"The [sunscreen] industry wants a lower SPF number for consumers who want tanning. But tanning still damages the skin," Pathak says. "Would you use an antiperspirant that was minimally protective? If you have been told to protect yourself, then why use something of minimal protection? [SPF 12], in my definition, is not a sunscreen."
The FDA's spokesperson downplayed the criticism of the categories, saying, "Anyone who wants more protection should use a higher SPF."
Rating System Applies Only to UVB Radiation
Dermatologists also are critical of the FDA for releasing a rating system that applies only to UVB radiation, the solar radiation that causes sunburn and is represented under the SPF rating system. In recent years, scientists have found that UVA radiation causes premature aging and also may contribute to some forms of skin cancer.
"This is a new issue. We don't have enough information to come up with a standard, validated measure of UVA," says Dr. Mona Saraiya, a medical epidemiologist with the U.S. Centers for Disease Control and Prevention. "The best we can do, at this point, is to tell people to use a sunscreen that protects against both."
But, says Rigel: "There are a couple [UVA testing] methods. The FDA decided to punt."
According to the FDA, there is no timetable for selecting a UVA measuring system.
Manufacturers will still be allowed to label products as providing both UVA and UVB protection, even though the amount of UVA protection is not quantified. Sunscreens with UVA protection often are labeled as having "broad spectrum" protection or contain a chemical such as Parsol 1789 or oxybenzone.
Don't Skimp, Say Dermatologists
Dermatologists are also chagrined that the agency chose not to make a recommendation on how much sunscreen should be applied. Most people need to apply about one ounce of sunscreen--about one-fourth of the typical bottle--to cover their exposed skin. But studies show that most people use only one-third to one-half that amount and, thus, are getting far less sun protection than the SPF achieved if the sunscreen is applied adequately.
"People put on the sunscreen and think they can be out all day without hurting themselves," Epstein says. "We think what the monograph should have done is say, 'Put on sunscreens liberally.' "
But the FDA has chosen not to advise consumers on this point.
"We don't tell people how much they should use because there are so many different skin types," the FDA spokesperson says. "What we do is provide SPF numbers."
There is general agreement, however, that sunscreens are not working as well as officials had probably hoped back in 1978 and that consumers need to think about other ways to avoid skin cancer and sun-damaged skin.
Organizations like the AAD, the Skin Cancer Foundation and the Centers for Disease Control in Atlanta have begun emphasizing a triad of sun protection factors: using sunscreen, wearing protective clothing and staying out of the sun during peak radiation hours.
"I don't see controversy about sunscreens as much as misunderstanding about their role," says Cynthia Jorgensen, a behavioral scientist at the CDC. "I see a desire among consumers for something that is a magic bullet. The picture, in reality, is a lot more complicated than that."