I’ve just returned from a few days at the
beach with my family. One thing that stands out as a key function of a
parent in the summer beach environment is making sure your child avoids getting
sunburnt.
This got me thinking about a world without
sunscreen. This cheap little cream enables us to withstand sun exposure
like super-humans, avoid painful sunburn, and partake in activities that would
be out of the question in a 'no sunscreen' world.
Since sunscreen allows us to tolerate so much more exposure to the sun,
is it actually contributing in some way to increased incidence of skin
cancer? Are the net health benefits of sunscreen
actually much lower
because of our change in behaviour? How big is the sunscreen rebound
effect?
There seems to be some acceptance of the
sunscreen rebound. This article states
that “Sunburn may even protect against melanoma - by keeping people out
of the sun.”
Again here:
The Australian experience provides the
first clue. The rise in melanoma has been exceptionally high in Queensland
where the medical establishment has long and vigorously promoted the use of
sunscreens. Queensland now has more incidences of melanoma per capita than any
other place. Worldwide, the greatest rise in melanoma has been experienced in
countries where chemical sunscreens have been heavily promoted.
And here:
sunscreen use tends
to prolong the amount of time people spend in the sun while
they are on vacation—and that
only sunburn modifies the behavior of sun-seekers
And here:
Sunscreens suppress natural
warnings of overexposure to the sun and allow excessive exposure to
wavelengths ofsunlight which they do not block.
Because sunscreens create a false sense of security, more
effective measures to reduce sunlight exposure, such as limiting
time spent in the sun or use of hats and clothing, may be ignored.
My experience suggests that all of these
statements are true to some degree.
If everything was held constant - time in
the sun, covered clothing, etc (notice the decline in hat wearing in the past
few decades?) - then sunscreen may be quite effective at preventing skin
cancer. But humans have a tendency to adjust their behaviour to take
maximum advantage of such innovations.
The question that remains is whether there
is still a net health benefit from sunscreen. But due to the plethora of
uncontrollable variable in any longitudinal study, I'm not sure that we will
ever have definitive statistical evidence for this.

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