WHY MOST SUNSCREENS ARE NEITHER SAFE NOR EFFECTIVE IN PREVENTING SKIN CANCER OR PHOTOAGING

The recent incident involving a 9 month male infant getting a second degree burn to his face after applying Banana Boat Kids Free Clear Ultramist ™ Sunscreen Spray,  has captured public attention after an online post went viral. Sara Dudley (my daughter) – analysed the incident from a mother’s perspective in a post entitled “When your sunscreen burns you.” Here is an excerpt from her post on this unacceptable shortcoming of most  brand name sunscreens that use the same soluble UV filters.

My quick assessment of the product leads me to suspect that it’s unlikely to be a true SPF 50+ with ingredients of 3% avobenzone, 6% octocrylene and 10% homosalate.  In looking at the solar simulator, a helpful on-line tool for estimating SPF and the UVA protection factor, this ingredient load would give an SPF of 15-17.  I would also consider whether the avobenzone was fully stabilized from photo-degrading (i.e. breaking down in the sun) by the octocrylene.  Finally, spray sunscreens are always problematic because you can just never be sure that you are applying adequate amounts evenly.  I understand they are convenient for children (I have a wriggly toddler so I REALLY understand) but stay tuned for some tips for applying sunscreen and providing the best protection against the sun for young children in our next blog post.

Excerpt: http://blog.thesunscreencompany.ca/sunscreen-burns/

Full disclosure- we have a small Canadian sunscreen company- www.thesunscreencompany.com. An explanation of why any brand of sunscreen using the same undesirable soluble UV filters could produce this sunburn, before I delve into the story of why we started a sunscreen company.

Many speculate on the exact diagnosis. Important information is missing from the story on the exposure time and if there was prior sunscreen use of the same filters. This alcohol free product has several soluble filters with  more serious adverse effects than irritation. There are differences in the available versions of the product  – avobenzone 3%, homosalate 10%, Octisalate 5% and Octocrylene 6% are slightly different from the avobenzone 3%, homosalate 10% and octocrylene 6% in another. No matter. All have the same problems that should deter a parent from ever using these and similar organic filters. The Non Medicinal Ingredients (NMI) or inactives also differ between the versions of the product – one has 4 parabens, the controversial preservative- that enters blood and is a known hormone disruptor – albeit of low estrogenic potency compared to human estrogens– voluntarily removed by most companies.

Three possibilities exist – a phototoxic reaction, photoallergy, and just a bad sunburn. The pictures look more like phototoxicity –  improbable since this usually occurs even with a first exposure, when sunlight reacts with a topical or mostly systemic drugs elicit a florid blistering eruption. The list of ingredients does not reveal any obvious culprit. All the actives are known causes of photoallergy and avobenzone is near the top of the photoallergen list. This acquired hypersensitivity usually requires a prior exposure, and of low incidence in the general population. Experts seem to be discounting just a bad sunburn to a sunscreen with a label  SPF value that is inaccurate, and will not afford the safe exposure time for the duration suggested by the SPF of 50. On the BASF Sunscreen Simulator, the ingredient load of this sunscreen gives a Real Life SPF value (what happens in sunlight) of 15-17.The different result on the face may be due to an uneven and inadequate application with a squirming 9-month old, while a better application is easier on arms that could be held steady. Over time  the child could be drooling or sweating, and maybe some product was wiped off. Regardless, inaccurate SPF values  are the first issue of concern with most sunscreens on the market.

