prevent skin cancer, mother applying sunscreen to a young girl, oxybenzone

For decades, dermatologists have encouraged us to slather on the sunscreen before we expose our skin to the sun’s rays. The goal is to prevent premature aging and, more importantly, to reduce the risk of skin cancer.

How much of your sunscreen is absorbed into your body? You might think that question would have been answered decades ago. Surprisingly, we are just learning how much sunscreen passes through your skin and gets into your blood stream. A new study published in JAMA (May 6, 2019) reveals that all four of the ingredients tested resulted in systemic absorption. One in particular, oxybenzone, far exceeded the 0.5 ng/mL level that should trigger toxicological studies.

Everyone LOVES Sunscreen:

Americans are not always good about following public health pronouncements. They are pretty lax about cutting back on salt, washing hands after going to the bathroom or eating lots of vegetables daily. What people ARE good at is slathering on the sunscreen.

Sunscreens produce detectable benefits. You may not see immediate results from eating vegetables or lowering blood pressure, but you know within a few hours the consequences of spending hours in bright sunlight without sunscreen.

A bad sunburn hurts and looks awful. As a result, people are rewarded for regular sunscreen use. Add to that the constant reminders from dermatologists to always use sunscreen. The messages work! Americans spend over $650 million on sunscreen products each year.

Sunscreen Absorption Into Your Body:

Many Americans assume that what they put on their skin stays on their skin. The idea that the chemicals in skin care products penetrate the skin and get into the body seems foreign. But the skin is not an impenetrable barrier. It is truly astonishing that until now, very little research has been conducted on sunscreen absorption.

The FDA has recognized this lapse. In 2018, the agency told the sunscreen industry that it is time to find out whether sunscreen ingredients are absorbed (Guidance for Industry: Nonprescription Sunscreen Drug Products Safety and Effectiveness Data). FDA scientists took the first step with the current study.

How They Did the Study:

The researchers recruited 24 individuals as their study participants and divided them into four groups. Following proper sunscreen application procedures, each volunteer got sunscreen on 75 percent of their skin multiple times a day, just as if they were spending a vacation at the beach. (It was less fun, though, as they were not actually at the beach and did not leave the clinical facility to go out in the sunshine. Instead, they had blood drawn at regular intervals.)

The investigators used two different sunscreen sprays, one lotion and one cream. Each group of volunteers used the same type of sunscreen for the full week of the study.

When the scientists analyzed the blood samples, they found that sunscreen ingredients were detected in the volunteers’ blood within a relatively short time. They wanted to know about avobenzone, which is a primary sunscreen ingredient. Until now, no one knew whether or to what extent avobenzone might be absorbed through the skin. In addition, the investigators considered levels of oxybenzone, octocrylene, and ecamsule.

Oxybenzone:

Oxybenzone has been controversial for years. It is a common ingredient in many sunscreens. According to EWG (the Environmental Working Group, a nonprofit nonpartisan organization), this is among the most worrisome sunscreen ingredients: “Oxybenzone can cause allergic skin reactions (Rodriguez 2006). In laboratory studies it is a weak estrogen and has potent anti-androgenic effects (Krause 2012, Ghazipura 2017)” (https://www.ewg.org/sunscreen/report/the-trouble-with-sunscreen-chemicals/)

What does “potent anti-androgenic effects” mean? Androgens are often called male hormones, but that is a misnomer. Men and women make testosterone. This critical hormone is essential for good health. The idea that a sunscreen ingredient can affect both estrogen AND testosterone is quite disconcerting, especially for young children.

EWG analysts note that:

“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).”

“Given the pervasiveness of oxybenzone exposures, further study is needed to evaluate the association between oxybenzone and hormone disruption in children and adults.”

How much oxybenzone is absorbed through the skin? In the new JAMA study, the researchers found significant absorption of oxybenzone. Within two or three days, participants exposed to oxybenzone-containing sunscreens had levels nearing 200 ng/ml in their bloodstreams. A week later, blood levels were still between 20 and 35 ng/ml, on average.

In contrast, the highest concentration of avobenzone was 4.3 ng/ml, and it took much longer to reach that level. For octocrylene, maximum concentration was 7.8 ng/ml. And for the one sunscreen containing ecamsule, blood levels reached just 1.5 ng/ml with no residual concentration after a week.

Oxybenzone and Coral Reefs:

The state of Hawaii banned both oxybenzone and octinoxate last summer.

The legislation stated that these chemicals:

“have significant harmful impacts on Hawaii’s marine environment and residing ecosystems.” 

The Governor of Hawaii stated (Washington Post, July 6, 2018):

“Studies have documented the negative impact of these chemicals on corals and other marine life. Our natural environment is fragile, and our own interaction with the earth can have lasting impacts. This new law is just one step toward protecting the health and resiliency of Hawaii’s coral reefs.”

