The People's Perspective on Medicine

Sunscreen Gets Under Your Skin | Is It Safe?

A new study shows that a common sunscreen ingredient, oxybenzone, is readily absorbed through the skin into the body. Should you worry?

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:

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

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I just read an article from ConsumerLab, and titanium dioxide was shown to increase inflammatory disease and colorectal cancer in mice. It looks like there needs to be tests by scientists and the sunscreen makers to see how much is absorbed and what percentage will affect humans negatively.

The titanium dioxide in that study was consumed, not applied topically. We still need more research on its safety in sunscreen.

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.

I use sunscreen very sparingly because I just don’t like how it feels on my skin! And it also seems to make my skin, especially face, look kind of ashen and wan.

I love the sun and being outdoors. But I do fear sun damage. Who needs wrinkles and crepey skin?! So I do use those “sunless tanning” products and am very happy with the “natural tan” look they give my legs.

However I’m very afraid that the chemicals in those “sunless tanning” products are even worse than sunscreens as far as putting chemicals into the body. Has anyone ever done a study on THOSE? If so, I’d be very interested to hear about it.

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.

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.

I play golf. Four hours out in the sun four days a week. My sunscreen has 6% oxybenzone. Broadbrim hats are not an option. I have to wear sunscreen. Give a list of safe ones.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Inhaled nanoparticles of titanium dioxide are “Possibly carcinogenic.” This review suggests that transdermal absorption is negligible.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3423755/

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!!!

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.

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.

I read awhile ago an anthropologist’s report on bone density in an area of dual cultures, one of which wore caps and the other of which shaved their heads so the sun could reach their scalps. It was reported the skull density of those who shaved their heads was a lot greater than the other culture. That’s a pretty good indication to me that issues with the sun are a lot more complicated than dermatologists and sunscreen manufacturers want us to believe. If the sun does, indeed happen to give you skin cancer, then you may have other issues contributing to the sun having that effect on you.

I live in Hawaii where my grandmother always carried a wooden umbrella to protect her face from the sun, and others were brown as berries from being out in it all the time. My grandmother was in the sun all the time; she just used the umbrella at midday whenever she was going to be in the sun for an extended period of time. She had skin like a baby’s and scolded us for being careless of what we put on our faces. That aside, I thank Peoples Pharmacy, not condemn them, for putting the facts before us and letting us make our own decisions. It is our own responsibility, after all.

Common sense maybe? This article is an alert not an alternative product suggestion. I live in Oz, and cover up, and use sunscreen, I also take meds that make my skin supersensitive to the sun. Nothing really protects us from the effects of these drugs, I have had multiple skin cancers removed, leaving big scars. All info on sunscreen gratefully accepted.

In the past year, I have started having small white bumps on my face. My dermatologist says the only way to remove them is to have them cut off by a professional. Could this be from wearing sunscreen? I only got serious about sunscreen in the past two years after having precancerous spots burned off.

I make my own home made sunscreen and add zinc oxide powder. Do you know if there are any health risks I don’t know about?

The article mentions zinc oxide and titanium dioxide are considered safe sunscreens. And they work. There are formulas on the market that are much less white than they used to be but are still effective. Our family gets a safe amount of sun exposure, for vitamin D3 and proper melatonin and nitric oxide production and probably lots of other benefits that haven’t been fully researched yet, and then put on sunscreen if we stay in the sun after that, and then cover up if we stay even longer. With timers on every cell phone, there is no reason anymore not to get safe sun followed by a reminder tone that it’s time to either apply sunblock or cover up. That way we can have the best of both worlds: good health/less wrinkles/balanced hormones AND a healthy glow. And, we don’t contaminate the reefs with chemicals that compromise the marine environment. Seems like a no-brainer.

Does the lack of sun exposure during this study, make a difference to the reported outcome?

A number of years ago, I used a sunscreen and found that I wound up TASTING it all day. I know that I did not get any on my mouth or lips. Since I was initially unaware of what was happening I used it again the next day and had the same result. On the second day I realized it was the sunscreen that I was tasting and realized it was being absorbed. A friend noted the same symptoms. I gave up that brand. A year or so later, someone offered me some sunscreen, a different brand. It had the same results – tasting it most of the day out hiking.

Again, since the stuff gets in my eyes when I perspire, I never apply it above my neck. Clearly, some component was being absorbed and leaving a very unpleasant taste for hours.

I never figured out which ingredient had the result.

Ideas?

I think the only safe sunscreen is shade! We need some sun to make Vitamin D, maybe 15 mins. a day 3-4 times a week. Vit D. pills do nothing to raise my Vit D level to normal. Wide brim hats and sun-proof gloves are healthy, attractive and stylish to wear.

My aunt lived to be 101, and every day she sat in the sun after lunch, about 20-25 mins. She never developed skin cancer, and she never used sun screen. Her theory was sun screen might cause cancer and she felt so much better when she sat in the sun. She lived in the sunny Texas Gulf Coast and had no fear of a little sun because it contributed to her well-being.

To helen: I don’t think the article is meant to stop you from using sunscreen! It is meant for you to be wise about your sunscreen ingredients. I’m late 60s & have minimal wrinkles for the same reason – I’ve used sunscreen since my 20s religiously. BUT I’ve used formulations with zinc oxide only for over 25 years – since when we first heard about the possibility of ill effects from oxybenzone.

I live in Florida and although I have used sunscreen for years, my skin bears the damage of years and years of sun exposure. I wear it AND I cover up AND stay out of the sun unless I can’t or just really need to be in the sunny water. I support additional research and the development of new sunscreens. Titanium and zinc formulas drive me nuts because my skin doesn’t breathe well when I use them, so I am just miserably hot. So, I use the chemicals, figuring nothing is perfect. But, I appreciate the information.

