Wednesday, July 22nd, 2015
There has been a lot of talk lately about sunscreens as they relate to chemicals, safety and SPF. Even ‚ÄúGood Morning America‚ÄĚ had a recent expose on the topic. The hype in the media comes from the EWG’s (Environmental Working Group‚Äôs) 9th annual Guide to Sunscreens, the release of which has spurred a significant amount of talk.
The first controversy surrounds SPF values higher than 50. The EWG does not feel sunscreens higher than SPF 50 should be recommended. Additionally, the FDA reports that the benefits of SPF max out around 50 and notes that in Europe, Japan and Australia, any SPF claims above 50 have been banned. The American Academy of Dermatology recommends SPF greater than 35 as its threshold. The bottom line here is that, if you are applying sunscreen that is above an SPF 35, reapplying every two hours when outdoors and using a sufficient amount of the product to cover you, there is no need to choose a sunscreen with an SPF of 100. That being said, if the one you like happens to have an SPF of 100, there’s no harm in having a higher SPF rating. I tell my patients that if you wear it, it works. So, wear what you like, reapply – and apply liberally.
Other controversies center on two ingredients in sunscreens: oxybenzone and retinyl palmitate. Oxybenzone is a synthetic estrogen that has been present in sunscreens since 1980. The controversy here exists in the concept that, as a synthetic estrogen, if absorbed by the body, oxybenzone could affect hormone levels. The EWG recommends avoiding all sunscreens with oxybenzone while the Skin Cancer Foundation suggests there is no evidence that it is absorbed in appreciable amounts and, even if it was, that there would be no adverse health effects. The original research that is cited for the dangerous claims comes from a study in 2001 that fed young rats more than 1,500 mg per kilogram per day which was in a very high dose that is not achievable in humans without oral consumption.¬†My bottom line to my patients is that if you are concerned about oxybenzone being a synthetic estrogen, even in small amounts,¬†there are plenty of sunscreens to choose from that do not contain it.
The second ingredient in question is retinyl palmitate. Retinyl palmitate¬†is a form of vitamin A that some people suggest may increase the risk of skin cancer. In fact, the EWG website reports that this form of vitamin A can be linked to skin damage. However, the Skin Cancer Foundation reports just the opposite, stating that, when used in this formulation for sunscreen, this vitamin A derivative may actually be an antioxidant and protect the skin. My bottom line for my patients on this ingredient is similar to that of oxybenzone; if you are concerned, there are many sunscreens that are available without it to choose from. With both oxybenzone and retinyl palmitate, the two sides cannot seem to agree. Luckily, we have many choices in the United States and we can all wait for all sides to agree and avoid these products in the meantime if we want to.
Another area that has been discussed recently is aerosolized sunscreens. The American Academy of Dermatology and other groups have long reported that cream-based sunscreens are better. We have known for a long time that application of aerosolized sunscreens can be irritating to the skin due to the propellants and alcohol base in these products. We have also known that people do not apply them in large enough quantities to make the SPF rating as it is stated on the bottles, and more recently people have been discussing the possibility of inhaling large quantities of the sunscreens as a dangerous delivery method. This is one area where the American Academy of Dermatology, the FDA, the EWG and the Skin Cancer Foundation can agree. Each group cautions against use of aerosolized sunscreens in favor of cream-based applications.
Nanoparticles, which exist in titanium and zinc oxide based sunscreens, are another controversial topic. Zinc oxide is EWG’s first choice for sun protection. This is the famous white paste that you remember from so many lifeguards‚Äô noses in the ‚Äė60s. These days, we micronize zinc oxide so the application looks less white. The micronizing is the nanoparticle. The nanoparticle is essentially necessary in order for it to be clear on the skin, otherwise it would look white. Current theory from EWG, the American Academy of Dermatology, the Skin Cancer Foundation and the FDA¬†supports that these particles do not penetrate the skin in appreciable amounts to cause damage. These are the physical based sunscreens or non-chemical that are advertised.
From my perspective, the most difficult things about a titanium or zinc sunscreen are the availability and price. Honestly, these are a more expensive type of sunscreen, sometimes costing up to five times as much as a chemical sunscreen. Titanium and zinc sunscreens can be difficult for some people to afford and difficult for some people to find in their area, and you have to become a label reader to find them. Look for labels that read ‚Äúchemical free‚ÄĚ or ‚Äúphysical blockers only.‚ÄĚ ¬†Some examples are from the Honest Company, which makes an SPF 30 called Honest Sunscreen Lotion. This product is completely chemical free. Aveeno recently came out with one that is available at regular drugstores called Aveeno Baby Natural Protection (for adults it‚Äôs labeled Aveeno Natural Protection.) These are essentially the same product with mineral-based sunscreen titanium and zinc oxide. If you can find either, they will work the same. CeraVe also produces a great line of physical blockers.
Other products we recommend and carry at our office: TIZO, Elta MD, Skin Ceuticals and Replenix all offer sunscreens that are chemical free.¬†TIZO‚Äôs Lip Fusion is one of the only sunscreen sticks for lips I have found that is physical blocking only.
A tip I give my younger patients is to use a titanium and zinc face stick. It does a great job covering the cheeks and nose without burning children‚Äôs eyes when they rub their faces. This product has been available over the counter for more than 15 years and I have used it on my own children since they were born. I used to only be able to find it at baby stores and online, but now major drug stores as well as Aveeno have created their own, more widely available formulations.
There is a lot of information to wade through when you are a consumer. When experts disagree, it further complicates things. Either talk to your dermatologist or avoid the controversial ingredients until all the experts can agree. Personally, I have been putting mostly titanium and zinc oxide based sunscreens on myself and my children for more than 10 years. There are times when chemical sunscreens are the only thing available or affordable, so I use some of those in a pinch. Today‚Äôs children will be the first generation to have sunscreen applied to the skin from six months old on to old age. If we make the best educated choices that we can at the time, then we’ve done what we can to protect ourselves from skin cancer and maintain as healthy as a lifestyle as possible.
Hopefully this information helps you sort through what is out there and to make your own, educated decisions.
Learn more about the difference between physical and chemical blockers.
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