You probably already know that using sunscreen regularly can slash your risk of skin cancer, reduce wrinkles and slow the effects of aging.
But recent concerns about sunscreen ingredients have made it more difficult than it used to be to choose a safe sunscreen. The Environmental Working Group (EWG), a nonprofit advocacy organization, says about 75 percent of sunscreens on the market provide inferior sun protection or have worrisome ingredients.
Recent studies also show that some sunscreens may cause damage to oceans and coral reefs. A growing number of destinations, including Hawaii and the U.S. Virgin Islands, have banned sunscreens with certain chemicals.
While more research is needed to prove whether sunscreen ingredients are harmful, the concerns have left many Americans with questions about sunscreen safety and uncertain about which products to purchase.
What’s important, experts say, is not to let those concerns stop you from using sunscreen altogether, because there’s no doubt that leaving your skin unprotected puts you at greater risk of skin cancer.
Skin cancer is the most common cancer in the U.S., and about 1 in 5 Americans will develop skin cancer in their lifetime. Both melanoma and nonmelanoma skin cancers have been rising in recent decades. While melanoma accounts for only 1 percent of all skin cancers diagnosed in the U.S., it is the deadliest.
“Any sunscreen is better than none,” says Mona Gohara, an associate clinical professor of dermatology at the Yale School of Medicine and a fellow of the American Academy of Dermatology (AAD). “We know that the sun can you give you cancer. There is thus far no proven data that says sunscreens can give you cancer.”
Can sunscreen ingredients harm your health?
The good news is, Americans are using a lot more sunscreen — and using it more frequently — than they did before. So if we’re being better about slathering on sunscreen, why are skin cancer rates rising? One 2008 study, published in the journal Advances in Experimental Medicine and Biology, attributed rising rates to a number of factors, including increased exposure to sunlight, more outdoor activities, changes in clothing style, and ozone depletion.
Because of the jump in sunscreen use, the Food and Drug Administration (FDA) a few years ago decided to reevaluate the safety data on sunscreen ingredients. After an extended clinical study, the agency found that some commonly used sunscreen chemicals — avobenzone, oxybenzone, octocrylene, homosalate, octisalate and octinoxate — can seep through your skin and into your bloodstream. The study found that even after a single application, the chemicals remain in your body for an extended period.
But the fact that those chemicals get into your blood, doesn’t necessarily mean those ingredients are harmful, says David Fivenson, an immunologist and dermatologist in Ann Arbor, Michigan.
Some laboratory-based studies indicate that chemical ingredients could interfere with the normal function of the body’s hormonal system, affect infant development or cause other health issues.
But Fivenson notes, “there has never been good, practical evidence of harm in a realistic study of people.”
If there’s one ingredient to avoid, it’s probably oxybenzone, says Tasneem Mohammad, senior staff physician in the department of dermatology at the Henry Ford Health System in Detroit. “In a lot of areas of the world, like Europe, it’s not really used anymore,” Mohammad says.
Oxybenzone can cause allergic reactions, and studies have linked it to hormone problems, lower testosterone levels in boys, shorter pregnancies, and increased risk of endometriosis and breast cancer. A 2020 study found that rats exposed to the chemical were more likely to develop thyroid tumors.
The FDA has asked U.S. sunscreen manufacturers to do more testing on the safety of chemical ingredients, but that may take years. In the meantime, in the absence of data showing harm, the agency has allowed the products to stay on the market.
Mineral-based sunscreens considered safest
For now, if you are concerned about health effects, the safest choice is a so-called “mineral” or “physical” sunscreen with zinc oxide or titanium dioxide, dermatologists say. Those are only sunscreen ingredients that the FDA says are “generally recognized as safe and effective.”
While chemical sunscreens act like sponges and absorb ultraviolet light, “a physical sunscreen acts like a shield,” Gohara explains. It sits on top of your skin and deflects UVA and UVB rays away from your body.
