Episode Chapters
- Sunscreen Basics19:34WDIDN Cough and CHF17:53Paper Chase #1 - Ondansetron Wins for Pediatric Vomiting3:38WartsFree Chapter31:37Lactate + Procalcitonin22:19Paper Chase #2 - Steroids Lack Benefit for Acute Urticaria4:52TOX TIME: UDS17:03Dog & Cat Bites29:43Paper Chase #3 - No Advantage of Acetaminophen + Ibuprofen for Acute Pain4:25Clinical Conundrum: Hyperglycemia15:50Paper Chase #4 - Colchicine vs. Naproxen for Gout Flares3:22PE basics: Parkinsons13:58USMLE Step 118:35Paper Chase #5 - Pediatric Rib Fractures = NAT Until Proven Otherwise4:38Mailbag8:51
While sunscreen is heavily regulated the evidence behind efficacy and potential risks is mixed. From variable degrees of sun protection, to concerns about potential systemic absorption, minor differences in product labelling may signify significantly different products.
Urgent Care August 2020 Written Summary 865 KB - PDF
Jennifer C. - October 8, 2020 9:14 AM
I was surprised that in your discussion of sunscreen you didn’t discuss mineral based sunscreens using zinc etc. Particularly for my young daughter, I’ve been cautious, avoiding avobenzene etc and using the sometimes thick and greasy mineral sunscreens. (Water babies is my go to - no disclosures needed). Are these any safer / better and do they have equivalent protection? She definitely prefers the spray (and it is easier to get applied. I wonder if it’s worth the effort to continue with the mineral based creams.
(Also it can be tricky to avoid the chemical sunscreens because the same brand changed to spray or foam frequently will use chemical barriers instead of mineral)
Mike W., MD - October 9, 2020 5:54 AM
From Matt Delaney:
Great question.
We have basically no studies comparing any sunscreens head to head in terms of efficacy but any sunscreen that is FDA approved goes through the same testing process so a zinc based product with an SPF of 30 should work as well as any of the chemical products with the same SPF.
The chemical products certainly do have the risk of systemic absorption. We don't have clear evidence when it comes to the actual risk of these chemicals getting absorbed but I suspect these studies will be out in the near future. From a long term safety standpoint I personally favor zinc over the chemicals but just don't have a good evidence base to stand on currently.