Skin Cancer Risk: Spray Away?

“There’s no such thing as a healthy tan.” While we may be coming around on that idea, are we getting distracted by potential reasons not to use sunscreen? Are there ingredients in sunscreens that are toxic to us, or to the ocean’s ecosystem? What about those spray sunscreens? Dr. Jenna Kelsey, UConn Health dermatologist, joins to help weigh the risks and benefits of these factors against the carcinogenic properties of sun exposure.

(Dr. Jenna Kelsey, Carolyn Pennington, Chris DeFrancesco, August 2025, studio and production support by Ethan Giorgetti and Ryan Bernat)

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Transcript

Chris: “It’s just a healthy tan.” But is there such a thing? Today On the Pulse, we get the latest on skin cancer prevention.

This is the UConn Health Pulse. a podcast to help you get to know UConn Health and its people a little better, and ideally leave you with some health information you’ll find useful. With Carolyn Pennington. I’m Chris DeFrancesco.

OneUConn Health dermatologist used to tell us, “The sun is the ultimate carcinogen.”

Carolyn: And we’ve heard for years about the importance of taking steps to reduce sun exposure. But with so many sources of information, it can be hard to know what to believe. So we’ve brought in UConn Health dermatologist Dr. Jenna Kelsey to tell us about the latest best practices. Thank you for joining us.

Dr. Kelsey: Thank you for having me.

Carolyn: So let’s start with the idea of a healthy tan. What do you, as a dermatologist, think of that term?

Dr. Kelsey: It doesn’t exist. You are correct. Unless you’re using like fake self-tanners, then that is technically healthy.

Carolyn: The QT — Remember the QT?

Dr. Kelsey: But there is no such thing as like a base tan, or a healthy tan. That is all causing damage to your skin.

Chris: And what’s actually happening when your skin is exposed to the sun for I guess too long or too intensely?

Dr. Kelsey: Correct. So what we worry about with the sun’s rays is actually UV radiation. We call it UV rays, but it is a form of radiation and that does cause damage to your DNAs in the cells in your skin. And if you get enough of that damage, it can lead to skin cancer. There are two types, UVA and UVB, that we are all exposed to from the sunlight. Both of them can lead to skin cancer.

Chris: And UV is ultraviolet, right?

Dr. Kelsey: Correct.

Carolyn: And I was going to say, how about a quick little primer about the different types of skin cancer?

Dr. Kelsey: Correct. The three most common types of skin cancer, are in order of frequency, basal cell cancer, squamous cell cancer, and melanoma.

Melanoma is the most deadly of all skin cancers, so it’s the one that we hear about the most, but the other two types are much more common. And there are a few other rare types of skin cancer. Most skin cancer is sun-related, but there can be a little bit of a genetic component, specifically with melanoma.

Carolyn: So I have had the basal skin cancer. but I used to get so burned when I was a little kid. Is there any hope for someone like me, like once you’ve got the damage, I remember some dermatologist saying, if you had a lot of burns and problems when you’re young, you’re, it’s just, you’re going to have some issues.

Dr. Kelsey: Right. It’s not too late for you. A lot of the sun damage that you get when you’re younger, specifically a lot of sunburns, and being fair-skinned, can increase your risk for skin cancer later in life. But sun damage is cumulative. So as long as you kind of stop exposing your skin to the sun as much and stop burning, you can decrease the risk later on as long as you’re not adding to that cumulative sun damage.

Chris: What kinds of things should we be watching for, or what should be watching for in our children, on their skin?

Dr. Kelsey: Sure. So obviously with children, again, trying to avoid those sunburns and excessive sun exposure, using sunscreen regularly. With all of us, it’s good to monitor your skin and keep an eye on your moles and freckles and watch for any changes in size, shape, or color.

And there is this mnemonic called ABCDEs of melanoma, specifically. I’m sure you’ve heard this before, but it’s sort of red-flag signs to look for with your moles.

1. So a mole that’s Asymmetric.
2. The Borders are irregular or jagged.
3. C is for color, more than one color or a really dark color.
4. D is diameter, anything greater than a pencil eraser.
5. And E means something is evolving or changing. So any of those signs, the ABCDEs, is just a reason to have something checked, to go see either your primary care doctor or specifically a board-certified dermatologist.

Carolyn: You mentioned sunscreen and there’s been a lot of conspiracy theories negative press about using suntan lotion. Can you describe what people are concerned about, and if there’s anything to it?

