A Cancer Girl’s Guide to Sunscreen

In the US it feels like there are no great options.

Please note, I’m about to talk about sunscreen WHICH YOU SHOULD WEAR. Wearing sunscreen (any sunscreen), in my opinion, is better than NO sunscreen at all. UV rays cause skin cancer. And wrinkles.

With that said, sunscreens have issues of their own and it’s tough to parse through all the crazy ingredients. So here’s a quick cancer-girl’s guide to sunscreen.

There are two main types of sunscreen — mineral and chemical. I’ll break down both below.

MINERAL SUNSCREENS:

Mineral sunscreens are titanium dioxide and zinc oxide, which create a barrier on your skin that reflects UV light (they sit like a shield on your skin, often not absorbing very well). When using mineral sunscreen it has to be re-applied often.

One study from the University of Oregon found that mineral sunscreens break down after two hours (no longer protect you) and may become toxic. The researchers found after 2 hours there was an 80% loss in filter protection against ultraviolet-A rays (which make up most UV rays and play a role in cancer / skin aging). [PMID: 34647278].

Titanium Dioxide (TiO2) was also recently classified under EU Regulation as a category 2 suspected carcinogen by inhalation (which, maybe, aerosol mineral sunscreen should be avoided).

Pros: Protects against UV rays for up to two hours. May be *safer* than many chemical sunscreens available in the United States (key word here: US).

Cons: May not hold up over long periods of time, is difficult to spread (if it’s not there, it’s not blocking), and can get irradiated by the UV rays.

CHEMICAL SUNSCREENS

Chemical sunscreens absorb the UV rays and alter them (but sometimes scatter them). These usually include:

• Oxybenzone
• Octinoxate
• Cinoxate
• Dioxybenzone
• ensulizole
• Homosalate
• Octisalate
• Octocrylene
• padimate O
• Sulisobenzone
• avobenzone

Many of the chemical sunscreen ingredients are NOT reef safe and MAY be carcinogenic or act as endocrine disruptors at high enough levels, like oxybenzone and avobenzone. However, more long-term studies on dosage, absorption, and exposure are needed to determine effects on human health.

In the meantime, Florida and Hawaii have banned the sale of oxybenzone (BP-3) or octinoxate for their possible harmful health effects.

The strongest sunscreens the US has for filtering UVA rays are: zinc oxide (mineral) and avobenzone (chemical), but avobanzone can have a photo-unstable issue, meaning it breaks down. [PMID: 25086322]

Let’s talk about the FDA and chemical sunscreen in the US

In 2020 the FDA finally reviewed OTC sunscreen regulations and confused the hell out of everyone.

They gave a “final order” recognizing 16 ingredients as GRASE / generally safe (leftover from a 1999 version that’s not active but allows OTC sunscreens to be on the market without needing “new” applications).

THEN, they issued a “proposed order” right after that final order “proposing” only 2 to be Generally Recognized As Safe & Effective. Both GRASE ingredients were mineral sunscreen ingredients: zinc oxide and titanium dioxide.

They also proposed changing the following sunscreen ingredients to “not GRASE” status: aminobenzoic acid (PABA) and trolamine salicylate, cinoxate, dioxybenzone, ensulizole, homosalate, meradimate, octinoxate, octisalate, octocrylene, padimate O, sulisobenzone, oxybenzone, and avobenzone. Citing that they needed more information to make them GRASE.

As you’ll recall those chemicals are also on the “not reef safe” lists.

So to recap, in the US you have a choice between mineral sunscreen and outdated, photo-unstable, possible endocrine-disrupting chemicals. But what if there were better options?

Let’s talk about European Sunscreen:

Europe has more options for chemical sunscreens and their ingredients may be better at blocking UV rays, while also not harming our health.

Indeed, studies have shown US sunscreens tend to let through 3x as many UV rays as European sunscreens. [Source: JAMA Dermatol. 2016;152(5):511–512, via EWG]

Examples of chemical sunscreens available in Europe, that you can’t get in the US, but may be more effective than avobenzone and more photostable are:

• Tinosorb S (Bemotrizinol), Tinosorb M,
• Mexoryl SX, Mexoryl XL
• Diethylamino Hydroxybenzoyl Hexyl Benzoate (marketed as Parsol DHHB).

Tinosorb S may be the most effective UV filter and is photostable.

It’s unclear why the FDA drags its feet on sunscreen, but Americans suffer for it.

All of this is to say that I buy my sunscreen from Europe (this doesn’t mean European brands sold in the US, because to sell here they have to alter their ingredients). If you’re going to go this route you have to buy it from a site that’s selling the actual European versions.

Or, I tend to stick with mineral sunscreen, but you have to be religious about reapplying.

Questions about sunscreen? Drop ’em below.