Setting the record directly on sunscreens

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As dermatologists and skin cancer researchers, we are dedicated to the health of our patients and, by extension, the wider community we serve. With this responsibility in mind, we got involved in the discussion about the use of certain sunscreens and reviewed the scientific data on the potential impact on the coral reefs we enjoy in our community.

As this discussion continues, we strongly believe that we need to get some facts straight. To that end, we were disturbed to see incorrect information and statements printed in Community Voice’s September 23 commentary, “How to Avoid Skin Cancer Without Harming Marine Species.”

The Community Voice article attempted to suggest that sunburn had nothing to do with skin cancer. This is completely false and dangerously inaccurate information. We treat patients suffering from skin cancer and address the risks of the disease which is mainly caused by overexposure to ultraviolet rays.

Sunburns are precursors to skin cancers caused by UV rays, which accumulate throughout life and can lead to melanoma and non-melanoma cancers. Research shows that having five or more sunburns doubles the risk of melanoma, which kills 20 people a day in the United States.

Hawaii has the highest rate of melanomas caused by UV rays compared to other US states according to an article in the International Journal of Cancer.

The August 2022 report from the National Academies of Sciences, Engineering, and Medicine confirms that consistent use of broad-spectrum SPF 30+ sunscreens has been shown to reduce the risk of skin cancer , sunburn and photoaging.

We encourage people to use sunscreen as part of a comprehensive, overall skin protection plan every day to reduce the risk of skin cancer, but unfortunately many people still don’t use it. sunscreen often enough or at the recommended level.

The NASEM report makes it clear that there is currently insufficient evidence to conclude that sunscreens harm the marine environment. In fact, few environmental studies have been conducted to determine the effects of UV filters in aquatic environments. The results of these few studies conducted have inconsistent results, with many showing ‘non-detection’ or very low concentrations of UV filters in the ocean.

Some research done on UV filters on corals has been done in the lab at concentrations 100 to 1,000 times higher than what is typically found in the ocean. We recommend people take a moment to review the committee’s report and findings that the EPA conducts a comprehensive ecological risk assessment of all sunscreens and supports modeling studies of the potential effects of changes in use. sunscreens on the risk of skin cancer.

The NASEM report also casts doubt on whether mineral sunscreens are, in fact, “reef safe” — something sunscreen ban proponents and lawmakers have assumed to be true. In fact, numerous studies show that zinc oxide and titanium dioxide can be harmful to marine life.

Is zinc really safe?
Data on the toxicity of UV filters in sunscreens on certain marine species. Source: National Academies of Science, Engineering and Medicine

The NASEM report reviewed studies that have shown that mineral UV filters can be toxic to marine life at even lower concentrations than chemical UV filters. In other words, mineral sunscreens aren’t necessarily safer for the environment.

Additionally, the term “reef safe” currently does not have a regulated or standardized definition, so products labeled as “reef safe” vary in composition and ingredients.

The authors of the previous Community Voice article misinterpret the Food and Drug Administration’s decision by saying that only two ingredients are considered safe and effective for sunscreens. It is simply not true.

In its most recent 2021 ruling, the FDA encouraged continued use of all sunscreens – both organic (chemical) UV filters and inorganic (mineral) UV filters as important skin cancer prevention tools. skin.

Only the FDA has final authority over the active ingredients allowed in sunscreens, and Maui County (and soon Hawaii County) could overstep its authority by withdrawing FDA-approved sunscreens from consumers.

Mineral sunscreens are not necessarily safer for the environment.

It is important for everyone to remember that protection from the sun is a comprehensive package and should include practices such as wearing UV protective clothing and seeking shade where possible. But sun protection practices should also include using a broad-spectrum SPF 30+ sunscreen on exposed skin whenever you’re outdoors (not just at the beach).

We see skin cancer in people who rarely go to the beach, but spend a lot of time working outdoors or commuting in the sun. The public health risk of skin cancer is real and it is clear that further studies on the potential environmental risks of sunscreen products are needed.

We can do better to protect both public health and the environment.

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