB rays, while SPF 100 blocks 99%… only providing an additional 1% protection at best! These high SPF numbers can create a false sense of security, leading people to stay out too long without reapplying sunscreen.

EWG’s peer-reviewed research found that, on average, products provided only 59% of their labeled SPF protection against UVB rays and just 24% of the UVA protection implied by their labels. It points out that the U.S. relies on in vivo testing, where technicians visually judge redness on human skin. This subjective method is wildly inconsistent.  The same formula can deliver a test result of SPF 51 at one lab and SPF 28 at another. EWG experts also point out that ‘target number’ pressure plaques the sunscreen testing industry. Test labs risk loss of business if they fail to validate a brand’s desired SPF. The EWG has formally urged the FDA to replace subjective human tests with objective, reproducible laboratory methods that measure UV absorption across the full spectrum.

This “mislabeling” and testing problem is not just happening in the United States. EWG states “The most dramatic recent example came from Australia, where testing by consumer advocacy group CHOICE found that 16 of 20 popular sunscreens failed to meet their SPF claims. One product labeled SPF 50+ tested at an SPF of just 4 at one lab and 5 at another. The scandal triggered sweeping government investigations, dozens of product recalls and a national conversation about whether consumers can trust sunscreen labels at all.”  We need to pressure the FDA to investigate these issues as well.

How To Choose a Sunscreen

• Stick with SPF 50+ or lower.  Don’t fall for high SPF labels that don’t really offer significant increase in protection and are not even likely to be accurate.
• Choose lotions and sticks over sprays to eliminate the risks of inhaling irritating chemicals, as well as uneven coverage.
• Look for mineral-based products with zinc oxide, the gold standard for safe, broad-spectrum defense.
• Screen label for toxic chemicals. Avoid oxybenzone and octinoxate, which are hormone disruptors. 
• Look for “fragrance free” products.
• Avoid sunscreen with vitamin A. Government data show that tumors and lesions develop more quickly on skin coated with creams containing vitamin A, also called retinyl palmitate or retinol. Avoid any sunscreen whose label includes retinyl palmitate, retinol or vitamin A.
• Read the full report EWG’s 20th annual guide to sunscreens | EWG’s Guide to Sunscreens and links to verified products.

EWG and Dr. Vliet’s Sun Safety Tips:

• Don’t get burned. Red, sore, blistered or peeling skin means too much sun exposure – and increases your skin cancer risk.
• Check yourself. Look at your skin regularly for new moles or growth or changes in an existing mole. See a dermatologist annually for a “mole patrol” skin cancer checkup, especially if you live in a sunny climate.
• Cover up when you will be out in the sun for extended periods or you have high skin cancer risks. Shirts, hats, shorts and pants provide protection from UV rays.
• Find shade or make it. Whether you’re picnicking, reading, or sitting on the beach, keep yourself safe under a tree, an umbrella or canopy, or some other source of shade. Keep infants in the shade because they are still developing the tanning pigments, known as melanin, that protect skin.
• Plan around the sun. Go outdoors in the early morning or late afternoon, when the sun is lower, but you still have many of the benefits of sunlight. UV radiation peaks at midday – though it is still a good time for getting vitamin D on a short lunch time walk.
• Extra Cautions: Bright, reflective surfaces like water can increase UV exposure, and UV radiation increases with altitude. The UV index, or UVI, measures the level of UV radiation for a given day and area. You can check the UVI in your phone’s weather app or wherever you check your weather.
• Consider sunglasses more than just a fashion accessory. Good quality polarized sunglasses protect your eyes from UV radiation, which over time is a factor increasing risk of cataracts, especially in older women not taking estrogen therapy (which decreases cataracts, and macular degeneration risks).
• Wear sunscreen when out for extended periods of time and reapply often due to sweat and swimming washing it off.
• Apply sunscreen generously. Make sure sunscreen is applied to every part of your body not covered by clothing, including along your hairline. The American Academy of Dermatology recommends applying one ounce – about a palmful – evenly to all exposed skin.
• Reapply often. Sunscreen chemicals sometimes degrade in the sun, wash off or rub off on towels and clothing. Sunscreen should be reapplied at least every two hours – more often if you have been swimming or sweating.
• Don’t combine sunscreen with bug repellent. If you need bug repellent, buy it separately and apply it first. Studies show that ingredients in sunscreen increase your skin’s capacity to absorb other chemicals. If you reapply sunscreen every two hours, as advised, you may overexpose yourself to bug repellent.
• Sun safety tips for kids.  A few blistering sunburns in childhood can double a person’s lifetime chances of developing serious forms of skin cancer. The best form of sun protection is a hat, shirt and shade. After that, protect kids with a sunscreen product that’s effective and safe.
• Infants: There are special precautions to take with infants and children. Infants under six months should be kept out of direct sun as much as possible. Their skin is not yet protected by melanin. When you take your baby outside:  Cover with a sun hat and protective clothing that’s tightly woven but loose fitting.  Make shade. Use a stroller’s canopy or hood. If you can’t sit in a shady spot, use an umbrella.  Avoid midday sun. Take walks in the early morning or late afternoon. Follow product warnings before applying sunscreen on infants younger than 6 months. Most manufacturers advise against using sunscreens on infants or suggest parents and caregivers to consult a doctor first. The American Academy of Pediatrics says that when it isn’t possible to find shade, it’s okay to apply small amounts of sunscreen on infants to avoid sunburns.
• Toddlers and children. Young children’s skin is especially sensitive to chemical allergens, as well as the sun’s UV rays.  Test sunscreen by applying a small amount on the inside of your child’s wrist the day before you plan to use it. If an irritation or rash develops, try another product, look for hypoallergenic products.  Use plenty of sunscreen on children and reapply it often, especially if your child is playing in the water or sweating a lot.

