EWG, which focuses on consumer and environmental health, claims that 72 percent of 750 available sunscreens the group evaluated offer inferior protection or contain ingredients that could harm skin. Some pediatric dermatologists weigh in.
The nonprofit Environmental Working Group (EWG) released its 10th annual (2016) Guide to Sunscreens Guide to Sunscreens last month.
EWG, which focuses on consumer and environmental health, claims that 72 percent of 750 available sunscreens the group evaluated offer inferior protection or contain ingredients that could harm skin.
This could impact especially children, according to EWG.
Nneka Leiba, M.Phil., M.P.H.âThis year we took a closer look at the best-rated and worst-scoring sunscreens specifically marketed for use on children,â says Nneka Leiba, M.Phil., M.P.H., EWG deputy director of research, in a press release. âGiven their increased vulnerability to the sunâs harmful rays, we were dismayed to find so many products marketed for babies and kids that still donât meet our standards for safety and efficacy.â
One problem, according to EWG, is about half of sunscreens sold in the United States donât filter enough UVA rays and, therefore, wouldnât pass the more stringent European standards.
Six issues that are key to consumersâ sunscreen use, according to an EWG press release:
Marissa J. Perman, M.D., a pediatric dermatologist at Children's Hospital of Philadelphia, says the EWG sunscreen guide is a comprehensive and detailed guide to many sunscreen ingredients, and EWG comments on several controversies regarding sunscreens currently available in the United States.
Dr. PermanâI am in complete agreement with the EWG on spray sunscreens, which I believe should be banned in the U.S., due to their risks of inhalation and inconsistent application. And, like the EWG, I am in favor of sunscreens with inorganic or âmineralâ ingredients, including zinc oxide and titanium dioxide. I also agree with generally recommending sunscreens of no more than 50+, as I think the higher SPFs may be misleading and pose more risk than good. And, lastly, the EWG does a nice job of emphasizing that these sunscreens should be used in conjunction with other sun protective measures,â Dr. Perman tells Dermatology Times.
However, Dr. Perman says sheâs not fully onboard with the guideâs very strict interpretation on the safety of current sunscreen ingredients â particularly controversial ingredients such as oxybenzone and retinyl palmitate.
âThey review the studies currently addressing these ingredients and state that more data is needed in both cases. Yet, despite the need for more data, they rank products with these ingredients poorly,â Dr. Perman says. âI believe the jury is still out on whether real-world application of these products on humans, which have been around for many years, actually cause harm to consumers. That being said, if my patients and their families are concerned enough, they can easily avoid these products with the sheer quantity of options available at this time.â
Dr. Perman says she tends to make this recommendation for her pediatric patients:
Use sunscreens with a SPF of no more than 50+, with inorganic ingredients zinc oxide and/or titanium dioxide in a lotion vehicle to be applied as directed and along with other sun protective measures similar to the EWG.
Sharyn A. Laughlin, M.D., a dermatologist, who specializes in laser and cosmetic dermatology in Ottawa, Ontario, Canada, says the EWG is a credible consumer agency and dermatologists should not ignore the groupâs message that most North American sunscreens are neither safe nor effective. EWG messages, she says, resonate with consumers.
âI use one EWG graph everyday as a starting point in discussing modern photoprotection with patients. It illustrates the difference in UV attenuation between a zinc oxide sunscreen and others with high SPF values but limited and inadequate UVA1 protection. I encourage patients to visit the site for general sunscreen information about ingredient and finished product toxicity, and other news about cosmetics in general. I may not agree with all EWG statements, but I believe it is a mistake to ignore or dismiss the EWGâ¦.,â she says.
Dr. Laughlin, who co-founded Cyberderm, an Ottawa-based sunscreen company, which has products highly rated by EWG, says most sunscreens in the United States are UVB-biased sunscreens, which prevent sunburn to some degree but offer little or no protection against skin cancer or photoaging (thatâs where UVAâmostly UVA1âplays a major role).
High SPF values beyond 30 to 50 are unnecessary, as many are false and bear no relation to performance in actual sunlight for several reasons.
âI tell patients, if your sunscreen allows you to burn despite an SPF value [greater than] 30, it did not provide enough UVB protection, and if it allows you to tan, it failed to provide longwave UVA1 protection. Using this UVB-biased sunscreen exposes you to a similar radiation profile as a tanning bed and may not prevent skin cancer or photoaging,â she says.
Dr. Laughlin says she advises all patients that most soluble small molecular weight filters (< 500 Daltons) reach blood and tissue.
âI counsel about percutaneous absorption [and] that allows them to make their own informed decision. The mounting body of evidence that they affect human health in many adverse ways invokes for me the first principle in medicine â first do no harm,â Dr. Laughlin says. âI go further than the EWG and advise patients to stringently avoid all soluble filters (oxybenzone, avobenzone, octisalate, homosalate, octocrylene, 4-methyl benzylidene camphor and regular octinoxate). [This is especially important for] expectant mothers, young or pubescent children and couples considering conception.â
Dr. Laughlin recommends that patients use particle type insoluble filters like zinc oxide, titanium dioxide and encapsulated octinoxate that never enter the body, and to focus on ingredient concentrations that ensure adequate SPF and, more importantly, UVA protection.