Skin care can be dangerous.
The Environmental Working Group (www.ewg.org) is a non-profit whose mission is “to use the power of public information to protect public health and the environment.” As sun season approaches I find there is often a great deal of confusion about which sunscreens are best? Which rays are the most dangerous? What ingredients may be potentially harmful? Recently updated Sunscreen safety data can be found at http://www.ewg.org/sunscreen/
Active ingredients in sunscreens come in two forms, mineral and chemical filters. Each uses a different mechanism for protecting skin and maintaining stability in sunlight. The most common sunscreens on the market contain chemical filters. These products typically include a combination of two to six of the following active ingredients: oxybenzone, avobenzone, octisalate, octocrylene, homosalate and octinoxate. Mineral sunscreens use zinc oxide and/or titanium dioxide. A handful of products combine zinc oxide with chemical filters.
Laboratory studies indicate that some chemical UV filters may mimic hormones, and physicians report sunscreen-related skin allergies, which raises important questions about unintended human health consequences from frequent sunscreen application.
The FDA, tasked with overseeing the safety of personal products, has been unable to keep potentially toxic molecules from reaching the consumers. The Danish EPA recently reviewed the safety of active ingredients in sunscreen and concluded that most ingredients lacked information to ensure their safety (Danish EPA 2015). Sixteen of the 19 ingredients studied had no information about their potential to cause cancer. And while the published studies suggest that several chemical filters interact with human sex or thyroid hormones, none of the ingredients had sufficient information to determine the potential risks to humans from hormone disruption.
The most worrisome is oxybenzone, added to nearly 65 percent of the non-mineral sunscreens in EWG’s 2017 sunscreen database. Oxybenzone can cause allergic skin reactions (Rodriguez 2006). In laboratory studies it is a weak estrogen and has potent anti-androgenic effects (Krause 2012)
The Centers for Disease Control and Prevention has detected oxybenzone in more than 96 percent of the American population, based on a representative sampling of children and adults (Calafat 2008). Participants who reported using sunscreen have higher oxybenzone exposures (Zamoiski 2015). Investigators at University of California, Berkeley, recently reported a dramatic drop in teen girls’ exposure to oxybenzone in cosmetics when they switched from their usual products to replacements that did not contain this chemical (Harley 2016)
In a recent evaluation of CDC-collected exposure data for American children, researchers found that adolescent boys with higher oxybenzone measurements had significantly lower total testosterone levels (Scinicariello 2016). The study did not find a similar effect in younger boys or females.
Retinyl palmitate, a common vitamin A derivative can be found in as many as 30% of products in the marketplace. In animals, retinyl palmitate increases skin cancer risk! Go figure!
EWG maintains ongoing vigilance in its assessment of sunscreen safety. At present, all available evidence suggests that zinc oxide and titanium dioxide can be safely used in sunscreen lotions applied to healthy skin. The weight of evidence indicates that both zinc oxide and titanium dioxide pose a lower hazard than most other sunscreen ingredients approved for the U.S. market.
EWG’s favorable rating of nanoparticle sunscreens is not an endorsement of nanomaterials in commerce. EWG has urged the FDA to review carefully the safety of nanosize particles used in cosmetics products, and to evaluate skin and lung penetration and the potential for greater toxicity to body organs (EWG 2007, 2011). Nanoparticles do not behave like normal minerals and get absorbed or taken up by cells so rapidly that they cannot be detected by examining blood levels. Therefore, stating that there is no evidence of absorption by measuring blood levels has no safety value.
More information nanoparticles in sunscreen:
Safest features include:
- The safest protection is mineral-based from zinc oxide, Avobenzone or Mexoral SX
- Avoid oxybenzone, retinyl palmitate (Vitamin A) and added insect repellant
- Pick creams and lotions over sprays and powders
- Avoid SPF above 50 (no added protection and more sunburn as people overestimate the protective effect.
- Try to physically block the sun with protective clothing, sunglasses, and hats
- Sensible sun exposure e.g., 15 -30 minutes 3-4 days per week of full arm and leg will allow vitamin D production with minimal exposure risk.
- Desire UVA and UVB (B= Burn) protection. Both UVA and UVB can increase cancer risk. Look for “Broad-spectrum protection” and water resistance
- Cover thoroughly and reapply at least every 2 hours, or after getting wet or sweaty.
- Sunglasses are essential with adequate UV protection.
Examples of some of the sunscreen products that received the safest recommendation from the Environmental Working Group include:
• Snowberry - BEST, New Zealand-based, they get it!
• Badger - GOOD all around
• All Good - less available but excellent
Skin care should and can be safe!
Be well and enjoy the sun-season!
~ Mark Pettus, MD, FACP, ABHM
Research Appendix: (from ewg.org)