Physical sunscreens are also a better choice for those with sensitive skin, since they cause fewer skin reactions, says Allison T. Vidimos, a board-certified dermatologist and chair of Department of Dermatology at the Cleveland Clinic.
“Since a mineral blocker doesn’t get absorbed by your skin, it’s less likely to clog your pores and tends to be gentler on sensitive skin,” she says.
The downside of physical sunscreens is that they can leave a white residue on the skin, especially on people of color. But many manufacturers have released newer formulas that use micronized particles or tints to minimize chalkiness, Vidimos and others say.
“The sunscreen industry has risen to the occasion and formulated tinted sunscreens that don’t look chalky on darker-skinned individuals,” Vidimos says. “They even have different intensities of tint, so you can match your skin tone to the right one.”
Which sunscreens are safest for the environment?
Mineral sunscreens are also believed to be a better choice for the environment.
Lab research shows some chemical ingredients can be toxic to coral and other marine organisms, says Fivenson, who is a cofounder of an American Academy of Dermatology group that examines environmental issues. However, the true impact is unclear because the concentrations of chemicals used in some studies were as much as 1,000 times higher than the amount in most real-world environments, he says.
To help answer that question, the National Academy of Sciences has convened a committee of experts to review the current research on the potential toxicity of sunscreen ingredients on corals and other marine organisms. The committee is expected to release its findings later this year.
For now, if you are concerned about the environment or traveling to a place that bans certain chemicals, you can look for sunscreens labeled “reef-safe” or “reef-friendly.”
Keep in mind, however, that those terms are not regulated by the FDA, Fivenson says. So you should also check the ingredients to ensure they don’t contain oxybenzone or octinoxate — the chemicals most often banned because of their detrimental effect on marine life.
Wearing a sun-protective swim shirt can also help the environment by reducing the amount of sunscreen you need to apply.
Other advice for choosing sunscreen
In addition to considering a product’s effect on your health and the environment, dermatologists offer the following advice for choosing a sunscreen that will provide maximum protection:
Beware of sprays. Although sunscreen sprays are easy to use, many dermatologists don’t recommend them. For one thing, there’s a risk of lung irritation or damage if you inhale it. Never spray it near your face. In addition, getting adequate coverage can be tricky. “It’s tough to get even product application, and a lot of sunscreen gets blown away by the wind,” Mohammad says. If you do decide to use a spray, apply it outside or in a well-ventilated room, and rub it in by hand to ensure a more even application.
Check the SPF. Short for “sun protection factor,” SPF is a measure of a product’s ability to protect you from the sun’s UVB rays, which cause sunburn. Chose a sunscreen with an SPF of 30 or higher, which blocks 97 percent of the sun's UVB rays. Higher SPFs are only slightly more effective, so don’t let sky-high SPFs lull you into thinking you are totally protected from sun damage.
Look for “broad spectrum.” Sunscreens that are labeled “broad spectrum” will ensure you are also protected from UVA rays, which cause wrinkles and aging. More importantly, they can contribute to skin cancer. (Note: EWG testing found that many broad-spectrum sunscreens do not protect as well as promised against UVA or UVB rays. See their top sunscreen picks.)
Apply properly. One study found that people apply only about 20 to 50 percent of the amount of sunscreen they need to achieve the amount of SPF on the label. To get full protection, most adults need about one ounce — or enough to fill a shot glass — to fully cover their entire body. Reapply every two hours or after swimming, and don’t forget your back, neck, face, ears and the tops of your feet.
7 Quick Tips
- Avoid sunscreens with oxybenzone.
- Use mineral sunscreens.
- Choose reef-safe or reef friendly options.
- Beware of sprays.
- Choose SPF of 30 or higher.
- Look for broad-spectrum sunscreens.
- Apply liberally and reapply.
Article written by Michelle Crouch for AARP: https://www.aarp.org/health/healthy-living/info-2022/safe-sunscreen.html