Dr. Kelsey: Sure. And just stepping back a second, for what I talk to my patients about in the clinic is, sunscreen is just one component of your sun protection. More important than that is sort of using sun-appropriate behavior, so not trying to spend too much time in the sun going outside, more in the morning and the evening, avoiding sort of the stronger midday sun. If you do go outside and spend any time in the outdoors, wear a nice wide-brimmed hat, wear sun protective clothing, cover up as much as you can, sunglasses, really protecting your skin from the sun is step one. And then in addition to all of that is putting sunscreen on any of the sun-exposed areas, the areas that are not covered by clothing.

There’s two different types of sunscreens, and you can kind of broadly put everything in two categories, either your mineral-based sunscreens or your chemical-based sunscreens, and those are the active ingredients in them. So mineral-based sunscreens have been out for a very long time. It’s titanium dioxide and zinc oxide. So they are physical blockers. They just sit on the skin and they reflect the sun.

Chris: Is that the one where the lifeguard has the white nose?

Dr. Kelsey: Yes, that’s classically, the zinc we used to think of as like the white paste on the nose. They’ve actually gotten a lot better. They’ve made the particles really, really small, so they actually rub in pretty well and they’re not as white and pasty as they used to be nowadays. That’s one type of sunscreen. The other type is called chemical-based sunscreens, and those, they have a lot of longer names, like oxybenzone, avobenzone, octocrylene, stuff like that. And you’ll see on the back of the sunscreen bottle what it contains. It’ll say the active ingredient. So those are absorbed into the skin and partially they reflect the sun. They partially also produce a little bit of heat when they reflect the sun’s rays.

The concern nowadays, the reason sunscreen has gotten a lot of press, is that some of the chemical-based sunscreens have been found to be absorbed into the skin and can be slightly measurable in your blood. That doesn’t necessarily mean they’re bad. You know, we put a lot of stuff on our skin. There’s a lot of stuff that we’re putting into our body that does make it to the blood and a lot of chemicals nowadays, no studies have been done that show that these are harmful to us, but at very small amounts can be sort of traced into the blood.

It’s still, for me, any sunscreen is better than no sunscreen, and we are not often using as much sunscreen as some of these studies tested. A lot of us use too little of a sunscreen, so maybe it’s not being as absorbed as much as we think it is. So any sunscreen is better than nothing. But if you are worried about some of these concerns, then just stick to the physical blockers or the mineral sunscreens, which are not absorbed into the body whatsoever.

Chris: It almost sounds like similarly, the idea of fluoride in the water, right? I mean, there are some studies that have come out that have gotten some people to think twice about that, but still the overall public health benefit and the overall good kind of beats the alternative, right?

Dr. Kelsey: Correct. So we know that the sun is a carcinogen and it causes skin cancer. So it’s all about the risks and the benefits. Sunscreen probably provides much more of a benefit than the risk. Just like fluoride, it’s very good for your teeth. It prevents cavities, and that probably outweighs any potential downsides.

Carolyn: And what about the environmental concern, though? The coral reefs? Are we killing the coral reefs?

Chris: Yeah. Do you get a lot of patients arguing with you about that because they feel like there’s a problem with the ecosystem in the ocean?

Dr. Kelsey: Right, right. That’s a great question. So unfortunately, I think we are slightly killing the coral reefs in terms of rising sea level temperatures and climate change. So that already is happening. There is some debate. There were some studies done, just in a laboratory setting, showing if you exposed the coral reefs to high levels of some of these chemical sunscreens, it’s not good for the coral reef. It’s hard to parse out what is harming our coral reefs. Is it just the rising sea level temperatures, which is not good for them? Or is it any chemicals in the water that is leading to some of this damage?

So some local governments, like in Hawaii and the Keys, some places are banning sort of chemical sunscreens. Again, if you have any concerns. Stick to your physical blockers or your mineral sunscreens, ‘cause those do not harm coral reefs whatsoever. And it’s only a few of the chemical sunscreens that they’ve tested. Not all of them. So a lot of them probably are OK.

Carolyn: What about the SPF clothing? Is that a good option?

Dr. Kelsey: Definitely. It’s one of my favorite options ‘cause it’s easy. Any areas that are covered by clothing, you don’t have to put sunscreen on, so it just makes your life easier. And nowadays they make these really like breathable long-sleeve shirts and sun protective clothing that has really come a long way in technology, and I find that it’s actually very cooling. A lot of people look at me like I’m crazy when I say, “You should wear a long sleeve in the summertime.” But these long sleeves are very breathable, very good for outdoor activities, and a lot of people do like them.

Chris: Regarding SPF, I think the conventional wisdom is the higher the number, the better. But why would anyone get the 15 if the 60 is available? Like, why do they even make the 15? What’s the difference there? Are these people who think they’re going to let a little bit through and get a tan? Is that, is that the idea?

