Is Sunscreen Causing Skin Cancer?

My colleague Dave Andrews, who was one of several from the research department at EWG who helped produce the 2010 sunscreen guide has drafted the following to address a few or our responses in the Comments section.

As a researcher on the EWG sunscreen report I have approached the topic with a vested interest. My family has a history of melanoma and I have often applied sunscreen with the faith and thought that this would prevent negative health outcomes. However the more research that our team has done the less clear the issue has become.

Do I still use sunscreen? YES.

Is it my first line of defense against sunburn and skin cancer? NO. Sunscreen is a just one part of a broader sun protection strategy as outlined in our tips page.

I am very concerned that sunscreen allows me to stay out in the sun longer then I should, but while often preventing a burn it may not reduce my overall risk of sun damage. The lack of FDA standards or requirements for UVA protection means that even if you read labels and wear suncreen appropriately, you won’t necessarily be protected from these rays. This concerns me since the International Agency for Research on Cancer recently classified tanning beds which emit primarily UVA light as “carcinogenic to humans” due to a 75% increase in melanoma for users under that age of 30. It should worry you too.

EWG’s report discusses health agency positions on sunscreen and skin cancer and details our findings in the peer reviewed literature. Countering the comments from the American Cancer Society (please see this recent article detailing their conflicts of interest) are comments from 2 of our federal agencies;
http://www.huffingtonpost.com/samuel-s-epstein/the... ( http://www.huffingtonpost.com/samuel-s-epstein/the... )

National Cancer Institute: “It is not known if protecting skin from sunlight and other UV radiation decreases the risk of skin cancer.”
http://www.cancer.gov/cancertopics/pdq/prevention/...

Food and Drug Administration: “FDA is not aware of data demonstrating that sunscreen use alone helps prevent skin cancer.”

Our concerns about the use of Vitamin-A in sunscreen are because FDA nominated the vitamin A derivative, retinyl palmiate (RP) for detailed testing 10 years ago based on increasing usage and health concerns. This research has led to 17 publications culminating in a one-year photocarcinogenicity study, the best available technique for testing if a compound causes cancer when exposed to sunlight.

As EWG's sunscreen report explains, our concerns are based on raw data from the 1 year cancer showing a significant effect between retinyl palmitate laced creams and skin damage (tumor and lesion formation). In late May we asked the heads of FDA and NIEHS, co-sponsors of this study to expedite evaluating these data, and give consumers meaningful guidance on the safety of vitamin A in body care products.

In the face of uncertainties and FDA inaction we have created a database that evaluates the hazards of the individual ingredients in sunscreens and the efficacy of the sunscreen to provide both UVA and UVB protection. We flag products that raise health concerns and work to present this information in the most approachable manner. Our goal is to empower consumers by providing information not on sunscreen labels, and guidance on effective sun protection.

Dave Andrews, Ph.D
Senior Scientist with Environmental Working Group

My colleague Dave Andrews, who was one of several from the research department at EWG who helped produce the 2010 sunscreen guide has drafted the following to address a few or our responses in the Comments section.

As a researcher on the EWG sunscreen report I have approached the topic with a vested interest. My family has a history of melanoma and I have often applied sunscreen with the faith and thought that this would prevent negative health outcomes. However the more research that our team has done the less clear the issue has become.

Do I still use sunscreen? YES.

Is it my first line of defense against sunburn and skin cancer? NO. Sunscreen is a just one part of a broader sun protection strategy as outlined in our tips page.

I am very concerned that sunscreen allows me to stay out in the sun longer then I should, but while often preventing a burn it may not reduce my overall risk of sun damage. The lack of FDA standards or requirements for UVA protection means that even if you read labels and wear suncreen appropriately, you won’t necessarily be protected from these rays. This concerns me since the International Agency for Research on Cancer recently classified tanning beds which emit primarily UVA light as “carcinogenic to humans” due to a 75% increase in melanoma for users under that age of 30. It should worry you too.

EWG’s report discusses health agency positions on sunscreen and skin cancer and details our findings in the peer reviewed literature. Countering the comments from the American Cancer Society (please see this recent article detailing their conflicts of interest) are comments from 2 of our federal agencies;
http://www.huffingtonpost.com/samuel-s-epstein/the... ( http://www.huffingtonpost.com/samuel-s-epstein/the... )

National Cancer Institute: “It is not known if protecting skin from sunlight and other UV radiation decreases the risk of skin cancer.”
http://www.cancer.gov/cancertopics/pdq/prevention/...

Food and Drug Administration: “FDA is not aware of data demonstrating that sunscreen use alone helps prevent skin cancer.”

