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Brian Lehrer: It's the Brian Lehrer Show on WNYC. Good morning again, everyone. Let's talk about sun safety and sunscreen disinformation. Of all the things we talk about regarding disinformation, global political issues, election denialism, all of this stuff, did you know that there is sunscreen denialism out there as well? According to a recent survey from the American Academy of Dermatology, 28% of 18 to 26-year-olds said they didn't think that suntans cause skin cancer, and 37% said they wore sunscreen only when others reminded them of it.

A new article in The New York Times that maybe some of you have seen breaks out how Gen Z is, "Soaking up misinformation about sunscreen," and it provides a little bit of a guide. Joining us now is the author of that piece, health and science reporter Caroline Hopkins. The article is titled, "What Gen Z Gets Wrong About Sunscreen". Caroline, thanks for coming on. Welcome to WNYC.

Caroline Hopkins: Thank you so much for having me, Brian.

Brian Lehrer: Listeners, we'll open up the phones on this right away. Wondering if we have any Gen Z listeners tuning in today who want to shout out an anti-sunscreen meme that you may have seen on TikTok or anywhere else. 212-433-WNYC. What are you noticing among your peers when it comes to sun safety? How seriously do you and how seriously do your friends take it? 212-433-WNYC, 212-433-9692. Who's seen any of these anti-sunscreen memes on TikTok or any other platform? 212-433-9692.

Parents of Gen Zers, also welcome to call in. Do you have to nag your adult children to put on sunscreen? Doctors, hello, dermatologists, this one's for you too. 212-433-WNYC, 433-9692. Call or text. All right, Caroline, you write, "Experts said that Gen Z is uniquely susceptible to misinformation about sunscreen and skin cancer that has proliferated on social media platforms like TikTok." From your article. What are some of these influencers saying?

Caroline Hopkins: Sure. First of all, I think just important caveat that when I first saw the results of this survey, the first question I had was, "Okay, is this Gen Z specific?" I'm a millennial and I remember when I was in my early 20s, sun care, skin protection wasn't quite as important to me as it is now. I'm like, "Is this a Gen Z-specific thing or just part of being a young person in general?" I think the social media factor adds quite a bit, right?

There's a lot of misinformation swirling around on the internet about sunscreen actually being more harmful to you than direct exposure from UV rays, which is entirely false. I think, yes, to a certain extent, it is just something about being young because you don't quite see the effects of the photo-aging of sun damage. Again, young people do have so much more information at their fingertips than they did have in previous generations, so that's certainly contributing to it from what I learned.

Brian Lehrer: Right. In fairness, what they call in public health, the young invincibles, right? Young people think they're invincible on any kind of health matter because they're not feeling any effects. You mentioned the early effects of skin damage not really visible on the skin when you're in your 20s, certainly when you're in your teens, so they're not feeling it. Whether it's on diet and heart disease or cancer risks or anything else, people change as they get older. You're saying that it is more than for other generations, at least on this?

Caroline Hopkins: Right. Exactly. The caveat being, yes, also a problem for earlier generations, but the extra misinformation online is adding to it now.

Brian Lehrer: What is online? What are you seeing out there?

Caroline Hopkins: Yes, I was shocked to read some of these misinformation bits in the survey. Then I headed over to TikTok to say, "Well, are people really saying this on TikTok?" The answer is yes. I saw a number of young people who were saying that you can protect your skin from the sun by just drinking water, that sunscreen itself is causing cancer, that sunscreen is actually dangerous, and a whole other host of really destructive and detrimental messages out there.

They are out there. I think there is also accurate and credible information on TikTok. I think that's important to note. It's not really productive to finger-point and say the entire generation blanket statement is making false claims, but yes, they are out there.

Brian Lehrer: Well, we know why people would deny elections. Why would people deny the benefits of sunscreen? Who's got motivation to do this? Who is putting out sunscreen disinformation and why?

Caroline Hopkins: I think that's a tough question because it's hard to speak to people's motivations. I think there's a tendency to, I guess, cling on to small findings in mice, or a few years ago, there was a chemical recall of sunscreen that was sorted out already and point to that, and it gets overblown pretty easily, maybe not maliciously. I don't think that anybody is saying, "I'm going to spin this into something bigger than it is." There's a lot of competition for eyeballs and attention on social media, and reading or watching something that is counterintuitive or surprising, I think, often gets a little bit more attention.

