COMMENTARY

Sunscreen Myths Busted

Hansa Bhargava, MD

Disclosures

July 19, 2016

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When it comes to sunscreens, what are your patients really worried about? Summer is here and parents are worried about sun protection. Or are they? Interestingly, there is a lot more talk in the media about the danger of not getting enough vitamin D as a result of sunscreen use instead of the importance of protecting against skin cancer. Your patients may also be worried about sunscreens actually causing cancer and how some ingredients are endocrine disrupters.

A recent question that a mom asked me was about how the European Commission banned certain sunscreens that are allowed to be used here by the US Food and Drug Administration (FDA). With all of these myths floating around, let's chat about common myths and the true facts.

Myth #1: You Will Become Vitamin D Deficient if You Use Sunscreen

Although the American Academy of Dermatology contends that there is no amount of UV exposure that is safe enough to prevent skin cancer, we do know that the sun can certainly contribute to appropriate vitamin D levels. A prospective 20-year study[1] of women conducted in Sweden that was published this year underscores the important potential health benefits of sun exposure. The investigators concluded that avoiding sun completely had negative health effects that are comparable to those of smoking. Some experts suggest that only 5 to 30 minutes of sun exposure twice a week between 10:00 AM and 3:00 PM would be enough for vitamin D synthesis.

An evidence review[2] that looked at this question concluded that even though sunscreens can reduce the production of vitamin D under very controlled conditions, their regular use will not usually cause vitamin D deficiency. Also, most people don't even apply enough sunscreen and certainly don't reapply it frequently. In fact, in a study[3] that was released last year in the Journal of the American Academy of Dermatology, only 15% of men and 30% of women used sunscreen as recommended. Almost half, 42% of men, never used sunscreen at all. Available data suggest that sunscreen use does not substantially affect vitamin D absorption.

Myth #2: Sunscreens Are Linked to Early Puberty, Cancer, and Other Diseases

Oxybenzone, a chemical-based ingredient found in sunscreen, has been specifically called out by several consumer media sites as being an endocrine disrupter. A study[4] on rats that were given large amounts of oral oxybenzone raised concern about the estrogenic effects of this agent. However, several studies of this product, which was used topically as a sunscreen on humans, concluded that this is not the case, even with large topical doses.[5]

Myth #3: Europeans Have Banned the Chemicals We Use in Our Sunscreens

Bottom line: There are no ingredients approved in the United States that are banned in Europe. The Scientific Committee on Consumer Products of the European Commission published an opinion paper[6] in 2008 based on a review of current evidence of the safety of oxybenzone and concluded that it was safe. In contrast, eight sunscreen ingredients that are approved in Europe are not approved by the FDA. For all of these ingredients, the FDA has determined that they need more data to decide whether they are safe for use in over-the-counter sunscreen products.

What Should Your Patients Know About Sunscreens?

Sunscreens are effective at preventing skin cancer and sun-related damage, and they are necessary. The American Academy of Dermatology provides online advice for consumers on how to purchase and use sunscreen. The Skin Cancer Foundation provides numerous downloadable patient education tools on all things sun-related, including sunscreen, clothing, and eye protection.

Remind patients and families that other measures in addition to sunscreen are just as important, such as covering yourself, not playing outside at certain times of the day, and reapplying sunscreen every 2 hours, especially if swimming. Wear those sunglasses, too.

Now that you know the facts, hopefully you are armed and ready to educate patients about what they really should do: Use sunscreen and protect themselves and their families.

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