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How Safe and Effective Are Sunscreens?

How Safe and Effective Are Sunscreens? Environmental Working Group Sees Improvements, but Still Gives Industry Low Marks WebMD Medical News By Kathleen Doheny Reviewed by Louise Chang, MD More from...

July 2, 2009 -- Sunscreens are improving, but three of five brand-name products either don't protect the skin from sun damage sufficiently, contain hazardous chemicals, or both, according to a report by the watchdog organization Environmental Working Group (EWG).

"I'd give the industry a C minus," says Jane Houlihan, EWG's senior vice president for research. "They have moved from a D to a C-minus in my book."

Overall, however, she says the industry is "not doing enough to protect consumers from UVA radiation."

The report is called the EWG 2009 Sunscreen Guide. An industry spokesman says the report is flawed.

Dermatologists who reviewed the report for WebMD offered praise and criticism. "Some points are definitely correct,'' says Henry Lim, MD, chairman of the department of dermatology at Henry Ford Health Systems in Detroit, who is a member of the photobiology committee of the Skin Cancer Foundation and chairman of the Council on Science and Research of the American Academy of Dermatology. 

But, he adds, ''This report has somewhat of an alarmist tone.''

Sandra Read, MD, a Washington, D.C., dermatologist and member of the board of directors of the American Academy of Dermatology, says she finds the report discouraging but says she hopes it will raise awareness of the need for sunscreen.

The 2009 Study on Sunscreen Effectiveness

This year's report is the third annual from EWG, which investigated 1,572 sunscreens, lip balms, and daily moisturizers with sun protection factor (SPF) of at least 15, typically the minimum recommended.

This year's study, as those in the past, was triggered, according to EWG, because the FDA has not set comprehensive safety standards for sunscreens. The agency has set guidelines for UVB protection but those for UVA are pending. UVA rays are associated with skin sagging and wrinkles, but more recently have also been associated with skin cancer; UVB rays can lead to skin cancer and sunburn.

The FDA is lagging behind other countries, the report charges, because it has approved only 17 sunscreen chemicals for U.S. use, compared to at least 29 in other countries.

To do the 2009 study, EWG scientists got a list of ingredients from retailers and then used numerous databases to evaluate safety and effectiveness.

10-Best Lists

Scientists from EWG developed a "best" list for sunscreens, lip balms, and moisturizers. On the 10 best sunscreens list (many sold online):

  • Soleo Organics Sunscreen Organic chemical-free sunscreen, SPF 30+
  • Badger Sunscreen, SPF 30
  • UV Natural Sunscreen, SPF 30+
  • Mexitan Sunscreen Lotion, SPF 50
  • Lavera Sunscreen Neutral, SPF 40
  • California Baby Sunscreen Lotion No Fragrance, SPF 30+
  • Trukid Sunny Days Facestick Mineral Sunscreen UVA/UVB Broad Spectrum, SPF 30+
  • Kabana Skin Care Green Screen Organic Sunscreen, SPF 22, Skin Tone Tinted
  • Obagi Nu-Derm Physical UV Block, SPF 32
  • Elta MD UV Physical, SPF 41.

On the top 10 lip balm list:

  • Fallene cotz LipCotz, Ultra High Sun Protection, SPF 45
  • Jane Iredale LipDrink, SPF 15
  • Badger Lip Balm, SPF 15
  • Caribbean Blue-natural basics Lip Shield, SPF 15
  • Shady Day Shady Kiss Lip Balm, SPF 30
  • Bare Escentuals Lip Guard, SPF 15
  • Lavanila Laboratories The Healthy Lip Butter, SPF 15, Pure Vanilla, SPF 15
  • Jack Black Intense Therapy Lip Balm Lemon & Chamomile, SPF 25
  • Rx Suncare Lip Balm Sunblock, SPF 45
  • Crabtree & Evelyn Naturals Protective Lip Balm, SPF 8, Cocoa butter & Cardamom