Medicinal Power of the Sun and How Much is Enough?
In answer to the question I posed at the beginning: how much sunshine is enough when you are trying to boost your immune system and get enough vitamin D?  This is a matter of dosing and is different for every person, as I mentioned earlier.  There are a few points on which I do not agree with the EWG’s guide. Yes, the sun is a major cause of skin cancer and a source of “aging spots” as we get older. But is fails to mention that ALL SKIN CANCERS ARE NOT THE SAME! ALL PEOPLE are not at same risk for skin cancer, AND SUNLIGHT IS ALSO GOOD MEDICINE!

It is correct that the relatively benign types of skin cancers (basal cell and squamous cell) are caused by sun exposure, the much more dangerous skin cancers such as melanomas, that is responsible for most skin cancer DEATHS, are due to a lack of sunlight. Most melanomas occur on the least sun-exposed areas of the body, and occupational exposure to sunlight reduced melanoma risk in a study reported in the June 2003 Journal of Investigative Dermatology.

Excessive sun exposure, especially with sunburns earlier in our lives, is an established risk factor for cutaneous melanoma, however, continued high sun exposure was linked with increased survival rates in patients with early-stage melanoma.

I also disagree with the statement that “for those with less melanin in their skin, just a few minutes of sun, a couple of times a week, is adequate.” And with the medical and dermatological organizations recommend against intentional sun exposure, I think we are creating a population of increasing vitamin D deficiency, not to mention all the other benefits of sunlight exposure to help maintain a healthy body circadian rhythm. As I said at the beginning, “all-or-none” is rarely wise.  Balance is the key. Sunlight in moderation, at the right time of day, for shorter periods and avoiding sunburns, can be a great step to improve your overall health—body, immune system, circadian rhythm, alertness, and mental outlook, followed by better sleep at night on days you have some sunlight time.

I stand by the statement that: Getting outside is good for you, and so is the sun – in moderation.  I did an entire Faith over Fear program in on this topic, and you can watch it here: FAITH Over Fear June 24, 2025: Light As Medicine: the Power of the Sun and More – Truth for Health Foundation. But here are a few highlights of the program and benefits of God’s gift of sunshine for our health:

• Vitamin D Production
• Bone Health
• Supports Immune System
• Improved Mood
• Better Sleep
• Lower Blood Pressure
• Reduced Risk of Disease
• Weight Management
• And even lowers risk of certain cancers: Hodgkin lymphoma, breast, ovarian, colon, pancreatic, prostate, and others

My Recommendation for Optimal Vitamin D Levels:
Getting out in the sun for a short while each day is rarely enough sunshine to boost your Vitamin D stores into the optimal range for all the health benefits this crucial hormone/vitamin gives us.  How do I know it is not enough?  I have actually measured Vitamin D blood tests in all my patients (based in sunny Texas and sunny Arizona, predominately) for the last 35 years! I am shocked at the number of “outdoorsy” people who are seriously deficient in Vitamin D! Of course, many who are outside a lot also cover up and use sunscreen daily, so that’s a factor in adding to the deficiencies.  But I think most people in our modern culture who are not literally working outside all day long every day are now Vitamin D deficient.

The ONLY way to be sure is to CHECK YOUR 25-OH VITAMIN D BLOOD LEVEL! You can either 1) ask your doctor to order it (usually covered by insurance), or if your doctor doesn’t cooperate, then 2) order the blood test yourself, pay for it and go have it drawn at Lab Corps or Quest Diagnostics.

Then correct any deficiencies or prevent low vitamin D by taking D3 regularly (ideally in a capsule in olive oil is best), especially in winter or if you get little sun.   If you need higher doses, ask your doctor to monitor your Vitamin D blood levels, then decrease the dose when you reach the optimal range of about 80-90 on the standard lab reference range.

I recommend: TruBioD3™ which contains vitamin D3 (cholecalciferol) in convenient soft gels in olive oil. Vitamin D3 is the bioidentical form of vitamin D synthesized in the body from cholesterol, following activation by the UV rays in sunlight. This form is excellent for maintaining healthy levels of vitamin D in the body. Mounting evidence suggests roles for vitamin D not only in bone health, but also in supporting immune, neurological, musculoskeletal, cellular, and cardiovascular health.