Sunscreens update: The ugly, the bad and the good

National report - After years of contesting claims that sunscreens are responsible for vitamin D deficiency, manufacturers now face a class action lawsuit that contends sunscreens are the snake oil of the 21^st century.

Still, dermatologists say they continue to urge sunscreen use along with sun-avoidant behaviors for their patients. And now mexoryl, a highly protective UVA sunscreen ingredient long popular in Europe and elsewhere, has entered the U.S. playing field.

In March, law firms in New York City and San Diego brought suit against Schering-Plough for Coppertone, Sun Pharmaceuticals and Playtex Products for Banana Boat, Tanning Research Laboratories for Hawaiian Tropic, Neutrogena Corp. and Johnson & Johnson for Neutrogena, and Chattem Inc. for Bullfrog. The plaintiffs allege:

Advising patients

Darrell S. Rigel, M.D., former president of the American Academy of Dermatology and a practitioner in New York City, says the lawsuit hasn't altered his advice.

"I recommend SPF 30 or higher - a product that's not too greasy, due to the risk of acne. People should apply sunscreen 15 to 20 minutes before it's needed, using one ounce over the entire body, and reapply every two hours."

When Dermatology Times reached Mark Steven Nestor, M.D., Ph.D., he'd just seen a patient confused about sunscreens.

"I told him sunscreens are incredibly important, because they can definitely reduce skin cancer," Dr. Nestor says. "However, if he wants to reduce brown spots and other signs of aging, the issue becomes more about blocking the UVA spectrum."

UVA has been implicated as a disease factor in skin cancer, polymorphous light eruptions, lupus, solar urticaria, hydroa vacciniforme, porphyria and chronic actinic dermatitis. It's also linked to photoaging indicators such as sagging skin, decreased elastic fibers and an increase in elastosis. While many dermatologists warn patients to stay out of the midday sun, it's important to note that UVA doesn't vary as much during the day as does UVB.

A dermatologic and laser surgeon in Aventura, Fla., Dr. Nestor summarizes the options approved by the Food and Drug Administration (FDA).

"Parsol 1789, avobenzone, covers some of the UVA range," he says, "but it's not stable and lasts only one-and-a-half to two hours. The new screens with helioplex (Neutrogena) work better. Sunblocks are very, very good for the UVA range."

Status of mexoryl

The FDA approved mexoryl for use in the United States on July 24.

Paris-based patent-holder L'Oréal has described mexoryl-based Anthelios XL (marketed throughout much of the world by La Roche Posay) as having the highest UVA protection ever made available.

Previous product literature has described Anthelios XL as non-oily, non-comedogenic, easy to apply, and offering a UVA protection factor of 80 with the immediate pigment darkening test and a rating of 28 with the persistent pigment darkening test.

Some U.S. dermatologists have said mexoryl is the best ingredient available for sunscreens because its broad-spectrum characteristics enable sunscreens to be made with very high SPF factors.