Our concerns about the use of Vitamin-A in sunscreen are because FDA nominated the vitamin A derivative, retinyl palmiate (RP) for detailed testing 10 years ago based on increasing usage and health concerns. This research has led to 17 publications culminating in a one-year photocarcinogenicity study, the best available technique for testing if a compound causes cancer when exposed to sunlight.

As EWG's sunscreen report explains, our concerns are based on raw data from the 1 year cancer showing a significant effect between retinyl palmitate laced creams and skin damage (tumor and lesion formation). In late May we asked the heads of FDA and NIEHS, co-sponsors of this study to expedite evaluating these data, and give consumers meaningful guidance on the safety of vitamin A in body care products.

In the face of uncertainties and FDA inaction we have created a database that evaluates the hazards of the individual ingredients in sunscreens and the efficacy of the sunscreen to provide both UVA and UVB protection. We flag products that raise health concerns and work to present this information in the most approachable manner. Our goal is to empower consumers by providing information not on sunscreen labels, and guidance on effective sun protection.

Dave Andrews, Ph.D
Senior Scientist with Environmental Working Group

Thanks for your comment. The reason that I stick with the commercial brands (I'm embarrassed to say) is because I like the smell. And I'm sure the smell is adding even more chemicals.

Anyway, I never rely just on sunscreen when I go to the beach. I bring an umbrella and sit under it 99% of the time. I also wear light-weight clothing and hats. And I prefer the spray sunscreens because I am more likely to re-apply at the beach (there's nothing worse than trying to rub sunscreen on yourself after you've been sitting on the beach).

I've always been worried about all the extra chemicals in sunscreens, and I really hope the FDA puts some mandates on the manufacturers to make them safer for consumers (it seems like a no-brainer).

Thanks again for commenting.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

There are plenty of natural sunscreens out there that include physical blockers (titanium dioxide and zinc), which are actually more effective than a lot of the other chemical-laden sunscreens on the market. The problem is, nobody wants to use the natural sunscreens because they leave a white film on the skin. Lavera has a new spray-on one out, which is the sheerest I've found, but it still doesn't absorb the way that Hawaiian Tropic or Coppertone does (which is a good thing in terms of sun protection, just not in terms of aesthetics).

I admit, while I exclusively use the natural sunscreens on my children, I let vanity prevent me from using them on myself - especially on my face, as I don't exactly want to walk around with a ghostly white sheen.

I think that cosmetics and sunscreen manufacturers need to step up their research on ways to make natural sunscreen formulations that are safe and also appealing to the average consumer. In the meantime, I'll continue to wear my super-sheer, oil-free, possibly toxic facial sunscreen while my children run around like casper the friendly sun-protected (and chemical protected) ghosts.

www.quinoaandcornchips.blogspot.com ( http://www.quinoaandcornchips.blogspot.com )

Hi Miss Britt.

Thanks for your comment. I think the problem is in the interpretation of the report, and the fact that so many aspects of the issue were addressed in one report. Everything from misleading labeling to cancer causing ingredients. And of course, the media prefers the sensational, so they are honing in on "cancer causing" and fear mongering.

For every person (like yourself) who will not buy into the sensational headlines, there are others who will. The message I was trying to promote with this post was that we need to take every precaution to protect ourselves and family from the dangerous affects of the sun, and that avoiding sunscreen out of fear isn't the answer.

Thanks for your comment.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

I actually found the information from EWG helpful and never got the impression that the message was no sunscreen.

What I got was the message that UVA protection was essential to preventing skin cancer - and that's something I want to know. It ticks me off to think that I, as a fair skinned person who burns easily, am going out of my way to prevent skin cancer and possibly misdirecting my efforts. It makes me angry to think that I may be lulled into a false sense of comfort because I've managed to avoid a sunburn by blocking UVB rays, but haven't done anything to protect against UVA rays.

What I got from the EWG was:

Protect against UVA rays as well
Look for sunscreens that use avobenzone, mexoryl SX, titanium dioxide or zinc
Avoid sunscreens that contain oxybenzone or retinyl palmitate

A quick check of my sunscreen found that they all contained oxybenzone. I'm going to do more research on that now, because the potential is enough to make me want to know more.

I kind of feel like anyone who got the message that "sunscreen causes cancer don't use it and you won't get cancer" isn't reading.

Miss Britt

http://www.miss-britt.com

"Dignity is Overrated"

This is a great comment Julie...I totally agree.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

Thanks Julie. Your comment is exactly what I was trying to convey...

"I think the EWG needs to be cautious in their advocacy on this issue or will do more harm than good for all."