The premise that SPF (Sunburn Protection Factor) numbers as measured under FDA and Health Canada rules can be used to plan or limit your exposure time is a fallacy. The emission profile of the lamp used in the test doesn’t come close to sunlight both in intensity and bandwidth. “In silico” computer calculations from the BASF Sunscreen Simulator already show that the Real Life SPF is only a fraction of the label value. Another false assumption is that the erythema reaction used in testing was mediated only by UV. Visible Light (VL) and Infra-red (IR) could be responsible for up to 30 % of the erythema response.  A landmark study  presented at the 26th Annual Meeting of The Photomedicine Society (February 2017), showed that when the solar lamp emission is modified to include missing VL first, then IR as well, there is a progressive fall in SPF values. Of greater concern is the significant  decrease when SPF is measured outdoors in actual sunlight. Labelled values of SPF 30-100  now fall to  SPF values of 6-10 (Hughes S. and  Cole C.). Many consumers fail to apply the amount of 2 mg/cm² applied for the lab test- another reason for low use efficacy. The best proof of this discrepancy – stand at the airport and observe fair-skinned travellers returning from vacation in the tropics- most are burnt yet insist they followed all the instructions on the sunscreen. With a “true” SPF 10 on the label- a very fair person (Type 1 who burns in 5 minutes without sunscreen), would know to get out the sun in < 50 minutes, even with sunscreen applied properly, instead of the 250 (50 x 5) minutes suggested by SPF 50. The false science of SPF is now so ingrained in consumers and physicians, that re-education to shorten exposure time to 1/5 of the time calculated from the label SPF may take awhile.

Even if this was a photosensitivity reaction (phototoxicity or photoallergy), there are other more compelling reasons to avoid soluble UV filters and others that are absorbed through skin into blood and tissues – one of the reasons that led my family into sunscreen R&D and eventually into the marketplace.

THE CYBERDERM STORY

I was a board certified OB-GYN specialist – focused on the sub-specialty areas of Maternal Fetal Medicine (MFM – or  known as High Risk Obstetrics), and Reproductive Endocrinology (female hormone disorders and infertility). Thirty years ago, I found the UV filter benzophenone (oxybenzone) in 3rd-trimester fetal blood – likely from expectant mothers using sunscreens and cosmetics that reached maternal blood and crossed the placenta to the unborn fetus. My wife was a photobiologist/ dermatologist – I jokingly asked her back then – if her specialty was trying to pollute the next generation. She was unaware then, that certain soluble small filters- benzophenone and others – gained entry to blood and some could bind to dopamine and serotonin receptors in the brain. We felt this was reason enough to look for alternatives even before considering possible adverse effects on the developing fetus. Over the next 20 years, we learned that these substances were known or suspected hormone disruptors and that benzophenone was quite ubiquitous. Other studies suggest that up to 6-11% of the amount applied to skin is absorbed into blood. Re-application every 2-3 hours compounds the problem.  This may be needed,  partly because that as they are absorbed, you need to replace the film on the skin surface- since they are soluble they wash off more easily than insoluble UV filters.

My wife was also concerned about rising skin cancer rates and photoaging in younger women. I was concerned that no one told expectant mothers about entry to blood and possible effects on the most vulnerable of all humans. The global sunscreen market, particularly in N. America, is still dominated by UVB-biased sunscreens, since all of these soluble filters are UVB filters, except for avobenzone with some UVA activity. They mostly prevent UVB effects like sunburn to some degree, but offer little or no protection against skin cancer or photoaging, where UVA (mostly UVA1) plays a major role. We believed that incomplete or UVB-biased protection contributes to rising annual skin cancer rates. CyberDERM was created to develop sunscreens with balanced UVA/UVB protection to prevent skin cancer and photoaging. Our sacred rule is to use only active ingredients that never gain entry to blood. As a former obstetrician, I appreciate the persuasive simplicity that anything safe to use in pregnancy is safe to use for everyone.

It is disheartening that 65% of sunscreens still contain benzophenone(oxybenzone), a likely hormone disruptor, which is now known to be destroying coral and marine life as it washes off ocean bathers. Most expectant or nursing mothers, parents, and all consumers are still unaware that soluble UV filters reach blood and tissue. These include  avobenzone, oxybenzone, homosalate, octisalate, octocrylene, Mexoryl XL™, Eusolex™ (4-methylbenzilidene camphor), octinoxate (un-encapsulated)- most are known or suspected hormone disruptors, photoallergens, and carcinogens. The fact that they attain levels in your blood is reason enough to avoid them even without considering they belong to a group of 1000 plus hormone disruptors, for which the WHO and The Endocrine Society provide scientific data showing strong evidence for links to adverse effects in humans. These include female reproductive disorders (infertility, uterine fibroids, endometriosis, PCOS) reproductive cancers (uterine, breast cancer, and prostate), thyroid cancer, childhood disorders (asthma, ADHD, and autism), neurodegenerative problems (Parkinson’s and Alzheimer’s disease), and metabolic disorders- obesity and type 2 diabetes. Whatever the level of risk, as a grandparent, I will err on the side of caution where my grandchild is concerned.