What Should We Learn About Sunscreen Absorption?

The scientists conducting this study do not consider it the last word on sunscreen ingredient absorption. They present it as proof that such studies are feasible, however. The FDA may encourage manufacturers to carry out similar studies to demonstrate whether their sunscreen products are absorbed into the body. If they are, toxicity studies should be carried out. Do you not find it astonishing that this kind of research has not already been done?

Editorial in JAMA Interpreting the Results:

In the Same issue of JAMA there is an editorial by Robert Califf, MD, former FDA Commissioner and Kanade Shinkai, MD, PhD, Editor in Chief, JAMA Dermatology. These two heavy hitters note that there was evidence sunscreens were absorbed systemically over 20 years ago and that research reported:

“the presence of the common sunscreen ingredient oxybenzone in 97% of urine samples collected as part of the National Health and Nutrition Examination Survey.”

They go on to add:

“The demonstration of systemic absorption well above the FDA guideline does not mean these ingredients are unsafe. However, the study findings raise many important questions about sunscreen and the process by which the sunscreen industry, clinicians, specialty organizations, and regulatory agencies evaluate the benefits and risks of this topical OTC medication. First and foremost, it is essential to determine whether systemic absorption of sunscreen poses risks to human health.”

We find it astonishing that after all these years there are so many unanswered questions. These two authorities add:

“At a minimum, physicians should recommend use of sunscreen formulations containing GRASE [generally recognized as safe and effective] ingredients such as titanium dioxide and zinc oxide as part of a larger program of photoprotection that includes seeking shade, and wearing protective clothing, hats, and sunglasses, until meaningful answers to these questions are available.”

The authors of the research in JAMA note, the mineral ingredients titanium dioxide and zinc oxide are considered safe and effective. Manufacturers using other sunscreen ingredients (chemical filters such as avobenzone or oxybenzone) will be expected to produce absorption data. Learn more about zinc oxide at this link:

How Can You Protect Your Nose from Sunburn?

Share your thoughts about the latest research on sunscreen absorption in the comment section below.

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  1. Sharon
    Jensen Beach FL
    Reply

    About 15 years ago my husband and I spent 10 days in Hawaii on vacation. We used sunscreen liberally every day to prevent sunburn. After a week of doing this consistently we were both totally exhausted and felt sick. My husband couldn’t even drive he was that wiped out. He went to bed late in the afternoon and slept for many hours. We concluded that we had a form of ‘sunscreen poisoning’ from the chemicals being absorbed into our bodies. I’ve been leery of using sunscreen ever since because our bodies told us something that day.

  2. Sharon
    Texas
    Reply

    Just several weeks ago I was speaking with a woman that works on a catamaran, taking tourists out on the water, and she shared this same information with me. She said that they tell everyone that is going on the water with them to NOT wear chemical sunscreen and that they have a huge tub of both coconut oil and olive oil available for use. I asked if that wouldn’t increase the sun’s damage on skin and she said that either oil applied to the skin keeps you from burning and they are both nourishing to the skin and they don’t harm marine life. It still doesn’t sound right to me, but she has been on the water for a long time and insisted that it’s correct.

  3. Gregg
    California
    Reply

    I was born and raised in Hawaii and never used sunscreens – in the ’60s some Moms put zinc oxide on their children’s noses. I am 62 and today my dermatologist regularly “burns” off small patches of pre-cancer on my face but it took 40 years for it to appear. I still rarely use sunblock.

  4. Dr. Phil
    TX
    Reply

    I agree with James in Colorado – the best sunscreen is shade.

    I live in coastal Texas and always wear long sleeves and a broad-brimmed hat when I know I’ll be out in the sun for more than a few minutes. Putting sunscreen on my hands, face, and neck is part of my morning ritual during the summertime.

    Have the chemicals in other cosmetics been studied as closely as the ingredients in sunscreens?

    Also, have nanoparticle zinc and titanium oxides been studied in the same way? The older, powdered products cannot penetrate the skin because they are too large, but nanoparticles are extremely small, generally 25 to 100+ times as small as the powders used in older sunscreens.

  5. Bill
    Columbia, South Carolina
    Reply

    I so appreciate this information. To see this research in JAMA means it may actually filter down through our medical practitioners. I’ve been using “healthfood store” sun protection products that don’t contain oxybensone for years with success.

  6. Sue
    IL
    Reply

    It adds chemicals to the bloodstream; it prevents the natural production of vitamin d; it pollutes the environment, and there are other options to take. This is not a tough choice.