I'm sure that EWG's intention was NOT to scare people into leaving themselves unprotected and vulnerable...However, as you pointed out, the comment below is an example of how good intentions can go wrong.

Personally, I believe the REAL culprit in this is the FDA for not requiring these sunscreen companies to use safe ingredients in their products (as they already do in other countries). The FDA has clearly dropped the ball (as they often do). But this doesn't change the fact that the benefits of the EWG report, do not outweigh the risks to the public.

Thanks again for commenting Julie.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

I've been a subscribed member of EWG for *years.* I still have the 2008 sunscreen message from Jane Houlihan, archived. I've used the helpful information and that sunscreen guide for years.

I fully and whole heartedly believe that the US does a pitiful job of ensuring that citizens have safe products. While we were in France, I found some great products. When we came back to the US, I found the same products on the shelves here, with different ingredients, which, upon investigation, were hormone disruptors. when I contacted Boiron, the manufacturer, they freely admitted that they used better and safer ingredients in Europe due to requirements, but cheaper and potentially more harmful ones in the US because OF NO REGULATION.

So you know what? I believe the EWG when they say "danger, will robinson, danger."

But EWG and others are OFF MESSAGE.

At no point did I ever think that EWG advocated NOT USING SUNSCREEN.

I always understood EWG evaluated sunscreen to recommend the safest for me and my family, and provide a helpful PDF guide with ratings and details a la Consumer Reports.

But what am I seeing here in Alex's comment? In Ken Cook's email? In crazy headlines and half-researched articles (excluding this one from Catherine, which holds good information I appreciate)?

I see fear-mongering and half-baked scare you away from sun protection assertions that sunscreen causes cancer.

That's beyond reckless.

I support all efforts to fight for and ensure safer ingredients in products, especially skin products such as sunscreen.

But come on EWG and EWG representatives: DO IT SAFELY.

I have skin cancer and am vigilant about using sunscreen. I think everyone ought to follow wise sun safety precautions -- I use the American Cancer Society's as a good guide. This includes using sunscreen.

I go one step further and use the EWG's guide to the best sunscreens.

But I am really frustrated with *all* of the messaging I get weekly from Ken Cook and EWG in my mail lately. I sure wish they'd go back to the helpful dissemination of information and helpful guidelines for safe products.

Julie Using My Words ( http://theartfulflower.blogspot.com/ )

The comment below illustrates my exact issue with this line of discussion and framing of the EWG's findings: that commenter has assumed/determined that *all* sunscreen is bad and it's better to avoid it and just eat vegetables. I can't tell you how many people I've heard similar "no more sunscreen" vows from.

Is that truly the outcome the EWG wants?

Not even your own site or literature that I've read says NO SUNSCREEN. It lists *safer* ones to use.

I think the EWG needs to be cautious in their advocacy on this issue or will do more harm than good for all.

Careful with that framing. Careful.

The real message is that the US needs to protect people better while they protect themselves from sun damage. Including using sunscreen.

Julie Using My Words ( http://theartfulflower.blogspot.com/ )

This has been a hunch of mine for years, due to the chemicals involved.

Covering up with really lightweight clothing does wonders. And a hat, of course, too.

But don't freak out when I say: Eating lots of leafy greens, veggies and fruit helps tons, by protecting skin naturally from the sun. Google it and you'll see. It's working wonders, right now, for me.

One Friday night, I loaded up my life and headed out... ( http://isledance.blogspot.com )

Thank you for your comment. While I do appreciate what you are saying in defense of your organization's report. I still have to side with the American Cancer Society.

"The American Cancer Society continues to believe that sunscreens--when properly used and applied--reduce the risk for sunburns and prevent skin cancers, and that the benefits of sunscreen use outweigh risks. Like the Environmental Working Group and many others interested in this issue, we await the new final regulations from the Food and Drug Administration which we anticipate will address some of the concerns raised by the EWG, as well as establish new standards for testing and promoting effective sunscreen products."

The problem I have is with the questionable timing of this report, and the scare tactics that seem to be associated with it.

Is the EWG stating that many sunscreens are not providing adequate protection? Or that sunscreens cause skin cancer? Because I'm seeing both interpretations. However, the repercussions of "not adequate protection" and "cancer causing" are very different.

The trouble is, until there are actual recommendations by the FDA stating otherwise...Sunscreen is still the first line of defense to prevent dangerous burns and skin cancer. And telling people otherwise, just before many of them are off to sunny summer destinations, is counter productive. How many parents will now be putting themselves and their children in jeopardy because they now fear their sunscreen will cause cancer?