Even more egregious to me is that labels, retailers, and few physicians ever advise patients of this established fact. This deprives consumers of making their own informed choice about sunscreens, and whether they might consider taking a precautionary approach. We believe in the Precautionary Principle, as advocated under Canadian law, since it meets our personal approach to medical practice and the first precept in medicine- primum non nocere or “first do no harm”. Most consumers – especially expectant or nursing mothers, parents of young or adolescent children, and couples trying to conceive – will likely prefer our approach and mitigate their risks.

SAFETY FIRST – THE SINE QUA NON OF ANY SUNSCREEN OR COSMETIC PRODUCT

The primary concern over sunscreen safety relates to certain soluble organic UV filters as known or suspected  hormone disruptors. These filters are included in the growing list of > 1000 Endocrine Disrupting Chemicals (EDCs). Their effects target  humans, wildlife and lower species, plankton, and coral reefs. Dying reefs cannot regenerate as EDCs are genotoxic to coral larvae.  In 2002, the International Programme on Chemical Safety(IPCS), a joint programme of the World Health Organization (WHO), the United Nations Environment Programme(UNEP) and the International Labour Organization, published a document entitled Global Assessment of the State–of–the–Science of Endocrine Disruptors (IPCS, 2002). They expressed an initial concern but stated that the evidence of a causal link was weak in most cases, including humans. Over the next decade several organizations issued consensus warnings and statements that this was becoming more serious – the Endocrine Society (Diamanti-Kandarakis et al., 2009), the European Commission (Kortenkamp et al., 2011) and the European Environment Agency (2012), the European Society for Paediatric Endocrinology and the Pediatric Endocrine Society. All called for  action regarding endocrine disruptors and their effects.

Ten years later there was  no longer much doubt. The 2012 WHO/UNEP report cited numerous examples of human and wildlife effects that require focused action on this growing problem. “Of special concern are effects on early development of both humans and wildlife, as these effects are often irreversible and may not become evident until later in life. Another extensive 2012 review from  The Endocrine Society stated : “The evidence for adverse reproductive outcomes (infertility, cancers, malformations) from exposure to endocrine disrupting chemicals is strong, and there is mounting evidence for effects on other endocrine systems, including thyroid, neuroendocrine, obesity and metabolism, and insulin and glucose homeostasis.” This warning keeps being repeated but regulators, the sunscreen industry, and most physicians continue to take “an ostrich” approach. In 2015 The Endocrine Society issued another warning and highlighted the link of EDCs to obesity and Type 2 Diabetes: “Unborn children are particularly at risk when exposed to endocrine disrupters, according to the society. Animal studies indicate that exposure to even tiny amounts in the prenatal period can trigger obesity in later years, and some disruptors directly target beta and alpha cells in the pancreas, fat, and liver cells. They modify the way cells handle glucose and fat – leading to insulin resistance and type 2 diabetes. Endocrine disruptors can also alter the way cells grow and develop by mimicking, blocking, or interfering with the body’s natural hormones.”

Several principles in human endocrinology are overlooked or ignored by the usual stakeholders.  Isoform function is a critical consideration- where chemicals with a similar structure usually bind to the same hormone receptors and exert the same cellular and biologic effects. All the soluble UV filters are aromatic hydrocarbons – organic because they are carbon based- with the 6-sided carbon benzene ring so inimical to human cells. Since oxybenzone and homosalate are proven hormone disruptors, then their structural cousins avobenzone and octisalate are likely to be the same, despite any conflicting research evidence from limited exposure studies  in animals and humans. Other endocrine precepts in humans encourage us to adopt a prudent perspective and precautionary approach, and negate all  the animal studies that some use to defend soluble UV filters:

• Age at exposure: Exposure of an adult to an EDC may have very different consequences from exposure to a developing fetus or infant. In endocrine disruption the “the fetal basis of adult disease” describes observations that the external and maternal environment of many developing organisms (humans and eutherian mammals, vertebrates) , interact with genes to determine the risk of  disease or dysfunction later in life.  Endocrinologists extend this concept beyond the fetal period to the early postnatal developmental period when organs continue to undergo substantial development. We now use the terminology “the developmental basis of adult disease.”  I also believe that puberty represents another period of increased vulnerability for obvious reasons.
• Latency from exposure: The developmental basis of adult disease also indicates there is a lag between the time of exposure and the manifestation of a disorder- consequences of developmental exposure may not be immediately apparent early in life but may be delayed to adult and later years, and even the next generation.
• Importance of mixtures: If individuals and populations are exposed to an EDC, it is likely that other environmental pollutants are involved because contamination of environments is rarely due to a single compound. Furthermore, effects of different classes of EDCs may be additive or even synergistic.
• Non-traditional dose-response dynamics: In humans, infinitely low levels or any level of exposure at all—may cause endocrine or reproductive abnormalities, particularly if exposure occurs during a critical developmental window. Surprisingly, low doses may even exert more potent effects than higher doses. Second, EDCs may exert non-traditional dose-response curves, such as inverted-U or U-shaped curves.  Both of these concepts affect  hormone, neurotransmitter actions, and apply to the effects of EDCs.
• Transgenerational, epigenetic effects: EDCs may affect the exposed individual and children and subsequent generations. Recent evidence suggests that the mechanism of transmission may in some cases involve the germline  and may be nongenomic. That is, effects may be transmitted not due to mutation of the DNA sequence, but rather through modifications to factors that regulate gene expression such as DNA methylation and histone acetylation.

Bisphenol A (BPA) and phthalates in plastics and tins are publicised as a source of human EDC exposure by ingestion. This exposure is more tangential and incidental than sunscreen or cosmetic chemicals. The liver may metabolize and ameliorate the effects of EDCs ingested. Sunscreen chemicals absorbed through the skin obtain direct access to tissues and the brain and bypass this protective (first-pass) mechanism. Logical and critical thinking leads you to the unavoidable conclusion that sunscreen and cosmetic chemicals, often used on a daily basis  and in combinations of products, which pass into the blood and possibly the brain, are the most important source of EDC exposure in a first world society (www.thesunscreendoc.wordpress.com).

The simplest way to resolve this complex issue is to consider the fact of entry through skin or percutaneous absorption. If there were no dermal penetration- then risks of hormone disruption and carcinogenicity are moot.

Basic physiology predicts that dermal penetration occurs when a substance or drug has a molecular weight (MW) of < 500 Daltons. All the undesirable soluble organic UV filters are below this critical very small MW and enter human blood to varying degrees. That is an established fact – confirmed by studies on benzophenone – the poster child and most studied of the group – but includes others in the group:

• The CDC in the USA reported that 96.8% of Americans – both genders age 6-70 – had benzophenone (oxybenzone) in urine (Calafat 2008) from its pervasive use in sunscreens and cosmetics.
• In the EU, 85.2% of nursing mothers had at least one UV filter in breast milk (Schlumpf 2010).
• Oxybenzone was found in the urine (99%) and amniotic fluid (61%) of patients having amniocentesis in the third trimester (Phillippat 2013).

Vested interests use words like ‘limited and minimal penetration’ to deflect concerns over human safety. Even mostly trustworthy reference sites like Motherisk use ambiguous language and seem to imply that all sunscreens are safe in pregnancy. They barely mention “sunscreens (oxybenzone, octocrylene, octisalate) – below the limit of detection up to 8.7%. I have no idea what this means and this is based on outdated studies from  2004 and 2006, on human volunteers using limited exposure times, and to my knowledge – for obvious reasons – could not include pregnant patients.  My simple and prudent approach is that “limited and minimal” is not good enough for a developing fetus at any stage of pregnancy, but particularly in the first trimester (conception to 12 weeks). This is a crucial time for all organ development, especially neuroendocrine systems, and when  programming or neural signalling of neurologic pathways, gender, and differentiation of hormonal systems is at a critical stage. Contemplate what the displacement of estrogen, progesterone, and other hormones, from even a few receptors might do. It is also difficult to prove a negative or that something is not harmful. Industry and their dermatology consultants cite  animal studies that if extrapolated to the human condition, suggest sunscreens may not be harmful. What is required – in looking at the serious, permanent, and transgenerational effects involved – is proof beyond any reasonable doubt that these agents are safe.

