SUnscreening is essential for summer. Sunscreen protects from ultraviolet light, which has been associated with skin cancers and other changes that are common in aging. These proven benefits have remained uncontroversial over the past nearly 100 years of sunscreen’s existence.
U.S. Food and Drug Administration (FDA), among others, have been examining the sunscreens’ chemicals over the past few years. While the subject still needs further study, concerns include ingredients making their way into the bloodstream, possible hormonal effects on humans—especially in young people—and the potential degradation of coral reefs when certain sunscreens make it into the ocean. In the near future, a National Academies of Sciences committee will publish a report on some of these safety concerns.
Here’s what experts say is the healthiest approach to sun protection.
Is sunscreen effective?
Two types of sunscreen are available: chemical and physical.
The physical sunscreens (also known as mineral sunblockers) are applied to the skin. “They are instantaneously effective,” says Dr. Julie Karen, a dermatologist and spokesperson for the Skin Cancer Foundation; users don’t have to wait the 15 minutes or so that chemical sunscreens require before the ingredients offer full protection. There are also only two active ingredients in physical sunscreens—zinc oxide and titanium dioxide—and these are generally good for sensitive skin, she says.
Karen says that physical sunscreen can cause skin to look chalky or pastey. The problem is solved by chemical sunscreen. It absorbs sunlight and turns it into heat. There are about 16 chemicals approved to be used in the United States. Other countries have many more.
“The chemical sunscreens are much more elegant,” says Karen, though both can be effective at blocking short- and long-wave ultraviolet light.
Which sunscreen is most effective?
Dermatologists believe that sunscreens should be tolerated and used. However, there is still much to be learned about the health effects of using chemical sunscreens on human and environment.
Oxybenzone is the chemical most in demand. “That is the one that is shown to have the most penetration,” says Dr. Henry Lim, a dermatologist at the Henry Ford Medical Center and former president of the American Academy of Dermatology. “And it’s the one that’s been shown to have the most environmental effect.”
A 2020 study was published in Journal of the American Medical Association, FDA researchers studied six active ingredients in chemical sunscreens—oxybenzone, avobenzone, octocrylene, homosalate, octisalate, and octinoxate—and found that the skin absorbed all of the chemicals at “concentrations that surpassed the FDA threshold for potentially waiving some of the additional safety studies for sunscreens,” the study authors wrote. “While additional data are needed, results showed that all six active ingredients were absorbed into the body’s bloodstream—even after a single use,” the FDA wrote of the findings, and “once absorbed, these active ingredients can remain in the body for extended periods of time.” Other studies have shown that oxybenzone can affect hormone production, though many of those look at relatively high concentrations in rats. The FDA still considers products containing all these chemicals safe.
“The FDA has reiterated that absorption does not equal risk and advises for the continued use of sunscreen while they work with industry to study the issue,” says Karen. But, she emphasizes, “if you are concerned about oxybenzone for any reason, I recommend choosing a sunscreen without it.”Oxybenzone also has an impact on the health of the ocean, says Katie Day, environmental science and policy manager at the Surfrider Foundation, a nonprofit organization focused on protecting beaches and water. Exposure to ultraviolet light can cause coral bleaching. A study was published in Archives of Environmental Contamination and Toxicology in 2016, found that it “poses a hazard to coral reef conservation and threatens the resiliency of coral reefs to climate change.” The National Oceanic and Atmospheric Association lists oxybenzone among ten chemicals found in sunscreen that “can harm marine life.”
Hawaii was the first to prohibit the sale sunscreens that contain octinoxate and oxybenzone in 2018. Similar or more strict bans have been implemented in other places such as Key West, Florida and the U.S. Virgin Islands.
The FDA asked for more research by sunscreen companies in 2019. In addition, the National Academies of Sciences has a committee that studies the effects of chemical sunscreens. Day, however, isn’t waiting for the results to tell people to avoid chemical sunscreens. “I would advise against their use completely,” she says.
Here are some facts about benzene
There were many headlines in 2021 about the dangers of using sunscreen. The catalyst was the discovery that certain sunscreens contained benzene, a cancer-causing chemical. These were mostly sprays. An online lab and pharmacy Valisure test nearly 300 batches of sunscreens from over five dozen companies and discovered that 27% had the carcinogen. This was despite the fact that benzene wasn’t listed in any ingredients. Some manufacturers, such as Johnson & Johnson and Coppertone, issued voluntary recalls for their products.
“The contamination may be related to inactive ingredients in drugs such as carbomers (thickening agents), isobutane (a spray propellant), or other drug components made from hydrocarbons (chemicals made of hydrogen and carbon),” the FDA wrote on its website. Karen emphasizes that this issue is not related to sunscreen. It was a manufacturing problem, which companies have addressed. “This should not make people fearful of sunscreen,” she says.
What sunscreen should I use if I’m concerned?
Lim tells his patients that all approved sunscreens are safe to use, but that anyone who is concerned about the health or environmental impacts of particular chemicals must carefully read the label’s ingredient list. Even the term “reef safe” can’t be taken at its word because it’s unregulated, he says.
“It’s simpler and more practical to go with mineral sunscreen,” he says, which does not contain any of the chemical filters. Day agrees and also recommends looking for the label “broad spectrum,” because it will provide protection against the widest range of ultraviolet light.
Experts add that sun management starts even before a person’s choice of sunscreen. Sun management begins with shade. People need to wear lightweight clothing and wide-brimmed sun hats. Then, they should make sure to continue to reapply every couple of hours when exposed to the sun—and Karen, Day, and Lim all expressed an aversion to spray sunscreens, which can be difficult to properly apply and run the risk of unintended inhalation during application.
“Sun protection is a total package,” says Lim. “Sunscreen is an important component, but not the only component.”
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