What Are the Biggest Sunscreen Misconceptions? With Kathleen Suozzi, MD

Ultraviolet (UV) damage is increasingly becoming a topic of consideration among much of the public, with awareness campaigns continuing to grow and dermatologists observing increasing patient interest in both preventing sun-related skin disease and reversing photodamage.1,2

Advances in laser technology, field-directed therapies, and photoprotection have expanded such discussions beyond traditional sunscreen recommendations, and new data is reshaping the ways in which clinicians view skin cancer prevention and long-term skin health. In this segment of her interview with HCPLive, conducted in light of July being UV Safety Awareness Month, Kathleen Suozzi, MD, associate professor of dermatology and director of Aesthetic Dermatology at Yale Medicine, discusses these evolving approaches to preventing and treating photodamage as well as myths and misconceptions:

HCPLive: Many patients think that sun damage is permanent. Are there any advances seen in recent years that allow dermatologists to treat cosmetic effects and reverse any underlying damage?

Suozzi: I'm a big believer in preventative therapies, and I think we are having a lot more understanding of things that we can do for prevention. So, starting first on the cancer side, when we talk about field therapy, this is the concept of treating broad areas of skin for precancerous change. We know that if you took a biopsy of someone's skin and looked at the mutations, it's like a quilt of precancerous mutations lurking there. As we get older, our body's immune system's ability to knock down these precancerous mutations or treat early skin cancers decreases our body's ability to repair DNA is lower.

We get fibroblast senescence as well, so in order to correct damage as these pathways are becoming less efficient, we have to sort of trick the body in certain ways. There are two kinds of 2 arms of what we can refer to as ‘field therapy.’ Our traditional field therapies used chemotherapy creams to treat precancerous changes, like Efudex, and now we have newer protocols where we can combine with calcipitrine to decrease the duration of treatment. These are more direct field therapy approaches. Also, under this umbrella would be photodynamic therapy, where we can treat broad areas of precancerous change. This is kind of seeking out the damaged skin cells, leaving the more normal skin cells alone.

What I do think is interesting is this emerging field in terms of looking at the skin more completely. So we already mentioned the immune system, but what's the role that the dermis plays? And we have more evidence that resurfacing lasers, which are not just getting epidermal cells to turn over, but also modulating the dermis and creating a healthier dermal milieu, are likely preventative for non-melanoma skin cancer as well. So understanding that, I think, is where there's some interesting science going. Is this the interplay between the immune system and the dermis and the epidermis, or is the ground substance of the dermis important? Collagen, blood vessels, right? So there are a lot of components where I think we're going to learn a lot, that it's not just the mutations that live in the epidermis; it's the whole ecosystem.

HCPLive: What would you say are the biggest misconceptions that you hear about sunscreen, and how do you counsel patients to incorporate photo protection into their daily practice?

Suozzi: I hear a lot of misconceptions about sunscreen. You know, there are the big, obvious ones. ‘I heard sunscreen causes skin cancer,’ for example. So we're dispelling rumors like that a lot. In more recent years, there have been some concerns around health risks related to skin cancer. As has been reported by your group and others, there was a lot of controversy a few years ago about the bloodstream absorption of sunscreen with the chemical sunscreen components. There was a lot of fear around that. But you know, I'm always reassuring patients about these sunscreen ingredients we've been using for decades [that they] do not indicate that there's any risk to human health from these very low levels in the bloodstream.

The other thing commonly is like, ‘The damage has all been done with no sun protection, so what's that going to do now?’ Counseling patients [by saying that] we can't reverse the damage of your youth, but good sun protective strategies now are going to minimize the number of skin cancers that you have moving forward. Those are some of the big ones in terms of counseling. I think it's really just about employing common sense strategies and looking beyond just applying SPF as your only level of protection. We have a lot more options now with UPF clothing, sun-protective clothing, telling patients who think that a baseball cap is enough for facial protection, where it's not protecting anything on the sides of your face and your lower face, to use broad-brim hats.