There is no definitive human study that will ever answer the question. There is already a high index of suspicion from available animal and human data – it would be unethical (even criminal) to conduct human studies. This would require controlled studies exposing pregnant women, adolescent children, couples trying to conceive, and older subjects to these chemicals and following their children and grandchildren, for at least two generations to monitor the effects – arguably impossible.  However, if there are indications from tests on cell lines, retrospective human studies, and  animal experiments that these agents have endocrine disrupting properties, we need to act before waiting for absolute proof of harm in humans. In my opinion, where EDC effects are concerned we are already too late. Consider the other findings for one soluble UV filter that enters our bodies- benzophenone:

• It is still used in 65% of sunscreens in N. America and in over 950 cosmetics, which may explain why it is so pervasive. Women and girls had higher levels of oxybenzone in their bodies than males likely due to differences in use of body care products including sunscreens.
• Other studies confirm the CDC report on this insidious and alarming concern that this  chemical absorbs through the skin in significant amounts. A previous biomonitoring study reported that 96% of 6 to 8 year old girls had detectable amounts of oxybenzone in their urine (Wolff 2007). An earlier study detected oxybenzone in the urine of all 30 adult participants (Ye 2005).
• Studies on human volunteers indicate a wide variation in the level of oxybenzone absorbed into the body, with some individuals absorbing at least 9% of the applied dose, as measured in excretions in urine (Hayden 1997; Janjua 2004; Sarveiya 2004; Gonzalez 2006). Volunteers continued to excrete oxybenzone many days after the last application of the chemical, an indication of its tendency to accumulate in fatty tissues in the body (Gonzalez 2006). In addition to its ability to absorb into the body, oxybenzone is also a penetration enhancer, a chemical that helps other chemicals penetrate the skin (Pont 2004).
• Mothers with high levels of oxybenzone in their bodies were more likely to give birth to underweight or small for gestational age baby girls (Wolff 2008).
• It was also cited in a 2015 NIH report as being an important factor in male infertility, according to a study by the National Institutes of Health and the New York state Department of Health’s Wadsworth Center. This study merely underscores what the Endocrine Society, The WHO and The United Nations Environmental Program, have been saying for a decade- that the entire group of about 1000 known hormone disruptors have adverse effects on human reproduction, along with other effects on endocrine function and neural signaling. This report was given context and an explanatory mechanism by a Danish/German study reported at the 98^th Annual Meeting of the Endocrine Society (Boston 2016, showing 13 of 29 (45%) of UV filters tested were toxic to human sperm cells, by interfering with the actions of progesterone and prostaglandin, thus interfering with calcium flux and normal sperm cell function. The industry and their dermatology consultants dismissed this and said I was “not science”.
• Sunlight also causes oxybenzone to form free radical chemicals that may be linked to cell damage, according to 2 of 3 studies (Allen 1996; Serpone 2002; Hanson 2006). Hence this generation of reactive oxygen species (ROS) could be carcinogenic to skin- this filter could be involved with causing the cancer it is supposed to prevent.
• Oxybenzone is contaminating marine environments – washing off swimmers and in  municipal, residential, and in the  wastewater effluent from marine vessels. A 2015 report (Downs et al) confirms other studies over the past decade that oxybenzone is genotoxic, kills larvae of reproducing coral, and converts the planula from a motile to a sessile state by ossification, due to its action as a skeletal hormone disruptor. Reef ocean water levels of oxybenzone in the U.S. Virgin Islands was 75 µg/L to 1.4 mg/L. Hawaiian sites were contaminated between 0.8 and 19.2 µg/L. Oxybenzone poses a hazard to coral reef conservation and threatens the resiliency of coral reefs to climate change. Hawaii tabled legislation to ban all products with oxybenzone (2016)
• Oxybenzone and its structural cousin avobenzone are now among the leading causes of photocontact allergy (Warshaw 2012). Although this is an infrequent problem, it is just one more reason why this chemical should be banned from personal care products. Consumers and physicians should question its continued use. In most cosmetics, its only used to prevent discolouration in the product.

