Is Sunscreen Helpful or Harmful?

From social media influencers spreading misinformation about sunscreen to surveys that show more young adults are unaware of the health risks of sun exposure, Generation Z could be at higher risk for skin cancer. According to a recent survey of people ages 18 to 25 conducted by the American Academy of Dermatology, 52% of those polled didn’t know that sunburns could increase risk for skin cancer or premature aging. The survey also found that young adults are tanning and sunburning more, which is increasing their risk for skin cancer. About one in four Gen Z adults report already experiencing skin damage from the sun, and around 37% only wear sunscreen when nagged to do so.

“Sunscreen plays a key role in protecting our skin from the sun,” says Dr. Shari Lipner, a dermatologist at NewYork-Presbyterian/Weill Cornell Medical Center and associate professor of clinical dermatology at Weill Cornell Medicine. “As a dermatologist, I see the impact of sun overexposure every day in my office. It is the most preventable risk factor for skin cancer, including melanoma, the deadliest form.”

Health Matters spoke with Dr. Lipner who explains what consumers need to know about sunscreen, its ingredients, and why it’s important to wear it to prevent skin cancer and protect your skin from damage.

What should people do to protect their skin?
To reduce your risk of skin cancer, I always recommend that patients use a sunscreen that is broad-spectrum, meaning it protects against UVA and UVB rays; is water-resistant; and is SPF 30 or higher. I encourage people to reapply every two hours, especially if you are sweating, swimming, or rubbing off sunscreen. I advise my patients to pick a sunscreen that they are going to use every day. When it comes to selecting sunscreen, there are a lot of choices: creams, lotions, sticks, and aerosols or sprays. So if you like the way a cream feels, use a cream. If you think you are more likely to use a gel or a stick, use that.

But sunscreen is just one part of a big picture. You also want to seek shade. The sun’s rays are strongest between 10 a.m. and 2 p.m., so try to stay in the shade during that time of day. What you wear is important too. Dress to protect yourself from the sun: Wear a lightweight and long-sleeve shirt, pants, wide-brim hat, and sunglasses.

Are the ingredients in sunscreen safe?
We have been using sunscreens for many, many years safely. The Food and Drug Administration is gathering more data on them, and I think that is helpful. Personally, I am comfortable using both physical sunscreens (also known as mineral sunscreens) and chemical sunscreens. But if anyone is concerned about the chemicals in sunscreen, they can use just mineral sunscreens.

What is the difference between a chemical sunscreen and a mineral sunscreen?
A chemical sunscreen works like a sponge. It absorbs the sun’s rays, and that involves some of the ingredients that have been called into question in the past. Chemical sunscreens are easy to rub into the skin, and they generally do not leave a white residue. Mineral sunscreens act like a shield. They sit on the surface of the skin, and they deflect the sun’s rays. They usually leave a white residue.

What is the FDA doing to protect consumers when it comes to sunscreens?
The FDA issued a proposed rule that asks manufacturers to provide more data about the safety of several sunscreen ingredients. There are already two ingredients that are “generally recognized as safe and effective,” or GRASE, and those are titanium dioxide and zinc oxide. But there are 12 other chemicals that need further evaluation in order to determine whether they can be classified as GRASE. The FDA is asking for more information, but certainly, based on the data we have now, they still recommend that we use sunscreen.

What are those 12 ingredients?
Those ingredients are cinoxate, dioxybenzone, ensulizole, homosalate, meradimate, octinoxate, octisalate, octocrylene, padimate O, sulisobenzone, oxybenzone, and avobenzone. The FDA is specifically looking at these ingredients in terms of absorption by the skin and the health risk of absorbed chemicals.

One of the ingredients, oxybenzone, has been rumored to be a hormone disruptor. Is this true?
Some studies have been done — mostly in vitro studies in rats — in which oxybenzone exhibited some estrogen activity. However, in these studies they used an extremely high concentration of oxybenzone, much higher than humans would get. Researchers estimated that it would take 277 years of daily application of a sunscreen containing 6% oxybenzone to obtain a comparable level of exposure in humans. There have been other studies as well. Oxybenzone was applied to the skin of human volunteers, and researchers saw that there were no biologically significant alterations in the reproductive hormones. So, at this time there’s not enough evidence to claim that it’s a hormone disruptor. It has been used safely since 1978.

What are other myths about sunscreen, and can you dispel them?
Some people incorrectly believe that people with darker skin do not need to use sunscreen. The truth is that people of all skin colors are at risk of developing skin cancer, and thus should protect their skin from the sun and use sunscreen.

While sunscreens may be labeled as “water resistant,” no sunscreen is waterproof. Make sure to apply after sweating or swimming.

Do young children or pregnant women need to be concerned about these ingredients?
Generally, it is not recommended to use sunscreen on babies younger than 6 months old. The best way to protect them is to keep them out of the sun. But certainly, for young children, pregnant women, people with sensitive skin, or any person who may be nervous about these ingredients, I would recommend a mineral sunscreen.

Shari Lipner, M.D., Ph.D., is a board-certified dermatologist at NewYork-Presbyterian/Weill Cornell Medical Center and associate professor of clinical dermatology, and chief of the nail division at Weill Cornell Medicine. She treats patients with common problems of skin, skin cancers, and cosmetic concerns, as well as nail conditions. She has authored more than 465 articles, 14 book chapters on dermatological conditions and cosmetics, lectures internationally, and is frequently called upon by the media for her expert opinion.