Oh Gosh,

What is a your average girl supposed to do? Are there sunscreens that are recommended? Please help.

I switched to a mineral based sunscreen a couple of months ago, and thoroughly investigated the ingredients before I bought it. And, I love it.

Here in Florida we have shirts, shorts and other garments with sunscreen woven into the product. Much easier that trying to put sunscreen on your back is a long sleeve swim top!

Think about driving: your hands are continuously on the wheel usually facing the sun. The damage from sun is cumulative. Best answer: cosmetic gloves, readily and cheaply available at your local drug store. That’s why people of an earlier age tried to keep out of the sun or protected themselves with gloves, hats, and parasols (Spanish–para sol–for the sun)!

Interesting that so many of the respondents so far are from Florida where sunburn and skin cancer are live issues.

Echoing Rosemary above, the skin is an organ (the body’s largest), and we should not put on our skins anything that we wouldn’t put into our mouths, which makes life problematic in a number of ways, e.g., makeup.

I haven’t used sunscreen in over 30 years. I used to have a job where I was outside all day long (in a vehicle verses being at home) and never used it. My brother died of skin cancer in 1997 at age 45. I just plan on not being directly in the sun for long periods. But lately, where I have been staying away from home, the sun hardly ever shines as much as decades ago. What about missing out on vitamin D using all those sun blockers?

Thank you for alerting us to this new study. Yes, it IS astounding that sunscreens have been around so long without study. Perhaps this study will spur others.
For those who want to learn more about sunscreen dangers as well as sunshine benefits, check out this recent article:
https://www.westonaprice.org/health-topics/environmental-toxins/sunscreens-the-dark-side-of-avoiding-the-sun/

I have been using sunscreen for 50 years. I am 72, and I have minimal facial wrinkles.
This study will have no effect on my sunscreen use. The effects are too beneficial to cease my use.

I have always resisted sunscreen use for just this reason. Skin is literally porous and obviously you are ingesting the absorbed chemicals. For me, I feel as if my skin can’t breathe when I apply that goop. I rely on broad-brimmed hats and long sleeves, and staying in the shade. And what about vitamin D?

I did not realize until recently that sunscreens seem to do NOTHING for cancer prevention! I’d like to request a sister article on this topic.

Uptake into the body via skin contact should be considered with all cosmetics, shampoo and cologne. Many people think skin application is benign, it is not. In addition things like scented dryer sheets can be a cancer contributor. This is scoffed at when people first hear it. I suggest you do research and will be shocked that this has been kept very quiet by the media.

Many years ago my sun sensitive Dad used this stuff and had a 3-plus allergic reaction, puffed out and got redder than the worst sunburn. Sold his boat that he had just bought, stayed in the shade, wore a wide-billed hat and long pants and sleeves rest of his life. Ditto my sister who had a melanoma removed. I just got a melanoma dx, and the usual sunscreen recommendation. Bought a wide-brimmed hat instead, wear a neck scarf, long sleeves and pants, only work in the garden when the trees shade it. I wonder if I can start wearing hijabs without someone else thinking I am an Islamic extremist. Tans are no more glamorous than cigarettes, Hollywood!

In my Wisconsin I get out in the sun in April/May to toughen my skin. Small pores make me overheat so don’t use sunscreen unless I am rafting or on my driving arm during all day driving after the first day. I think sunscreen promotes skin cancer.

I switched to a “baby” sunscreen formula to avoid oxybenzone. But my first line of defense is to cover up, including while swimming, which greatly reduces use of sunscreen (and effect on environment).

I live in coastal South Florida. Wearing sunscreen is second nature. Most residents of Florida, unlike tourism visitors, do not seek sun tans and avoid burns, as we know how excess sun ages and damages skin. However, it’s frightening to realize how little testing of the ingredients in sun tan lotions has been done. I tend to cover up outside, wearing wide brim hats and sleeves. Still, I try to use a moisturizer with sunscreen added every morning and am trying to buy and use the safest and most effective. I hope more studies will be done. In the meantime, as the potential dangers of oxybenzone are made known [and the potential for reef killing is also a problem for Florida] I’ve gotten rid of all products containing the chemical.

We were at a marine preserve in Mexico last year and saw numerous written requests NOT to use sunscreens because of its effects on marine life. This isn’t a problem for me because I can’t find a sunscreen that doesn’t cause rashes, irritated eyes, and itching. I use hats and sun block clothing when I”m out during mid day.

Since the skin is the largest organ in the body and readily absorbs lotions applied to it, I have always been curious about the safety of sunscreen lotions and sprays. I discussed this with my internist who told me that while he applies sunscreen prior to his daily jog, he showers immediately upon returning to remove the sunscreen from his skin. I use sunscreen at the beach and pool and wear an SPF rash guard shirt over my swimsuit. I am fair skinned and prefer to avoid sun, I take 2 daily two mile walks just after dawn and just before sunset when the sun strength is presumably weakest. I wear a broad brimmed hat and long sleeved SPF rated T-shirts. I also have UVA and UVB window film installed in my cars.

so once again your article has made us confused and worried about the the safety of a product that millions have confidently used to protect against sin cancers for decades with absolutely no clues about what if anything we can or should do about it.. thank you so much..

The ONLY safe sunscreen is shade!!!!!

I much prefer zinc and titanium oxide sunscreens. They do not irritate the skin or make eyes water and their effectiveness does not breakdown nearly as quickly.

I am committed to using only non-nano mineral-based sunscreen. The ocean and corals are too fragile and already suffer from plastic contamination.

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