Brian Lehrer: You set out in your article to bust some of these myths, and here's one, "Getting a base tan, as they call it, a base tan, a tan before your beach vacation, say, can help prevent cancer." True or false?

Caroline Hopkins: False. That one was a little bit surprising to me that so many thought it was true. Actually, something that dermatologists and the doctors I spoke with for this article emphasized to me over and over again is that any tan, whether it's a "healthy tan", which is a false title in and of itself, but any tan is skin damage.

When you see your skin tanning, that means that already the UV rays from the sun have damaged the DNA in your skin cells, and that effect is, it's already happened. The base tan is not actually protecting you from sunburn. It sort of is, in and of itself, damage. Maybe not as extreme damage as sunburn, but sun damage is cumulative.

Brian Lehrer: There's a pervasive perception, let's say, that way predates millennials or Gen Z, that there's such a thing as a healthy tan, right? You look healthy to other people, in many cases, if you have a bit of a tan, not if you're really, really pale. People talk about a healthy tan. You look healthy, you look nice and tan. There certainly is a widespread belief out there that a suntan can be healthy, different than a sunburn.

Caroline Hopkins: This is so interesting to me because I think part of this is also cultural. I think in some parts of the world, that's not the case, and having fairer skin that doesn't have sun damage is more healthy, the perception there. I can't really speak to the broader societal roots of that, but yes, people do look at somebody who has a slight sun-kiss look to them, if you will, freckles or a tan. They might say, that person, they've had the chance to be outside running around.

They might not be glued to a desk. They're out there having a healthy life. They're, I guess, combining those two things. I think the reality that a lot of the experts I spoke with emphasized over and over is that you can get all the benefits of a healthy outdoor lifestyle while also protecting yourself from the sun.

Brian Lehrer: Tess in Stuyvesant Town read your article. Tess, you're on WNYC with Caroline Hopkins, health and science reporter, who wrote in the Times about myths pertaining to sunscreen. Hi, Tess.

Tess: Hi. Thanks so much for taking my call. Yes, I did read the article, and at the time, I didn't quite put it together. Then in recent weeks, as you know, the kids had to be outside more, and what my kids have gotten really into is checking with the barcodes. They use an app, and they can look at the health rating of any product, and so they're doing it with cosmetics. They're doing it with a lot of things, and the sunscreen is really one that stands out as being particularly, they're like, "You have got to throw this away. It's terrible for you." I think the sports sunscreen that my husband uses because he works outside got a 0 out of 100, and the sheer one that I would use on my face that I liked also is rated very badly. I had to look for new ones, and we actually check and we make sure that it has a safer rating because in America, there's a lot of things that are allowed in our products that are actually illegal in Europe and in other places. I wonder if that's a real part of it that has gotten overblown and not really looking at the nuance of what is actually good and what's bad in the products.

Brian Lehrer: Thanks, Tess. Great question. Did you address this in the article, Caroline?

Caroline Hopkins: I will say we didn't dive too much into the very specific different ingredients in sunscreen, but broadly, there's two types. There's mineral sunscreen and there's chemical sunscreen. I think what I chatted about with these experts is that chemical sunscreen gets a bad rep. I think part of that is, as I mentioned before, a few years ago, there was a recall of one of the ingredients. Some sunscreens were found to have more benzene in them than they should have.

The FDA's job is to take those products off the market or put out that information, and then the companies recall them. I think that led to some of these fears about chemical sunscreen. I think also, there might have been one or two very small studies in mice. This is something I touched on. Caveat, I don't know the exact details, but that found an extremely high amount of one of the chemicals that was in sunscreen, higher than would ever be in human sunscreen, slightly altered a hormone receptor in a rodent.

That, again, overblown. The important thing to think about when you think about, "Oh, maybe there's a teeny risk if I had an unrealistic amount of this sunscreen anyway," is that what we do know is that 90% of melanoma is caused by the sun for the UV damage? It's harsh, but just putting it out there, if you're diagnosed with stage 4 melanoma, you only have a 35% chance of living past five years. That data we do have, that's concrete information about protection.

There's just endless collections of studies to support that. Whereas a one-off small animal study might raise concern and alarm bells, but really to look at the risk-benefit in the grand scheme of things, you're much, much, much likely to have a detrimental health effect or potentially even die of skin cancer than any chemical that's in your sunscreen.