I do spend time with my patients, counseling them about the use of sunscreen. There's a lot of kind of concern about what the best sunscreen is. ‘Which product should I be buying and using?’ And I always say the best product is the one you're going to wear and the one that you're going to use, and that could be different for different individuals, based on your skin tone, based on whether you're acne-prone, etc. Sometimes it's just a personal trial and error of different products. But I think the biggest mistakes people make are not applying regularly. I tell patients every day, even in the winter, we do talk about cumulative exposure.

[We mention] that commuting, driving to work, gardening, and daily activities of daily life all add up. But the other issue is that if you only apply in the summer and not the winter, it doesn't become part of your routine that you just do reflexively. I am always encouraging that. Then I think the other common question I get is around what SPF level I have to use. [I counsel] patients that SPF protection is nonlinear, and I usually tell patients SPF 30 or above because at 15 you're getting about 93 to 95% coverage. At SPF 30, it's about 97% of UVB protection. Over that, SPF 50, it’s 98. It's a small incremental change as you go up in SPF. In order to achieve those higher levels of SPF, the product often can become less wearable, which will then have an effect on use

HCPLive: I know there were recently some concerns about benzene in certain sunscreen products. How do you help assuage patients’ concerns over carcinogens?

Suozzi: Again with the benzene levels, in terms of the risk to human health, it’s really unsubstantiated there. It could be detected [in certain products], but it’s important to know what that means. You know, if the aerosol products were more of a concern, that's a simple thing that you can counsel patients on. Just to know, you can avoid the spray sunscreens in favor of the cream-based ones or lotion-based ones.

HCPLive: Looking ahead, whether it's new technologies for detecting photodamage, novel treatments to reverse UV-induced skin changes, or advances in skin cancer prevention, what do you think clinicians should be watching over the next few years?

Suozzi: I'd be remiss if I didn't mention the recent FDA approval of bemetrizonol, which is the first addition to the OTC monograph of the FDA in over 20 years. This is big, big news. Bematrizonol, or Tinosorb S is the other name. It's a chemical sunscreen that has been around in Europe and Asia for over 20 years, and it has a very good safety profile. But why it's so exciting is for the following reasons. Number one, it has broad UVA and UVB coverage in a single molecule. It is photostable, so many of our chemical sunscreens are photolabile, meaning they break down while you're wearing them in the sun.

Whereas bimetrizonol has good durability, which means you have to apply it less often. It's cosmetically elegant, sheer, and wearable. And there’s a low risk of irritation. Then, going back to that concern about bloodstream absorption because it's a larger molecule, the risk of absorption is lower too. So it's kind of hitting all the things that we look for in ideal sunscreen. I can't wait for that to come to the U.S. market, which should be soon. That approval was just last month.

I think I also touched on this before in terms of understanding how we can use energy-based devices to decrease skin cancer risk. That is very exciting. We are also making advancements in terms of skin cancer treatment. As a Mohs surgeon, I'm surgically removing skin cancers every day, but I look forward to the day when we have medical therapies that make the need for surgery less. I think we are moving there. Our use of immunotherapy and PDE1 inhibitors, cemiplimab for squamous cell carcinoma, has really changed how we approach skin cancer. [There is] burgeoning use of neoadjuvant treatments for skin cancer with PDE1 inhibitors, and we are looking forward to interregional treatments and studies that are ongoing in that realm. I think it's going to really change how we're treating skin cancers as well.

References

1. Suozzi K. What Are the Key Signs of UV Damage to Look For? With Kathleen Suozzi, MD. HCPLive. July 13, 2026. Accessed July 15, 2026. https://www.hcplive.com/view/what-key-signs-uv-damage-look-for-kathleen-suozzi-md.

2. FDA expands sunscreen options for the first time in 20 years. News release. US Food and Drug Administration. June 9, 2026. Accessed July 15, 2026. https://www.fda.gov/news-events/press-announcements/fda-expands-sunscreen-options-first-time-20-years.