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As surely as summer follows spring, every year, questions about the effectiveness of sunscreens flourish. This year, the Environmental Working Group, a public health watchdog organization in Washington, has raised the issue not only of sunscreens not doing the job they're supposed to, but of these products contributing to the spread and seriousness of skin cancers.
This year is no different; those questions have arisen, but there's a new concern, as well. The Environmental Working Group (EWG), a public health watchdog organization in Washington, has raised the issue not only of sunscreens not doing the job they're supposed to, but of these products contributing to the spread and seriousness of skin cancers.
The group published a report contending that the vitamin A derivative retinyl palmitate - contained in numerous common sunscreens - breaks down cells, enabling cancer to spread. The EWG's findings also contend that 40 percent of sunscreens contain ingredients that break down when exposed to sun, and aren't stable enough to provide the protection claimed by manufacturers.
Amy H. Kassouf, M.D., practices in South Euclid, Ohio, a suburb of Cleveland. She's very aware of the notoriety the news release is receiving.
"It was on our local news the other night. I've not seen the actual scientific article that says this is happening, so I'm not aware of any scientific proof at this point," she says.
"I mean, we may not have seen this happening, but we've used retinoids for a long time to improve sun-damaged skin. We know retinoids, used properly, can actually help get rid of signs of sun damage. The concern is that the retinoids may exfoliate the dead skin layer, allowing more sun to get in, but it also has antioxidant properties that help protect the cells. So, I would have to examine where the EWG is coming from more carefully," she says.
Still need sunscreen
In Wellesley, Mass., Madeline C. Krauss, M.D., says that while she thinks the group raises some interesting questions, that doesn't obviate the need for wearing sunscreens.
"They do say some things that are food for thought - for example, I never liked aerosol sunscreens, although for children who are intolerant of creams, they're better than nothing. The EWG raises the issue of the potential dangers of ingesting sunscreen. Nobody's ever tested what sunscreens do when they are inhaled," Dr. Krauss says.
"The vitamin A issue is also interesting. Does vitamin A work like glycolic acid and make you more prone to skin cancer? That's a big question mark, and I would never want to say it's impossible," she says. "Nevertheless, in my patient population, despite the kind of sunscreen they are using, I've seen a lot less actinic keratoses and repeated nonmelanoma skin cancer in patients who regularly use sun protection."
A practitioner for 13 years, Dr. Krauss says she likes to emphasize that sunscreen is not the entire answer, anyway.
"Hats and protective clothing are important. I actually give patients names of fashion lines that now include sun-protective clothing, and I'm on a campaign against tank tops. I think they cause more cancer than vitamin A," Dr. Krauss says.