I digress going back to the point about mineral versus chemical. If you are at all concerned about chemical, mineral sunscreens are a great alternative. The way they work is just sit on your skin and create a barrier. The chemical sunscreens absorb the sun's rays, whereas the mineral ones sit on your skin.

Brian Lehrer: A listener writes, "I'm a boomer." Now, this, sorry, already went down on my screen. A lot of people are writing to us about sunscreen right now. I'm going to read this. The boomer was saying that even when they were young, they remember hearing, "Oh, don't use sunscreen, it can cause cancer in so-called wellness circles." Another listener writes, "I'm in the ewg.org website." I don't know what that is, but a listener says, "that says, there are health concerns with many ingredients in sunscreen except for zinc oxide and titanium oxide. Can you explain further?" Did you go into that at all because I know people will say that who are not anti-sunscreen.

Caroline Hopkins: Zinc oxide and titanium oxide are two of the mineral sunscreens I was just noting, and that prevented the physical barrier instead. I think, again, everyone I spoke to with this article said chemical sunscreen gets a bad rep that it doesn't deserve, and it's really effective and there have been no human studies. I should emphasize that because I spent a little bit of time talking about the [unintelligible 00:14:43] one, but there have not been human studies to show that any of the chemical sunscreens actually cause detrimental health outcomes for humans, and that's important.

Anyway, if you are concerned, the mineral sunscreens are a great alternative. There's no harm in choosing those instead if that's something that is going to make you feel more comfortable about wearing sunscreen because the important thing is to find one that you are comfortable putting on every single day.

Brian Lehrer: Listener writes, "What about vitamin D which comes from sun exposure?"

Caroline Hopkins: This is something that also came up a lot in my reporting to this article. I guess vitamin D is technically a hormone, not a vitamin. That's something I learned that was interesting. Your body makes vitamin D from the sun, but you can also get it through your diet.

If that's something you're concerned about not getting enough of it from the sun, foods that have vitamin D, there's a lot of healthy options out there.

I think salmon came up a few times in my call. We had conversations about-- Trying to think of other vitamin D-rich foods. I guess my point being that it doesn't have to be the sun. At least that's what I learned.

Brian Lehrer: Lisa in Flagstaff, Arizona. You're on WNYC. Hi, Lisa.

Lisa: Hi. Thank you for taking my call. I wanted to make the point that I think that Gen Z is also very aware that in late capitalism, we have to be careful about what we buy because private equity doesn't really care about the products and how safe they are. There's a lot of suspicion there, which is really reasonable.

Brian Lehrer: You still then have to look into the particulars regarding any specific product. Lisa makes a great point, right? Progressive Gen Zers who don't trust corporations, maybe more than their parents, didn't trust corporations, maybe look at this with a different eye from square one.

Caroline Hopkins: I think that's such an important point. I'm really glad this has been brought up. I think there's a tendency to read this article and listen to this conversation and view it as Gen Z shaming. That is not at all what the idea is here.

First of all, it's an amazing thing that Gen Z is so interested in questioning health and what's in our skincare, what's in ingredients. I think the key thing there is in seeking answers to those questions. It's important to, I guess, make sure that sources are credible. Again, there is a lot of credible information on TikTok that you can find by double-checking it from a reputable source or a credentialed expert. There are a lot of people that call themselves experts that aren't necessarily experts.

Again, I think that that's actually something that is incredible and wonderful and important about this generation. It's also just a bigger and more diverse generation than ever before. I think, again, not trying to point fingers and say that this is a shaming thing, but I do think that that's, I guess, an advantage and a positive attribute.

Brian Lehrer: Nneka in Riverdale, you're on WNYC with Caroline Hopkins. Caroline Hopkins, who wrote the article, What Gen Z Gets Wrong About Sunscreen in The New York Times. Hi, Nneka.

Nneka: Hi. Good morning. I was actually calling about the mineral versus chemical sunscreen. I'm African-American, and I've tried to move away from chemical sunscreen. Some of the ingredients, there might be a bioaccumulative effect affecting the endocrine system and some other reproductive systems. Regarding mineral sunscreen, zinc oxide leaves a very strong light cast on your skin.

For individuals who are darker skin, you look quite ghastly when you use mineral sunscreen. I've been using something called Love Sun Body. It's one of the few mineral sunscreens that doesn't leave me looking like Casper when I put it on.

Brian Lehrer: There you go. Thank you very much.

Nneka: That's a plug.

Brian Lehrer: Thank you.