And the top 10 SPF moisturizers, according to EWG:

  • Keys Soap Solar Rx Cosmetic Moisturizing sunblock, SPF 30
  • Marie Veronique Organics Crème de Jour Tinted, SPF 30,no nanoparticles
  • Devita International Daily Solar Protective Moisturizer 30
  • SanRe Organic Skinfood Supple Sunshine, Organic Rosemary and Lavender Day Creme (Dry to Normal), SPF 30
  • Lotus Moon Sage Sun Protective Crème, SPF 25
  • Institut Dermed Sun Protective Cream Oil Free, Untinted, SPF 28
  • N.V. Perricone M.D., Targeted Care Solar Protection Face with DMAE, SPF 26
  • Sue Devitt Promarine Tinted Moisturizer, SPF 30, Capri
  • Sun Science Organic Daily Wear, SPF 30
  • Karen's Botanical Lovely Lavender Cream, SPF 15

Failures and Improvements

Among the failings of the sunscreen products and industry, according to EWG:

  • Only 5% of products overall met their criteria for safety and sunscreen effectiveness -- and that includes blocking UVA and UVB, maintaining stability, and having no or few ingredients with health hazards.
  • Product claims are overstated, promising such things as "all day" protection.
  • Many spray and powder products contain tiny "nano-scale" ingredients that could be absorbed more easily in the lungs and cause problems.

EWG scientists did find that 70% of sunscreens available this year contain strong UVA filters, compared to just 29% last year. Among the top brands that were reformulated to boost UVA protection are Solbar, Zia Natural Skincare, Nivea, L'Oreal, and Hawaiian Tropic.

The ingredient oxybenzone, which the EWG contends disrupts hormone systems, was in 19% fewer sunscreens this year, according to the report.

Among the 339 sunscreens not recommended are:

  • Coppertone NutraShield, Sunscreen Lotion SPF 30
  • Neutrogena Ultra Sheer Dry-Touch Sunblock, SPF 30
  • Huggies Little Swimmers Sunscreen, Moisturizing Blue Melon Splash
  • Jason Natural Cosmetics Sunbrellas: Complete Block Spray, SPF 26
  • CVS Sport Sunblock Lotion, SPF 30

 

Industry Response

The recent EWG report is "unscientific and unsubstantiated," says John Bailey, chief scientist for the Personal Care Products Council, an industry group, in a statement.

In part, the statement also reads: "Consumers can be confident in the safety of the sunscreens they buy for themselves and their families because all sunscreens sold in the U.S. are regulated as over-the-counter (OTC) drugs by the U.S. Food and Drug Administration (FDA), which requires them to go through rigorous scientific assessment and approval process that includes safety and performance testing before marketing."

In a telephone interview, Bailey tells WebMD: "I think there are so many flaws in this report that it's difficult to really know where to start." One flaw, he says, is that "they should have consulted real experts in the area," Instead, he says, they developed their own way of scoring and didn't consider ingredient stability in a realistic way.

Other Opinions

"The most important thing they highlight is that the FDA is really lagging behind in getting a UVA rating," says Eric Schweiger, MD, a Manhattan dermatologist and clinical instructor of dermatology at Mount Sinai School of Medicine, New York, who reviewed the report for WebMD.

The report also contends that higher SPF products may tempt people to stay out longer, but Schweiger says he tells patients to use as high as possible "because people tend to not apply it right."

Lim says the report's authors caution that oxybenzone can be absorbed into the skin. "It's true, but there is no evidence that it is of any clinical significance."

Lim also points out that sunscreens are improving, according to the report. "Not all products have good UVA protection," he says, "but more do."

"Ingredients are not the full story of good sun protection," says Read. Using sunscreen correctly, using the right sunscreen for your exposure and skin type, and reapplying every two hours is crucial, she says.

Lim advises patients to look for ingredients known to help protect against UVA, such as avobenzone (Parsol 1789), titanium dioxide, zinc oxide, or mexoryl.

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