(Skin)

Real Talk — Sunscreen Safety Is Even More Complicated Than You Think

The recent recall left many questions unanswered — here’s what we know.

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Woman standing in the sun

Every year, as summer approaches, news headlines question the safety of sunscreen — and this time, the research was troubling. In spring 2021, an independent analysis by Valisure found that 78 sunscreens and after-sun products had high levels of benzene, a known carcinogen. Some products had more than three times the maximum FDA concentration limit of two parts per million. Researchers believe that there is likely no safe level of exposure to benzene, given its association with leukemia and other blood cancers. And since research shows that many sunscreens don't just sit on our skin, they get into our bodies and bloodstream (trace amounts of some chemicals used in sunscreens can be found in everything from blood to breast milk), the presence of benzene is a serious concern.

For some people, the recent recall and other news reports regarding SPF ingredients pose enough of an issue that they're questioning the safety of sunscreen overall. Robert Finney, MD, a board-certified cosmetic dermatologist at Entière Dermatology in Manhattan, says many of his patients have been asking him about the Valisure findings. "I think the results caught everyone off guard," he says. "It creates a level of mistrust and uncertainty within patients — which is completely understandable."

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Why Was Benzene Found In Some Sunscreens?

Here's what is known: sunscreen manufacturers aren't purposely adding benzene to sunscreen. Experts say that most likely, the benzene appeared during the manufacturing process. "The whole benzene scandal was a contamination and supply chain issue," says cosmetic chemist and formulator Esther Olu. "Benzene is not added to make cosmetics, but it can be used to synthesize raw materials." For instance, she says, benzene can be used as a solvent (a substance used to dissolve other materials) for some raw materials, then removed from the final product after processing. "This is why the FDA has permissible limits for some ingredients or contaminants," she says.

Dr. Ava Shamban, MD, a dermatologist in Beverly Hills, also believes that the supply chain is unintentionally culpable. "While I don't think companies are intentionally introducing benzene for these products, between various laboratories used by international companies with various safety and standards, contamination is possible," she says. (The challenge, of course, is tracing individual batches to discover the root source of the problem.)

This recent instance of benzene contamination, most experts agree, is no reason to panic — in part because benzene, like many other harmful chemicals, is inescapable in our overall environment. "It is important to understand that benzene is impossible to avoid because it is a building block for many chemicals and is also emitted anytime you burn anything, including a candle," Dr. Finney says. "For example, living in a city such as NYC, just breathing city air for a day will likely expose you to more benzene than if you applied one of the listed sunscreens head to toe." Still, it doesn't belong in sunscreen or any other personal care product — which is why last month, Johnson & Johnson voluntarily recalled the Neutrogena and Aveeno aerosol sunscreens included in the list of contaminated products.

Everyone from toxicologists to dermatologists to chemists agrees that benzene exposure is unhealthy, and that people should eliminate exposure where they can. (Which is why it's wise to review Valisure's results and see if your sunscreen could be among the contaminated.) But what about the other ingredients in sunscreen — the chemical UV filters such as oxybenzone and octinoxate? Well, that's where people start to disagree.

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How Sunscreens Work

First, a quick course in sunscreen formulation: Sunscreen is formulated with either mineral or chemical active ingredients. Mineral formulas use physical barriers such as zinc oxide and titanium dioxide to reflect the sun's rays. They shield skin from UVA and UVB rays, which means they're considered "broad-spectrum" sunscreens. The downside is that they often give skin a white cast, which is especially noticeable on dark skin — but some newer formulas, such as EleVen by Venus Williams Unrivaled Sun Serum SPF 35, are formulated to be sheer. The Food and Drug Administration (FDA) categorizes zinc oxide and titanium dioxide as Generally Recognized as Safe and Effective (GRASE).

Chemical sunscreens work differently. They absorb into skin, where they convert UV rays into heat before releasing it from the body. In the United States, chemical sunscreens feature active ingredients such as oxybenzone, avobenzone, octisalate, octocrylene, homosalate, or octinoxate — often working in concert with each other to provide extended protection. They're typically invisible to the eye, and since they soak into skin, they leave behind no greasy feel or unwanted tint.

