Americans have far fewer and worse sunscreen options than people in the European Union (EU) do – and have for decades.
There are only 16 ingredients approved to block UVA and UVB rays from the sun in the US.
In the European Union (EU), there are 27 active ingredients approved to block sunburn and skin damage.
Quantity doesn’t always mean better quality, but, in the case of the EU’s sunscreen options, top dermatologists say it might be.
‘Compared to the EU, the US’s sunscreens do not provide the longevity of protection that the EU does,’ says Dr Steven Wong, a dermatologist and skin cancer expert at Memorial Sloan Kettering Basking Ridge in New Jersey.
The US Food and Drug Administration (FDA) has been slow to review new products – in spite of the fact that they are already used in Europe where many say they not only feel better on the skin and require less re-application, but provide superior protection.
Between 2003 and 2010, the FDA received numerous applications from sunscreen makers who wanted to make products with active ingredients commonly used in the EU, according to the Environmental Working Group.
Americans have been essentially wearing the same sunscreens for as long as the last 40 years.
Among the most common and effective ingredients, oxybenzone is at least lighter weight and can be rubbed in, but it’s also oily, which is neither great for the skin nor the environment.
In fact, Hawaii has banned oxybenzone sunscreens because it is known to fatally damage coral reefs.
If other states follow suit, the limits on oxybenzone may help to put pressure on both the industry and the FDA to make and produce new sunscreens.
However, that leaves a serious – even dangerous – hole in the market.
Oxybenzone is one of only a very few widely approved ingredients on the market that protects against both UVA and UVB.
The two that are broadly protective, and deemed broadly safe by the FDA are titanium and zinc oxide, the thick white pastes brought to 1980s infamy by Sean Penn’s character in Fast Times at Ridgemont High (and later as the hallmark of the stereotypical American dad).
Zinc and titanium oxides’ appearances made them part of pop culture, but that’s also a deterrent to use.
‘It’s harder to make [them] with high SPF, and the products make people look white even if they’re African American or Asian or Hispanic,’ says Dr Wang.
‘They don’t want to wear it, it’s a problem that it’s aesthetically not pleasing.’
And these screens can’t protect anyone if no one is wearing them.
But as skin cancer rates continue to climb, it becomes clear just how important it is to protect against both UVA and UVB radiation.
UVB stops at the skin’s surface layer, causing painful, visible sunburns.
UVA rays, on the other hand, are less powerful but more prevalent than UVB, and penetrate through to the deeper layers of skin, where the radiation can corrupt cells, causing aging and more importantly raising the risks of skin cancer.
Besides oxybenzone and zinc oxide, avobenzone also provides wide protection from the full spectrum of UVA rays as well as some UVB rays.
But avobenzone doesn’t last long. It quickly breaks down in the sunlight, so after an hour, as much as 90 percent is gone.
After nearly a decade without giving any kind of verdict on the eight additional sunscreen ingredients, Congress passed the Sunscreen Innovation Act in 2014, in an attempt to nudge the FDA forward.
In February, the Food and Drug Administration promised to look into the protection provided by the other 16 active ingredients that are approved and on the market, but may or may not be effective.
What’s more, the US regulates sunscreen more tightly than do its counterparts in the EU, and yet has lower standards for necessary skin protection.
A recent study found that nearly half of the 20 studied types of sunscreen sold in the US meet the US’s lower standard for UV protection but fail to live up to the standards held by the EU.
Because sunscreen is regulated as a medical product, the FDA is very concerned with its possible toxicity. The agency focuses primarily on how much of the products’ active ingredients might be absorbed into the skin, placing a cap on that amount at 0.5 nanograms per milliliter.
In fact, following its February promise to review more filter ingredients, the FDA published a study in JAMA earlier this month finding that 12 that it examined exceeded its skin absorption limit, so would need to undergo further testing for carcinogenity and toxicity.
However, the FDA itself admitted: ‘Without further testing, FDA does not know what levels of absorption can be considered safe.’
In other words, the agency can’t say what any of the products do when more than 0.5 ng/mL of them get absorbed into the skin, but even if it was sugar water being absorbed, that’s too much, because the FDA had previously said it’s too much.
All of this was done in accordance to the Sunscreen Innovation Act of 2014, and so far all the FDA has to show for it is to say that none of the filters except zinc and titanium oxide are broadly safe.
The FDA is required by law to finalize its list of safe and effective sunscreens by November 26, 2019 – and so far, it appears to be a very short list, unless companies provide a wealth of additional testing data.
‘These tests cost millions of dollars to complete, and most of these filters are no longer protected [by patents held by] specific companies, so there’s no incentive to go through the testing process.’
‘Obviously, there’s not really time at this point for all these filters to be approved,’ any way, said Dr Wang.
The last approved sunscreen ingredient in the US was for ecamsule, used in L’Oreal’s Anthelios SX, in 2006. Ecamsule is a common ingredient in the EU, but L’Oreal received only a limited approval for it, which is part of the reason that Anthelios products are sold for between $20 and $30 in the US.
It provides broad protection and is available in high SPFs, but it’s pricey and hard to find.
Another study found that more than a third of sunscreens sold in America don’t even live up to the SPFs that they claim.
These shortcomings are leaving millions of Americans vulnerable to sunburn and much worse.
Every year, skin cancer continues to be the most frequently diagnosed cancer in the US, striking about one in five people in the US.
As long as we have insufficient sunscreens to protect against both UVA and UVB radiation – or only sufficient ones that people don’t want to use – those rates will continue to climb.
‘It’s the long-range UVA protection that’s the challenge because [here in the US] we don’t have those long-range UVA filters,’ says Dr Wang.