Dr. Kelsey: Maybe, so the American Academy of Dermatology’s general recommendation is sun protective factor, SPF, of 30 or higher, because an SPF 30 does block 97% of UV rays. An SPF of 15 blocks, 93% of UV rays. So it’s still OK, but not quite good enough. So I always tell my patients, if you’re going to do it, you might as well make it more effective. SPF of a 50 blocks, 98% of UV rays, and SPF of a hundred blocks 99% of UV rays. So it is better, the stronger sunscreens are more effective, but it’s only a tiny, tiny, tiny bit more effective. So the general recommendation is at least an SPF 30.

Chris: And what’s the formula for success as far as applying and reapplying? And does it vary based on how old, how old the kid is?

Carolyn: Oh, yeah, you’ve got to have a shot glass full.

Chris: That’s right. She used tell us that one too. Dr. Grant Kels?

Dr. Kelsey: Correct. Yes. Yes, she’s right. So for an average adult, if you’re going to cover your body in sunscreen, it is recommended to do at least an ounce or a shot glass full of the sunscreen, which is a lot more than people probably do on a regular basis.

Reapplying, so no matter what SPF, it doesn’t make a difference in how long it lasts. They all wear off at about the same rate, so you do need to reapply every two hours. If you go in the water, you sweat a lot, it does wear off faster. So if you were to get out of the pool and dry off, you have now toweled off all the sunscreen. So you do have to put it on again. And specifically if you know that you’re going to be outside and you’re going to be either sweating a lot or you’re going to be swimming in the water, we do recommend a water-resistant sunscreen, which will last a little bit longer in the water. And it will say that on the bottle of the sunscreen and it will say how long it lasts. So it’ll say like, water resistant up to 60 minutes or 80 minutes. That means after that set period of time, you do need to reapply. So reapplication is very important and I think that’s what people forget to do the most, but it is very important.

Carolyn: So what about spray SPF? Are they just as good? And I’ve also heard that they have toxic chemicals and it can get into your lungs. And if you’re like spraying it on the beach, then–

Chris: The wind picks it up.

Carolyn: The wind picks it up, and the toxins go into your lungs.

Dr. Kelsey: Sure. Great question. So the spray sunscreens are just as effective as the other types, as long as you apply it correctly. The goal is to apply it close to the skin, and then also sort of rub it in as soon as you’ve applied it to make sure it’s not streaked.

In terms of, you’re right, it is an aerosolized compound, so you can breathe it in. I do not recommend spraying your face with the sunscreens. It is best to spray the sunscreen into your hands, rub it in and rub it in onto your face. But you’re right, as with all things that are aerosolized, like bug sprays and hairsprays, it’s probably not the best thing to sort of attempt to breathe it in. So if you’re going to do it, put it on in a well-aerated location or well-ventilated location, and try not to breathe it in as much as you can.

The sunscreens that are in it, we, again, we don’t know that they’re harmful to you, even if they do get into your body. So there’s no good studies on that. There is a compound called benzene that people worry about in a lot of products that are sort of over-the-counter and can rarely be found in sunscreens, and that is a known carcinogen, but it’s usually at very, very low levels. And also the sun is a known carcinogen and I just wanna harp on that. So anything that we can do to sort of lessen the risks of causing skin cancer, the benefits probably do weigh out those small risks.

Chris: We’ve spoken a lot about prevention. Melanoma especially can get to a point where it’s too late for prevention and now it’s time to treat it. We have colleagues who specialize in that, when there’s only so much you as a dermatologist can do, there’s another place for those folks to go.

Dr. Kelsey: Sure. So we do have a great melanoma care team here at UConn. Most commonly, the dermatologist is who diagnoses the melanoma, and if it is more advanced, we often have our colleagues in surgical oncology and medical oncology — Dr. Phan, Dr. Callahan, specifically — they will go and cut out the melanoma sample, any nearby lymph nodes, from a surgical standpoint, do advanced scans, PET scans, CAT scans to see if the melanoma has spread because that is possible, and then our medical oncology team will talk about more targeted treatments, our systemic therapies that help get rid of the melanoma.

Chris: We’ll put some information about the advanced melanoma group in addition to how to find you.

Dr. Kelsey: Sure.

Chris: And more information about our dermatology practice, and maybe we’ll even link to the American Academy of Dermatology for some resources on skin cancer prevention there as well. And we’ll have all that in the show notes as you listen.

Dr. Kelsey: That would be great.

Chris: Dr. Jenna Kelsey, thank you so much for being with us.

That is our time for today. Thank you to Ethan Georgetti and Ryan Bernat for your studio support.

For Dr. Kelsey and Carolyn Pennington, this is Chris DeFrancesco, thanking you for listening to the UConn Health Pulse. Be sure to subscribe so you can catch us next time, and please share with a friend.