I understand that you may be correct about some statements being made in defense of sunscreens, by people paid by the companies making them. Unfortunately, that's how it is in every high profit corporation in this country (something I do not appreciate). I imagine you yourself are being paid by EWG. Does that make your comments unethical? I don't think so.

Don't get me wrong, I'm the first one to question the motives of big corporations profiting from the sale of sunscreen. And I think claiming 80 - 100 SPF is beyond deception. But it doesn't change the fact that if you are spending the day at the beach, you need to use sunscreen.

I know your website doesn't recommend people not use sunscreen at all...Just that they only use one of the 8% your organization recommends. Conveniently (for the EWG), none of these sunscreens are available where most of us are shopping for sunscreens. But not to worry...EWG has their very own Amazon store to sell scared parents these "safe" sunscreens...Is that where the timing comes in? That would actually make a lot of sense.

Again, I'm not opposed to your organization bringing attention to the problem of toxic chemicals in consumer products...However, I do think it is disingenuous to scare the public about something that they can only rectify by purchasing products that fund your organization...or go unprotected.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

As we've now pointed out to US News and World Report's Deborah Kotz: She used (possibly unwittingly) a dermatologist as a source for her story whose also a paid sunscreen industry consultant who dismissed ours and FDAs concerns.

Dr. Henry W. Lim - who seems ready to defend sunscreens despite the known problems in the industry such as over-inflated and misleading SPF (sun-protection) claims and who blithely dismisses the FDA's ongoing Vitamin A research is also a paid consultant for a number of companies that manufacture sunscreen products.

With regards to the ongoing FDA-NTP study of retinol palmitate (a derivative of Vitamin A found in 40% of sunscreens) as a possible carcinogenic factor when it is applied to skin and exposed to sunlight - Dr. Henry W. Lim dismissed the findings on grounds the study tested the chemical on mice. But scientists throughout the world who assess human carcinogenicity risks consider the government scientists’ methodology and NTP (National Toxicology Panel) studies in general to be the gold standard for research.

Dr. Lim told US News: "It's dangerous to apply a finding in mice to humans, and I've spoken with a number of my colleagues about this and we all agree that it's very premature to even cast doubt about the safety of this chemical."

This seems more like a statement you'd see come from someone paid by the sunscreen industry. Oh wait, he is. In the July 2007 edition of Skin and Aging Dr. Lim disclosed that he “is a consultant for Johnson & Johnson, La Roche-Posay Laboratoire Pharmaceutique, Orfagen Laboratories, and Dow Pharmaceutical Sciences.”

Of course, as EWG president Ken Cook put it in a letter sent today (5/28/10) to the heads of the Food and Drug Administration and the National Toxicology Program, urging their respective agencies to conclude their research into Vitamin A:

“As the FDA points out, “testing for photococarcinogenicity in humans is unethical; animal testing has been used as a surrogate.” As you well know, FDA, NTP and other scientific institutions are working to develop sorely needed non-animal methods for toxicity testing. Butuntil reliable non-animal models are available, animal tests are established, state-of-the-art methods for evaluating toxicity. FDA acknowledges uncertainties in applying these results to humans (FDA 2003), but nevertheless, NTP cancer studies like the RP study conducted by the center are currently considered the “gold standard” for assessing human carcinogenicity risks.” Cook’s entire letter to FDA and NTP can be found here: http://www.ewg.org/ewg-asks-fda-to-wind-up-study-o...

I always apply my sunscreen (in moisturizer)every morning. But even though I live in Florida, it never occurred to me to keep a small bottle in my purse (except when I know I'm going to the beach). I think I'm going to start doing that, and tell my daughter and mother too. Thanks.

Contributing Editor Catherine Morgan
Also at Catherine-Morgan.com ( http://catherine-morgan.com/ )

I wear it on my face pretty much every day. I use a moisturizer with sunscreen in it. My days are sometimes unpredictable and this way at least I have some on my face, you know?

I try to keep a smallish container of sunscreen in my purse. I rarely put it on before I leave the house if I'm just running errands but sometimes they progress to me spending more time outside than I thought. It's nice to be able to pull it out than worry about burning to a crisp.

I freckle in the sun so I have a decent "warning system." If I can tell that they are multiplying and I haven't put it on I have to pronto. If I've put it on and I see them multiplying it's probably time to reapply because it means I've been out in the sun longer than I thought.

Something I've heard before is that we often don't use enough sunscreen when we use it. I heard that we should use about a shot glass worth of sunscreen when we apply it (for basically fullish body coverage).

Contributing Editor Sassymonkey also blogs at Sassymonkey ( http://sassymonkey.ca ) and Sassymonkey Reads ( http://sassymonkeyreads.ca ).