Data from FDA-funded research published in the Journal of the American Medical Association (JAMA)1 in 2019 and 20202 have shown that certain ingredients in sunscreen products may build up in the body at unhealthy levels. The chemicals studied were avobenzone, oxybenzone, octocrylene, homosalate, octisalate and octinoxate.
Some of these ingredients may accumulate at levels greater than what would be considered safe, according to the lead researcher and team that conducted both studies. This begs the question of whether the FDA should reconsider whether the products are safe.3 As Consumer Affairs explained:4
"The FDA gets concerned if ingredients are found in the bloodstream at a level of 0.5 nanograms per milliliter or higher. At that level, the FDA says chemicals need to undergo a rigorous analysis to make sure they don't have harmful health risks … [the] six chemicals found in sunscreen products were found at levels ranging from 3.3 to 258.1 per milliliter, depending on the product and how it was applied."
This is worrisome because the study showed that all of the sunscreen chemicals were still above safety levels seven days after application, with two of them still above the threshold on Day 21, according to The Wall Street Journal:5
"… if active ingredients are found in the blood at a level of 0.5 nanograms per milliliter or higher, they should be analyzed to determine whether they increase the risk of cancer, birth defects or other adverse effects … Previous studies have indicated a possible association between some of the chemicals and health risks such as endocrine disruption and reproductive harm, but no comprehensive safety data are available."
The studies serve as yet another warning as the fear of the sun and the infatuation with sunscreens continues. In 2010, environmental groups warned that nearly two-thirds of sunscreens provide inadequate UVA protection compared to their UVB ray protection.6 UVA rays are linked to skin aging and UVB rays are linked to skin burning.7
In 2010, Sen. Chuck Schumer, D-N.Y., asked the FDA to require warnings on sunscreen labels of products containing retinyl palmitate, because a lab study showed that the chemical caused the growth of tumors in animals.8 While some dermatologists vociferously claimed retinyl palmitate is safe because there was no definitive study on it yet,9 Schumer insisted the studies need to be done because consumers "have a right to know."10
Oxybenzone, a hormone-disrupting chemical that is often added to sunscreens, was also of concern. Astoundingly, despite this evidence and the fact that only 7% of products studied in the report he cited were determined to be both safe and effective, the FDA had not put forth any guidelines at that time.11
Data Show Sunscreen Ingredients Enter the Bloodstream
Several years ago, researchers found that almost everyone — 96.8% — who took part in the 2003-2004 National Health and Nutrition Examination Survey had detectable levels of benzophenone-3, another name for oxybenzone.12 That same ingredient is also used in cosmetics and food packaging materials.
In the 2019 JAMA study, the authors also found a host of sunscreen ingredients in the blood of participants who'd used the products. At least one (oxybenzone) can show up in breast milk and amniotic fluid, in addition to making its way to the blood and urine, as told by the researchers.
They also wrote that the ingredients were absorbed after only one day's exposure, and some persisted in the body after use. Results from their 2020 study corroborated their work from 2019 and its implications for safety. What did the second study add to what was learned from the first one? According to the researchers:13
"In the prior study of 24 healthy volunteers, systemic absorption of sunscreen active ingredients was demonstrated. This follow-up study expanded the sample size, tested additional sunscreen active ingredients and formulations, and confirmed the finding that sunscreen active ingredients are systemically absorbed.
This included 6 of the 12 active ingredients in the sunscreen over-the-counter monograph for which the FDA has requested additional data to make a determination as to whether these ingredients are generally recognized as safe and effective (GRASE)."
The FDA Is Continuing to Analyze Ingredients' Safety
In February 2019, just three months prior to publication of the JAMA study, the FDA proposed a list of updates to regulations for most sunscreen products sold in the U.S.14 However, the new rules have not been finalized as the FDA continues to analyze information after the second study.15 According to Good Housekeeping:16
"The FDA believes that the outcomes of these two studies are in line with their proposal [pending] and support their ask for additional safety data on those 12 chemical sunscreen actives. Given the recognized health benefits of sunscreen use, the FDA continues to advise the public to use sunscreen in conjunction with other sun safety measures …"
The Environmental Working Group (EWG), "a nonprofit, nonpartisan organization dedicated to protecting human health and the environment,"17 has weighed in on the effects of oxybenzone:18
"'For a decade, EWG has worked to raise concerns about sunscreens with oxybenzone, which is found in nearly all Americans, detected in breast milk, and potentially causing endocrine disruption,' David Andrews, Ph.D., senior scientist at EWG, said in a statement."