Caroline Hopkins: It's funny. Just to jump in there.

Brian Lehrer: Go ahead.

Caroline Hopkins: I had that same question. I had used chemical sunscreens prior, and some zinc, I pictured, I think, a white cast in your skin. What I learned in reporting this is that there's so many newer formulations now. I guess part of finding a sunscreen you're comfortable wearing every day is just trial and error. I think the older formulations of mineral sunscreens did do that, but there are plenty now to choose from.

Brian Lehrer: Listener writes, "I look at the Environmental Working Group website and Consumer Reports and they contradict one another. Consumer Reports says, "Mineral sunscreens are not as effective." Did you test effectiveness at all? Besides trying to break these myths about sunscreens not being necessary or sunscreens causing cancer that are going around as false social media memes, what about relative effectiveness?

Caroline Hopkins: That is not something that I heard from-- I spoke to a number of dermatologists and primary care doctors, nobody said that mineral sunscreens were any less effective. That's news to me. I think part of seeing some of this contradictory information speaks to exactly what we're talking about, which is the difficulty finding credible, accurate information out there. I think that also goes back to what I was saying about this not being anybody's fault.

It's more of when there's misinformation out there, it's a lack of clear public health messaging and campaigns that get the bottom line clear message across. It's not surprising to me that there's some conflicting information out there, but that's interesting.

Brian Lehrer: A listener writes, "Is there an SPF pass which there is no clinical value? I'm told it's SPF 24," writes this person.

Caroline Hopkins: That's also very interesting. It's something that I asked about in my interviews for this piece. SPF, the Sun Protective Factor, it's like SPF 30. I think a lot of people see that and think it means 30 minutes or 30%. What SPF 30 actually means is that I think 130th of the UV rays are getting through it. I guess it's blocking 97% of the harmful UV rays. When you go above that, SPF 50, it's 98% instead of 97%.

You can see there's a small difference there in the grand scheme of things, but I think it's not like it doesn't get more effective when you go up. It does, but the degree to which it does isn't quite what you think when you look at the numbers 30 to 50 in other words. Most of the doctors I spoke to for this story, everybody is different. If you have fairer skin, that's different. I think there's no blanket recommendation, but they all said that SPF 30 or above is their recommendation for daily sunscreen.

Brian Lehrer: Some of these other myths that you bust in your anti-disinformation article, you found that in the Orlando health poll, nearly a quarter of respondents under 35 believe that staying hydrated prevent sunburn. No relation there. Well, last question, I guess, are there other words on the label that people should look for besides the SPFs you were just describing? For example, broad-spectrum is another one that comes up.

Caroline Hopkins: Yes, broad-spectrum, it means that it protects against both UVA and UVB, which both damage your skin different types of UV damage from the sun. I think now any sunscreen that you're going to find is probably going to say that. Well, first of all, something I haven't actually mentioned in this chat so far is that in the US, all of our sunscreen that's labeled with an SPF and with that has to go through FDA testing to confirm that. I think if you go to the store and you see broad-spectrum, that means it's been tested to protect against both UVA and UVB.

Brian Lehrer: UVA and UVB. I'm going to throw in one more here because I'm noticing in our texts, that this question keeps reoccurring and from people with different phone numbers so I'll read one version of it. "There have been multiple reports about US sunscreens being much less effective than products from the EU and Asia. They block much lower levels of UVA. How do we push the government and the FDA, in particular, to update their regulations? Apparently, there are sunscreens that are legal in Europe, but not here." Are you aware of that?

Caroline Hopkins: I caveat that this wasn't what I reported on in this story. This is just anecdotal of what I stumbled upon in reporting this story. I think there are other chemical blockers that are in sunscreens in other countries that aren't necessarily in the US sunscreens. I haven't seen anything about them being more effective or not. That's something that I would certainly be interested to look into.

We do have a pretty comprehensive review process for anything that goes to the FDA in America, which has its pros in that we can be confident in the efficacy and safety of the drugs and products that we use, but the cons being maybe it's a little slower. I don't know the solution for pushing those through review. I think that there are a lot of efforts out there to expedite that, but that might be a question for somebody else. I'm certainly interested in learning too.

Brian Lehrer: Fair enough. Health and science reporter, Caroline Hopkins. Her latest piece in The New York Times, What Gen Z Gets Wrong About Sunscreen. Caroline, thanks for coming on.

Caroline Hopkins: Thank you so much for having me.

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