Dermatologists say rub on sunscreens, tune out influencers

Atlanta doctors emphasize risk of skin cancer trumps concerns over chemicals in sunscreens

In a country where debates now run as hot as a summer day in Bacon County, it was bound to come to this: sunscreen is the latest topic dividing families and friends. Some say reapply it every two hours – even while working inside at computers. Others decry its use, fearing it causes cancer and blocks the sun’s “life giving” rays.

Experts reason the truth is somewhere in between: sunscreen is safe, they say, but overdoing it might not be as helpful as simply seeking shade during peak daylight hours and wearing protective clothing.

“All day long, I’m telling people they need to wear sunscreen,” Dr. Sumayah Taliaferro of Atlanta Dermatology & Aesthetics told the Atlanta Journal-Constitution, “It’s about having a conversation – meeting patients where they are.”

Taliaferro says patients routinely share with her their concerns about chemicals in sunscreens, based on posts they’ve seen on social media. But she and other experts tell patients that the risk of skin cancer far outweighs that of the ingredients in the lotions — and that sunscreens play a critical role in protecting all skin types.

“There’s a myth that people of color don’t need to wear sunscreen— but everyone does,” Taliaferro noted.

Tans and occasional redness from a summer day outside can cause big skin problems down the line. Every hour, at least two people die of skin cancer in the United States. Though treatment success rates are high, skin cancer has become the most common cancer in America, and 6.1 million adults are treated each year for basal cell and squamous cell carcinomas, according to the Centers for Disease Control and Prevention.

People of color can also develop the disease, and when this happens, skin cancer is often diagnosed later and harder to treat.

Manufacturers had used the terms sunscreen and sunblock interchangeably, but the FDA ruled in 2011 that they cannot label sunscreens as “waterproof” or “sweatproof,” or identify their products as “sunblocks,” because these claims overstate sunscreen effectiveness, according to the FDA’s website. That notwithstanding, consumer health website sometimes refer to sunscreens made of zinc oxide and titanium dioxide as “sunblocks” since they sit on the skin and form a physical barrier to the sun’s harmful rays.

The debate about whether sunscreens are safe has been fueled, in part, by the U.S. Food and Drug Administration, after it published a study that said some sunscreen ingredients had been found in trace amounts in human bloodstreams. The FDA subsequently asked manufacturers for more data to see if chemical sunscreens were safe, while giving the green light to mineral sunscreens.

The FDA’s mixed messaging has frustrated doctors, however, who felt that the FDA cast doubt on sunscreens already on American store shelves, before approving newer, better, and safer sunscreen ingredients already used in Australia, Canada, Europe, and Asia.

Krista M. Rubin, a nurse practitioner with the Massachusetts General Cancer Center Melanoma Team, says there is little proof that sunscreens are dangerous, but clear-cut evidence that excessive ultraviolet (UV) radiation from the sun is a carcinogen.

“There are no benefits to being in the sun without sunscreen,” Rubin told the AJC. “There is no such thing as a safe tan; a tan is an injury to your skin.”

Though Americans seem to be aware of the risks of sunburns, many remain wary of sunscreen. A Yahoo News/YouGov survey found that 80% of people say protecting their skin from the sun is “important.” Yet 33% reported never wearing sunscreen, and 29% wore it infrequently. The study was conducted from May 10 to 13 and had a sample of 1,794 U.S. adults.

Some believe that having darker skin makes sunscreen use superfluous. That’s incorrect, Taliaferro emphasized. Though deeply melanated skin might have a natural SPF offering mild protection from the sun, Taliaferro said it’s not enough to offer full protection, nor prevent wrinkles and crow’s feet from cumulative sun exposure that breaks down collagen in the skin.

Darker skin is also more predisposed to develop hyperpigmentation. After acne, it’s the second most common concern among patients at her Atlantic Station dermatology practice, Taliaferro said. She recommends sunscreens that contain zinc oxide and titanium dioxide. While some people dislike the white cast that mineral sunscreens can leave on the skin, there are formulas that go on clear.

Still, product recalls of sunscreens containing benzene – a known human carcinogen – haven’t helped build confidence in the products.

Between April 2021 and April 2022, companies issued 11 recalls for hand sanitizers, sunscreens, deodorants, and hair products contaminated with the chemical, according to a report by Environmental Health Perspectives. The most recent study by Valisure, a product testing company in New Haven, CT, found benzene in several spray sunscreens.

Emily Spilman, a program manager of Healthy Living Science at the Environmental Working Group who manages the update to the sunscreens guide and product reviews for the EWG Verified Sunscreens program, said benzene is not an intentionally added ingredient. It may be a contaminant related to isobutane, a propellant used in spray products.

“Consumers can minimize their exposure to this cancer-causing chemical by using sunscreen lotions and sticks instead of sprays,” Spilman told the AJC.

American consumers have also taken to social media to voice their concerns about zinc oxide and titanium dioxide nanoparticles. Spilman said these sunscreen ingredients don’t penetrate the skin in significant amounts, but there are valid concerns about inhaling floating particles.

“When inhaled, nanoparticles can enter the bloodstream and cause lung damage,” Spilman noted. “(The Environmental Working Group) strongly discourages the use of spray sunscreens with zinc oxide and titanium dioxide, where particles can be easily breathed in during application.”

Experts consulted by the AJC said social media platforms owned by Facebook, Instagram, Google, and TikTok could be doing more to remove disinformation about sunscreen and skin cancer.

“Disinformation about sunscreen and skin cancer, often propagated by social media influencers, pose a significant risk to public health,” Spilman said. “These influencers may persuade people to adopt unsafe behaviors, potentially increasing their risk of skin cancer.”

Doctor’s tips on keeping skin safe and healthy

– Stay in the shade during peak sunlight hours, 10 a.m. to 4 p.m. daylight time.

– Wear hats and sunglasses.

– Use UV-blocking sun umbrellas and clothing.

– Reapply sunscreen every two hours.

– Consult the EWG’s Guide to Sunscreens for science-based information backed by peer-reviewed studies on the safety of sunscreen ingredients: