On May 6th, 2019 news headlines around the country heavily implied that sunscreens were dangerous. CNN’s headline said, “Sunscreen enters bloodstream after just one day of use, study says”. The first sentence of that article read:

“It took just one day of use for several common sunscreen ingredients to enter the bloodstream at levels high enough to trigger a government safety investigation, according to a pilot study conducted by the Center for Drug Evaluation and Research, an arm of the US Food and Drug Administration.”

Further reading clarified and contextualized the headline and stated that people should still use sunscreen. However, the damage was already done. It’s now common for people to think the news has reported that sunscreen is bad for you because all of the active ingredients tested were found in the blood.

We’ve received many calls at the office asking if sunscreens are safe to use and which ones are safe.

Let’s break it down. Let’s understand what was tested, what the results were, and what sunscreens to use now.

Takeaways If You Don’t Want to Read the Whole Article

If you don’t want to hang around to the end to read the conclusion, it’s this: Yes, we should all continue to use sunscreen. If you don’t want to use a sunscreen with one of the tested ingredients, any mineral based sunscreen will work as the minerals aren’t absorbed into the skin.

We carry Ulta-MD, Tizo, Revisions and Blue Lizard, which are all zinc based and highly recommended. Call the office at (910) 794-5355 if you’d like to purchase a bottle.

You can also continue to use sunscreens that contain the tested ingredients, as there’s no evidence that shows that the presence of these ingredients are harmful. While there’s further research to be done, we have a generation’s worth of data of people using sunscreen and the largest negative effect we see is that some people get rashes with some brands.

The much bigger concern is harmful rays from the sun. Trust me, you don’t want skin cancer. Make sure you use an SPF of 30 or higher, that you use enough – about a shot glass worth for your whole body – and that you reapply according to the bottle’s instructions. Use clothing, hats, umbrellas, tents, or other coverings to help you stay out of the sun. That’s the best way to stay safe this summer.

Want to Learn the Details? Great! Keep reading.

The US Food and Drug Administration (FDA) issued a proposed rule to update the regulatory requirements for most sunscreen products in the United States. This action was aimed at bringing over-the-counter sunscreens up to date with the latest scientific standards.

As part of the rule, the FDA asked industry and other interested parties for additional safety data on 12 active sunscreen ingredients currently available on store shelves. A key data gap for these ingredients was to what extent they were absorbed into the skin.

Per the FDA, active ingredients in sunscreen that are absorbed into the bloodstream at a level higher than 0.5 ng/mL (nanogram per milliliter), or that have general safety concerns need to undergo further testing to see if their presence increases the risk for cancer, birth defects, and other adverse effects.

In order to find out what, if any, of the active ingredients got into the bloodstream, researchers at the FDA conducted a maximal usage trial (MUsT). A maximal usage trial is a standardized approach to assess the absorption of all drugs, including topical drugs, into the body. It’s now customary to determine the safety of a drug based on MUsT studies.

The Study and Its Results

The MUsT study included 24 participants. They were randomized to 1 of 4 sunscreens. Two milligrams of sunscreen per 1 cm2 was applied to 75% of the body surface are 4 times per day for 4 days. 30 blood samples were collected over 7 days from each participant.

The ingredients studied were avobenzone, oxybenzone, octocrylene, and ecamsule, all of which are commonly available.

Among 24 participants randomized, 23 (96%) completed the trial.

For avobenzone, geometric mean maximum plasma concentrations were:

  • 4.0 ng/mL for spray 1
  • 3.4 ng/mL for spray 2
  • 4.3 ng/mL for lotion
  • 1.8 ng/mL for cream

For oxybenzone, the corresponding values were:

  • 209.6 ng/mL for spray 1
  • 194.9 ng/mL for spray 2
  • 169.3 ng/mL for lotion
  • 5.7 ng/mL for cream

For octocrylene:

  • 2.9 ng/mL for spray 1
  • 7.8 ng/mL for spray 2
  • 5.7 ng/mL for lotion
  • 5.7 ng/mL for cream

For ecamsule:

  • 1.5 ng/mL for cream.

Systemic concentrations greater than 0.5 ng/mL were reached for all 4 products after 4 applications on day 1. The most common adverse event was rash, which developed in 1 participant with each sunscreen.


Conclusions and Relevance

According to the study’s authors:

“In this preliminary study involving healthy volunteers, application of 4 commercially available sunscreens under maximal use conditions resulted in plasma concentrations that exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens. The systemic absorption of sunscreen ingredients supports the need for further studies to determine the clinical significance of these findings. These results do not indicate that individuals should refrain from the use of sunscreen.”

What Sunscreen Should You Wear?

The study found the highest blood plasma concentrations of the ingredient oxybenzone. There’s some research out there that shows an association with oxybenzone and some negative health effects but no data yet suggests that oxybenzone is the cause of these negative health effects. That being said, oxybenzone is bad for coral reefs so it wouldn’t be the worst thing to consider using a sunscreen that doesn’t contain it.

An easy way to find a sunscreen that’s good for you and the environment is to visit this non-profit website run by the Environmental Working Group. There they rank sunscreens for potential health concerns and environmental concerns. Their current database contains more than 240 safe sunscreens for you to choose from.

https://www.ewg.org/sunscreen

You, of course, can also call our office as we have an array of safe and effective sunscreens and lip balms for your sun protection needs.

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Make sure you don’t have any spots, moles, or rough patches of skin that need attention. We’ll also talk about skin care and sun protection. Schedule your appointment today.