Sunscreens Are a Scourge on Coral Reefs
The effect of sunscreens on the world's coral is devastating. As reported by The Guardian,19 researchers found in 2015 that up to 14,000 tons of it wash into coral reefs every year.20 Coral bleaching, caused by oxybenzone, causes "baby coral to encase itself in its own skeleton and die," The Guardian said.
In addition to the accumulation washing off from swimmers and boaters, sunscreen chemicals also reach waterways through wastewater treatment plants, which do not always filter out such pollutants.21
The situation is so serious that in 2019 a Florida state senator proposed legislation to require a prescription for any sunscreen containing oxybenzone and octinoxate.22 The proposal was based on restrictions that Key West and Hawaii put into place, which will become effective in January 2021.23
Vitamin D Deficiency Is Also a Concern
Strong warnings from medical associations and the media to avoid sun exposure or to apply sunscreens have resulted in many people being deprived of sunshine's multiple benefits. One of these is vitamin D production, and avoiding the sun may be the reason why so many people are deficient in vitamin D.
While it's important to avoid getting sunburned, you need to take care in determining the best way to do that. Obviously, if they have chemicals in them that may not be safe, sunscreens come with their own set of dangers. But, avoiding the sun altogether also isn't good, since that can cause vitamin D deficiencies. This is particularly concerning because a deficiency in vitamin D can put you at risk of other health problems.
For example, the authors of research in the International Journal of Environmental Research and Public Health suggested that low sun exposure may be correlated with the development of "specific cancers (more on that later), multiple sclerosis, diabetes, cardiovascular disease, autism, Alzheimer's disease and age-related macular degeneration."24
How To Be Sunscreen Safe
As the researchers noted in the 2019 JAMA article, zinc oxide and titanium dioxide have been found by the FDA to be generally recognized as safe (GRASE), as opposed to the sunscreen chemicals whose safety is still under investigation.25 Both protect against UVA and UVB rays.
In addition to avoiding dangerous sunscreen chemicals I caution against using sunscreens and other personal care products that contain synthetic preservatives and fragrances. Some common synthetic chemicals with health-altering properties include:26,27
- Parabens — Synthetic preservatives known to interfere with hormone production and release.
- Phthalates — Another synthetic preservative that's carcinogenic and linked to reproductive effects (decreased sperm counts, early breast development, and birth defects) and liver and kidney damage.
- Synthetic musks — These are linked to hormone disruption and are thought to persist and accumulate in breast milk, body fat, umbilical cord blood and the environment.
Also, remember that if you apply sunscreen every time you're out in the sun, you'll block your body's ability to produce vitamin D. And, optimizing your vitamin D levels may reduce your risk of as many as 16 different types of cancer, including pancreatic, lung, ovarian, breast, prostate and skin cancers. According to research published in the journal Medical Hypotheses:28
"Since it was discovered that UV radiation was the main environmental cause of skin cancer, primary prevention programs have been started. These programs advise to avoid exposure to sunlight. However, the question arises whether sun-shunning behavior might have an effect on general health.
During the last decades new favorable associations between sunlight and disease have been discovered. There is growing observational and experimental evidence that regular exposure to sunlight contributes to the prevention of colon-, breast-, prostate cancer, non-Hodgkin lymphoma, multiple sclerosis, hypertension and diabetes.
Initially, these beneficial effects were ascribed to vitamin D. Recently it became evident that immunomodulation, the formation of nitric oxide, melatonin, serotonin, and the effect of (sun)light on circadian clocks, are involved as well … Considering these data we hypothesize that regular sun exposure benefits health."
In summary, if you do use a sunscreen, your safest choice is a lotion or cream with non-nanoscale zinc oxide,29 as it is stable in sunlight and provides the best protection from UVA rays. Your next best option is non-nanoscale titanium dioxide.
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