Sunscreen has suddenly become controversial.
Web reports describe certain ultraviolet filters as toxic.
A recent magazine article compared sunscreen to margarine - as if it’s an outdated health fad.
Hawaii passed a law that will ban the use of two sunscreen ingredients (oxybenzone and octinoxate) based on early research suggesting that they may damage coral reefs.
And the Food & Drug Administration (FDA) is reviewing and updating the scientific research and labelling of sunscreen ingredients as part of the Sunscreen Innovation Act.
These and other factors have led to recent controversy and questions about the creams, lotions, sprays, powders, and other products that guard against ultraviolet light. While scientific study about sunscreen is ongoing, and the FDA’s regulatory wheels keep turning (verrry slowly), here is what we can safely say about sunscreen right now.
Sunscreen is important (really important) to skin health. Ask just about any dermatologist, and they’ll tell you the same thing: Consistent sun protection is the single most important step we can take for the long-term health of our skin. That’s because ultraviolet light damages skin cells every time we step out in the daylight - and the effects are cumulative. (The intense UVB rays that can cause summertime sunburns can be highly damaging, but we can also rack up significant cellular damage from the more deeply-penetrating UVA light that’s present year-round.) Even if you wear protective hats and clothing and avoid peak sun hours and indoor tanning, it can be hard to adequately protect your skin without the help of a broad-spectrum SPF 30+ sunscreen.
Sunscreen helps prevent skin cancer. Exposure to ultraviolet light accounts for approximately 80-90% of all skin cancers - and skin cancer is the most common type of cancer in our country, affecting 1 in 5 Americans. (I diagnose between 1 and 10 skin cancers in a typical day in my dermatology practice.) Sunscreen has been shown in scientific studies to lower the risk of the three most common kinds: basal cell carcinoma, squamous cell carcinoma, and melanoma, the deadliest type.
Sunscreen is effective. It’s true that sunscreen is far from perfect. It can be inconvenient to apply, it may last 2 hours at best, or even less if we’ve been swimming or sweating. It could lower our vitamin D levels if we’re really consistent about applying it (though probably very few of us are, and UV exposure is not the safest or most effective way to bolster vitamin D levels). It’s also true that international sunscreens do a far better job guarding against UVA light compared to U.S. formulas. But in spite of these challenges, sunscreen can and does help to protect skin from ultraviolet damage. The most common reasons we may wind up with a surprise sunburn or UV damage in spite of sunscreen? We may not slather on enough (studies show most people apply 1/4 to 1/2 the recommended amount), we don’t choose one that’s broad-spectrum with at least SPF 30, or we don’t apply it often enough (reapplication every 2 hours is where many of us fall short).
Sunscreens are tightly regulated in the U.S. compared to other developed nations. While much of the world regards sunscreens as cosmetics, the FDA categorizes them as drugs, making them subject to significantly more scrutiny, bureaucracy, and regulation in our country. This is a key reason why the U.S. lags behind other nations in offering safe and effective ingredients for sun protection - particularly those that guard against UVA light.
Sunscreens are widely considered to be safe. The mildest ingredients - zinc oxide and titanium dioxide - are made from minerals that have been labelled by the FDA as GRASE (Generally Regarded as Safe and Effective). These gentle protectors are often found in sunscreens labeled with terms like “baby,” “pure,” “mineral,” and “sensitive,” and an increasing number are now being marketed as “reef safe” for beach and snorkeling days. As part of the Sunscreen Innovation Act, the FDA recently requested an updated review of research on an additional 12 UV-filtering ingredients to make sure that labelling, regulations, and safety profiles are up to date with current science - though most physicians and scientists haven’t considered these ingredients harmful based on the scientific data to date. Two old-school sunscreen ingredients - PABA and trolamine salicylate - are no longer considered safe and effective by the FDA and are being phased out of any U.S. sunscreen products that may still contain them.
Sunscreen is the world’s most powerful anti-aging cream. For those who feel no other motivation to wear SPF, at least consider the cosmetic payoff. Sunscreen helps to guard against fine lines, wrinkles, spots, visible blood vessels called telangiectasias, rosacea flares, irregular skin texture and tone, loss of collagen and elastin, and reduced skin firmness and volume - in addition to preventing skin cancers and precancers. I see such a stark difference between patients who protect their skin from the sun and those who don’t. By their 30s, 40s and 50s, sunscreen users typically look years or even decades younger than their sun-loving counterparts - and this difference becomes more and more obvious as we march further along in life.
To me and many other dermatologists, there’s no true controversy about sunscreen - it remains as important, helpful, and relevant as ever for protecting the long-term health and beauty of our skin.