Dermatologists Emphasize The Importance Of Sunscreen

Dermatologists unanimously recommend using either type of sunscreen, as skin cancer is preventable with proper sun protection. "It’s proven that up to 90 percent of skin cancers are a result of unprotected sun exposure," says Dr. Elizabeth Hale, MD, a board-certified dermatologist in Manhattan, a VP of the Skin Cancer Foundation, and the chief medical advisor to Vacation sunscreen. "One of the best ways to protect yourself against harmful skin cancer is consistent use of sunscreen, as well as avoiding the sun during peak UV times. In terms of sunscreen safety, chemical and mineral sunscreens have been used and tested for over 40 years and are absolutely safe and effective to use."

...But Some Researchers Disagree

But as mounting research finds correlations between sunscreen chemicals and a host of health issues, some other scientists aren't certain that they're benign. "We know very little about the safety of sunscreens, but what is known is that the petrochemical sunscreens — e.g., oxybenzone, homosalate, octocrylene — are linked to a number of toxicities and diseases," says Craig Downs, PhD, the executive director of the Haereticus Environmental Laboratory and a researcher of sunscreen chemicals. "We know so little about their safety that all the petrochemical sunscreens were moved out of GRASE category 1 by the FDA in 2019. This means that the petrochemical ingredients are not Recognized as Safe and Effective."

Here's What The FDA Is Doing

When it comes to sunscreens, the FDA has been busy. In 2014, the Sunscreen Innovation Act mandated that the FDA review existing and proposed active ingredients for safety and efficacy. In 2019, the FDA released a proposed final monograph that, among other things, called for further information on 12 sunscreen chemicals for which there was "insufficient safety data." These proposed rules don't necessarily mean that the chemicals are unsafe, but it doesn't mean that they're safe, either — hence the call for more safety data from industry before they earn the GRASE designation.

Judging by recent independent research, there's certainly plenty to evaluate. Last month, the European Union Scientific Committee on Consumer Safety published its opinion that homosalate is not safe to use in skin products above 0.5%; here in the U.S., the FDA allows it in concentrations up to 15%. And in March, a group of French and American researchers, Dr. Downs among them, found that another sunscreen chemical, octocrylene, produces benzophenone — a suspected endocrine disruptor and possible carcinogen — as it breaks down over time. (Their research, published in March 2021, appeared as a separate group published similar results.) "That our results were replicated by an independent group speaks to the virtue of science," Dr. Downs says. "The truth is replicable, when it is pursued with honest intentions."

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To further complicate matters, newer chemical UV filters are available in Europe and Asia. "There are many new advances in sun filters in cosmetic and skincare hubs in Australia, Korea, and Japan that are available because the regulations are aligned with OTC cosmetics and skin care," says Dr. Shamban. "They have been able to introduce upgraded and updated formulas and innovations."

Options for active sunscreen ingredients may expand next month, when the FDA is due to issue new rules on ingredients, formulations, and labeling — the first such update since 2011. "If the next wave of directives and guidelines truly allows for US companies to work with international manufacturers to introduce new actives, filters, and screens, there will be more viable options coming to market," Dr. Shamban says. "That responsibility, however, does need to come with more effective education and transparency as well."

Whether that will happen remains unknown. The 2020 CARES Act for coronavirus relief included a provision to sunset the Sunscreen Innovation Act in 2022 — which effectively returns FDA oversight to status quo. "The FDA is not doing their job in protecting the American public," Dr. Downs says. "More, Congress, because of the CARES Act, is facilitating this threat of chemical toxicity and disease by further threatening the well-being of the American public."

Bottom Line: Sun Protection Is Essential (& Varied)

Of course, any potential risk of using chemical sunscreen has to be evaluated against the well-established risk of skin cancer, which is the most common cancer in the United States. "Skin cancer should be the top concern," says Dr. Hale. She and other dermatologists are confident that chemical sunscreens are safe to use, but there's always the alternative of mineral/physical sunscreen if you're concerned.

"Physical sunscreen ingredients are great options for anyone concerned about potential harmful effects of chemical ingredients," says Dr. Finney, who also recommends wide-brimmed hats, UPF clothing, sun shields, seeking shade, and avoiding the sun between 10 a.m. and 4 p.m. "All of these things can be helpful, but typically you will still have exposed skin, so these measures are best if used in combination with sunscreen," he says.

Right now, there are no simple answers when it comes to sunscreen — but there are options to shield your skin, Dr. Shamban says: "The key is not to be unprotected but to know your options and have an understanding of the best ways to maximize health benefits and minimize risk."