Despite decades of research providing insight into its benefits, a debate over the safety of wearing sunscreen has gained traction over the last few years on TikTok. The popular social media site is a breeding ground for viral trends and has become the go-to skincare source for many of its users. The TikTok holistic health community, often criticized for sharing incorrect information about wellness topics, has recently turned its attention to sunscreen, highlighting the increasing gap between social media trends and scientifically supported facts.
A few reports released in recent years, such as a 2020 clinical trial and a 2021 report from Valisure, highlight the presence of chemicals found in sunscreen that could become absorbed into our bloodstream. Social media influencers seized this information and mischaracterized the findings, encouraging their followers to ditch sunscreen all together. While it is often difficult for lay audiences to decipher complex scientific studies, this significant misrepresentation of facts to a wide audience via social media is concerning for physicians, scientists, and public health advocates.
As a dermatologist and skin cancer specialist, Dr. Larisa Geskin has devoted her career to treating patients and promoting awareness about skin cancer prevention and the importance of daily sunscreen usage. We spoke with Dr. Geskin and two members of her team, Sara Suhl and Brigit Lapolla, about the potential dangers of this trend, along with the best ways to protect yourself against harsh UV rays while still enjoying the sun.
A 2021 Valisure report highlighted Benzene in regard to harmful chemicals that could potentially be found in common sunscreen brands. Is this chemical a genuine concern or is it more about moderation?
Benzene is not an ingredient purposefully included in sunscreens. Rather, it is a contaminant that may be incorporated due to issues with the manufacturing process, and it is present in many beauty products- not just sunscreen. It is true that benzene is a known carcinogen, and there are still ongoing studies trying to understand the degree to which its presence in some sunscreens could impact a person's risk of cancer with long-term use. What is known is that sun exposure without sun protection definitely increases a person's risk of cancer. We recommend using a benzene-free sunscreen whenever possible. You can search for whether your sunscreen has been recalled here: https://www.fda.gov/drugs/drug-safety-and-availability/drug-recalls.
How much of these chemicals are actually being absorbed into our bloodstream?
This is difficult to quantify, as the systemically absorbed amount of any topically applied substance depends on multiple factors including the concentration found in the product and the amount used. Unfortunately, benzene is found all around us- at work, in other consumer products, including beauty products, and in the environment, so we are all constantly exposed to benzene regardless of our sunscreen use.
Would mineral sunscreens be a better option compared to chemical sunscreens?
Mineral sunscreens have many advantages- most notably, they may be better for people with sensitive skin and are effective immediately after application as they reflect UVA/UVB rays.
Another prominent claim from the anti-sunscreen movement is that daily sun exposure is a necessary component of human development. How much truth is there to "needing" a certain amount of sun exposure per day?
There is no amount of sun exposure that is "needed." While it is true that Vitamin D is activated by sun exposure, oral vitamin D supplements are significantly more effective. Other benefits of sun exposure, including circadian rhythm regulation and mood benefits, are not related to unprotected skin exposure, so these aren't diminished by sunscreen use. People can still safely enjoy time in the sun without increasing their risk of skin cancer by wearing sunscreen and/or protective clothing.
Some influencers also allege that the only true defense needed against UV rays is a nutrient rich diet with ample hydration. Does our diet really affect how our bodies handle sun exposure?
The damage caused by sun exposure is due to UV light, which is a type of radiation that damages the DNA in your cells, making them more likely to become cancerous. The best way to prevent this damage is by blocking the absorption of UV light from the skin, either through protective clothing or sunscreen. Adequate hydration and nutrition are, of course, important to your health in other ways, but they do not prevent your skin from being exposed to harmful UV radiation. While foods containing antioxidants may prevent some cell damage caused by free radicals, nutritional supplementation is not an effective alternative to sun protection with sunscreen or protective clothing. Interestingly, some foods, like citrus1, for example, may actually increase your sensitivity to sun damage.
A national survey by the Orlando Health Cancer Institute found that young people are more likely to believe misinformation about sun protection. What are the potential public health ramifications of this viral trend of not using sunscreen?
This is a very concerning trend and, unfortunately, one based on misinformation. Sun exposure causes skin damage and significantly increases the risk of skin cancer- this is well-understood. Importantly, skin cancer affects people of all skin colors and types. The concern with this trend is that people will stop protecting their skin and will be at greater risk of skin cancers, including melanoma, which has a high mortality rate.
We've started to see a decrease in rates of melanoma and other skin cancers in certain areas, largely due to public health efforts working to educate people about the importance of sun protection. Already, one in five Americans will develop skin cancer in their lifetime and nearly 20 Americans die from melanoma every day. The estimated annual cost of treating skin cancers is almost 9 billion dollars. It would be a public health crisis for even more people to be affected by skin cancer, especially when it can be so easily prevented. So many of my patients tell me they wish they had started protecting their skin sooner, but it's never too late to start!
The internet is full of differing opinions about how to best apply SPF, how much to use, which brands, etc. What is the best way to get the most out of your sunscreen?
I recommend using a sunscreen that is water-resistant, broad-spectrum (protects against UVA and UVB rays), at least SPF 50, with a combined concentration of zinc oxide and/or titanium dioxide of around 20%. There are many different types of sunscreens, including ones that do not leave a white cast on darker skin, so find what works best for you!
To ensure adequate sun protection, it's essential to use enough sunscreen and remember to reapply. Ensure all exposed skin is covered, which for adults usually requires around one ounce of sunscreen (enough to fill a shot glass). People should reapply every two hours or after swimming or sweating. Also, don't forget to apply it to the tops of your feet, ears, neck, or the top of your head if the skin is exposed- these are places people often forget.
What advice would you give about the importance of avoiding misinformation and staying up to date on the facts around sun safety? Are there any sources you recommend?
It's incredibly important for people to have accurate information when making these impactful healthcare decisions. The American Academy of Dermatology is a trustworthy, unbiased resource that has very helpful information about skin cancer prevention as well as everyday skincare advice. However, the best resource is your dermatologist, who knows you and your medical history and can provide personalized recommendations in real-time and address any questions you may have.
We recommend that people have yearly skin checks, but some people may need more or less frequent visits depending on their skin cancer risk. Patients and dermatologists are partners in skin cancer prevention and detection. If you notice spots that are new or changing, look different than your other spots, or are itching or bleeding, go see a dermatologist.
References
- Cancer Facts & Figures 2024. Accessed 3/5/2024, https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2024/2024-cancer-facts-and-figures-acs.pdf
- Kao SZ, Ekwueme DU, Holman DM, Rim SH, Thomas CC, Saraiya M. Economic burden of skin cancer treatment in the USA: an analysis of the Medical Expenditure Panel Survey Data, 2012-2018. Cancer Causes Control. 2023;34(3):205-212. doi:10.1007/s10552-022-01644-0