  7. Marla
    Reply

    Mike in NYC: The article says that until the matter is studied more it suggests using sunscreens with GRASE ingredients (titanium dioxide and zinc oxide), seeking shade and wearing protective clothing, hats, etc. ? People’s Pharmacy graciously provides health information to us. I do not expect them to conduct studies on their own.

  8. Darryl
    NC
    Reply

    FYI….ordinary cotton T-shirts have an SPF of about 4. I looked into this and was surprised to find it was so low. Sunlight easily penetrates the weave.

  9. Lynn
    NSW Australia
    Reply

    I decided not to use sunscreen about 25 years ago. I avoid the sun whenever I can. I wear hats and a rash shirt when swimming. I take a lot of MEDICATION and my decision was based on that. I have enough chemicals going into my body and choose not to have extra chemicals by putting sunscreen on my body. Looks like I was right.

  10. Katie
    Great Lakes region
    Reply

    The Environmental Working Group published something on nanoparticles in sunscreen some years back. After that I stopped using sunscreens because it was thought that the nanoparticles could cross the blood brain barrier. Not sure if this is accurate anymore. The problem is that the zinc and titanium oxides are in nanoparticle form. They are coated with silicon or aluminum. So while zinc is a supplement I take daily, not sure about the nanoparticles being safe. I wear protective clothing, heavy large hats, etc. This can be tough when it’s very hot out. I’m not a heat-loving person, so staying out of the sun isn’t hard for me.

    Thing is, that some skin cancers, basal cell and squamous cell, are easily treated if you catch them in time. Suntan lotion protects against these.

    Melanoma is more dangerous, but from what I’ve read, there’s mixed opinions on whether sunscreens protect against melanoma.

  11. Jim
    Winchester, VA
    Reply

    I have avoided oxybenzone for several years due to articles on PP. I find that the “Sport” formulation of a popular brand does not contain oxybenzone, nor does the private label “Sport” at my local supermarket. I also wear SPF-rated long-sleeved shirts, which are no longer hard to find in local stores. I previously had a basal cell skin cancer removed from my nose, so I limit sun exposure, especially during mid-day.

  12. Tom N.
    Kansas
    Reply

    Everything that you’ve written in this “article” has been known for years. Oxycodone has two benzene rings and associative molecular bonds. As a former research chemist and examining the penetration of the compound thru the skin and into the body, I am amazed that this compound has been OK’d for use on humans. The main excretion methods in humans is thru the urine and the feces…..this is not a quick process but continues for a considerable length of time. This should be a concern for any of us that use sunscreen, especially for children. For the life of me I do not know why people don’t limit their time in the sun and slowly develop a healthy tan and the vitamin D that it brings. After having numerous dealings with the pharmaceutical companies and the FDA, I would advise all people to not wait for them to act in your best interest.

  13. Anne
    Wisconsin
    Reply

    You used to recommend Blue Lizard. I bought it for awhile, but even the sensitive formula made me break out. Plus, it seemed to get on my car doors and seats, and anything else I came into contact with.

    It’s especially frustrating when you have a hobby like horseback riding. There’s no good way to avoid the sun during the summer months.

  14. Bette
    Washington DC
    Reply

    This is a serious no-brainer and has been for more than 20 years. Don’t slather on sunscreens, and, for that matter, don’t slather on anything you wouldn’t want absorbed into your body. By the time the FDA’s recently directed study comes to fruition, it will be too late for an entire generation of people who took their doctors’ advice and applied bottle after bottle of sunscreen. For shame.

  15. Tom
    Kingwood, TC
    Reply

    Nano Titanium dioxide is a known carcinogen. I am 87, do not use sun screen, wear polo shirt and shorts while playing golf. I do not burn. ( I did when I was a teenager, but generally only once per summer. ) I question the science of using sunscreen for everyone. The incidence of skin cancer has increase about 5 fold since 1970. Just the reverse of what should have occurred. Sunscreen use began about 1970.

  16. Hella
    MD
    Reply

    This seems to be another case of “you’re dammed if you do and dammed if you don’t!” I guess it’s best to stay out of the direct noon sun as much as possible!!!

  17. Noah
    Chapel Hill, NC
    Reply

    Considering that people do not just slather on sunscreen unless they are going to be spending time in the sun, I would be more, a lot more, impressed with a study that actually had subjects spend time in the sun. Who knows what effect the sun has on the chemicals in sunscreens? It may be salutory when used for its purpose. And the absorption may be cut down considerably through the effects of the sunlight on the chemicals and the sweat produced by the subject.

  18. Katherine
    Reply

    Personally wondering if this “sunscreen world” is related to the increasingly more common development of moles and other skin surface growths.

    Never have used those products and only have the 2 moles I’ve had since birth — and darned few wrinkles for 76 years. Doubt it’s genes, because have some very wrinkly relatives.

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