There are enough permanent and serious reasons for prudent people to avoid soluble UV filters – perhaps  simply because they pollute the bodies of our children. Photoallergy is rare but another reason to avoid them. The alternative of insoluble particle type filters provide better protection without risks to our health, wildlife, the environment,  and the marine ecosystems of our oceans. Next, the second imperative in a sunscreen- the ability to prevent all types of skin cancer, immune suppression, and photodamage.

EFFECTIVE PREVENTION OF UVR EFFECTS ON SKIN REQUIRES ADEQUATE UVA EXTINCTION

For 70 years the sunscreen industry and its medical consultants have fostered the idea that the role of a sunscreen is to allow users to tan without burning. Some of us may remember the iconic Coppertone ® ad – “Tanning without burning”  – where a puppy pulls down a swimsuit bottom to expose the deep contrast of a young girl’s white skin protected by the swimsuit  to her tanned skin, presumably allowed by the sunscreen. Such a sunscreen only requires UVB filters and the deep tan indicates the absence of any UVA protection. In 1991 Professor Brian Diffey exhorted us ” We do not yet know the importance of UVA with regard to photoaging…and…skin cancer… . It would seem prudent, therefore, to encourage the development of sunscreens which absorb more or less uniformly throughout the UV spectrum. Professor Diffey, still one of the world’s leading scientists on sunscreens and photoprotection, was encouraging us to give equal weight to UVA as UVB in developing the ideal sunscreen – a principle he called “spectral homeostasis” or in lay terms “balanced protection” – where there was virtually uniform or equal protection at every wavelength across the UV band (290-400 nm). This concept of balanced protection brings sunscreen protection to the same level of indoor shade and protection from textiles – the two proven and most effective methods of photoprotection. Sadly, despite compelling evidence over the past 20 years of the primary role that UVA plays in UV damage, many of our available sunscreens have little or no UVA activity. We are still radiating that little girl on the beach with the most harmful UV rays.

A quick summary of some of the persuasive science implicating UVA – particularly UVA1 at 340-400 as the main driver of every aspect of sun damage, except for your early sunburn. Persuasive  contemporary science shows a  complex interplay where both UVB and UVA cause direct DNA mutation, but UVA is the main driver of a cascade of effects leading to skin damage, skin cancer and photoaging. This includes, but is not limited to, immune suppression, generation  of reactive oxygen species (ROS)  or free radicals, suppression of the P53 repair gene and other repair mechanisms, and stimulates the synthesis of matrix metalloproteinases  (MMPs) that mediate several aspects of cellular damage and promote invasion behaviour by cancer cells. UVB initiates and modulates the damage cycle, but UVA (particularly UVA-I) drives the enabling cascade and completes the process.” UVR but mainly UVA suppresses the normal immune response that would recognise and remove mutated or atypical cell by inducing apoptosis(cell death).  Here are few of these landmark studies:

• Skin cancers contain more UVA than UVB fingerprint mutations and UVA plays the primary role in human skin carcinogenesis (Agar and Halliday et al 2004).
• UVA radiation causes more oxidative stress than UVB,  10 times more lipid peroxidation, and is more cytotoxic. It damages DNA by causing strand breaks and oxidation of nucleic acids. UVA can inhibit DNA repair and induce MMP synthesis, all enabling the growth of the cancer. (Nelson 2005).
• UV radiation suppresses the normal immune response locally in skin and beyond. At the same SPF 25, a high UVA sunscreen (UVA 14) completely prevented any change in the immune response, while a product with poor UVA at 6 failed to do so (Moyal 2008).
• Equal mutagenic doses of UVB and UVA on DNA damage showed that UVA-induced pyrimidine dimers were more mutagenic than UVB-induced ones (Rünger TM 2012).
• Australian scientists in a milestone discovered that properly applied sunscreen can prevent skin cancer through a variety of mechanisms including the sparing of the “superhero” gene p53 that works to repair UVR damaged skin. They  found that application of a balanced sunscreen – with both UVB and UVA activity – a titanium dioxide and zinc oxide formula – provides 100% protection against all forms of skin cancer including melanoma (Hacker et al 2013).
• These results only reinforced an earlier study from another Australian team that showed daily application of a mediocre balanced sunscreen, with some UVA protection from avobenzone, reduced melanoma and basal cell cancer (Green et al 2012). A later study by Green showed that daily balanced sunscreen application reduced the rate of photoaging and wrinkling compared to less frequent users or non-users of a sunscreen.

The science only confirms what basic photobiology tells us. UVB accounts for only 6% of UVR compared to UVA at 94%. UVB varies with time of day and latitude, whereas UVA is a constant anywhere on the globe regardless of the time of day, penetrates clouds and window or auto glass.  UVB reaches only to the basal or last layer of the epidermis, while UVA penetrates to the deep reticular dermis, where collagen and the immune apparatus resides. It is evident and intuitive to see why  photoaging and skin cancer can only be due primarily to the deeper penetrating rays of UVA1. The global sunscreen marked is dominated by UVB-biased sunscreens, particularly in N. America that can only give little or no protection against skin cancer or photoaging. This incomplete protection contributes to rising annual skin cancer rates – 2-3% in N. America and an alarming 40% in the UK over the past 4 years. Melanoma was the 2nd fastest rising cancer in Canada for 2014 and is now the leading cause of cancer death in young women age 25-30 and the 2nd leading cause in those age 15-25.

A UVB dominant sunscreen with SPF 50 reduces UVB by 98%, UVA2 by a lower amount, and UVA1- the most damaging and deeply penetrating rays- by almost none. Sunscreens meeting our regulations for a “Broad Spectrum” claim will still transmit over 33% of the UVA1 radiation hitting the skin, compared to UVB of 3.3% for a SPF 30 and 2% for a SPF 50- a major UVB bias. Daily use of UVB biased sunscreens exposes you to asymmetric UVA1 radiation like a tanning bed. More people develop skin cancer because of tanning than develop lung cancer because of smoking. Chronic UVA exposure allowed by a UVB-biased sunscreen leads to chronic UVA damage over time, and increases your risk of skin cancer and photoaging.

A SIMPLE GUIDE TO SELECTING A SAFE AND TRULY BALANCED EFFECTIVE SUNSCREEN

Every consumer, particularly expectant or nursing mothers, parents of young or adolescent children, and couples trying to conceive- deserve to make an informed choice:

• Either use sunscreens with soluble filters of small molecular weight that give incomplete protection and pass into blood, tissues and brain, and are implicated as hormone disruptors and carcinogens, with adverse effects on lower species and the environment/
• Or to use insoluble particle based UV filters with large molecular weight or particle size that give better protection against skin cancer and photoaging, and remain on the skin without any risk to human health or the environment.
• Absolutely avoid– avobenzone, oxybenzone, homosalate, octisalate, octocrylene, Mexoryl XL™, Eusolex™ (4-methylbenzilidene camphor), octinoxate (un-encapsulated)- some are known or suspected hormone disruptors, photoallergens, and carcinogens. The fact that they all attain levels in your blood is reason enough to avoid them even without considering risks, particularly for expectant or nursing mothers, young or adolescent children, and couples trying to conceive.
• Select – large molecular size insoluble particles or engineered filters: Zinc oxide, titanium dioxide, encapsulated octinoxate, Mexoryl SX™, Tinosorb S™, Tinosorb M™, Parsol SLX™, iscotrizinol, octyl triazone, and bisdisulizole disodium. They have no entry into blood and none are hormone disruptors or photoallergens. They give balanced protection without any risks to human health or the environment. Only the first four are available in N. America.
• Select a particle based product with adequate concentrations to provide an accurate SPF and enough UVA protection. A SPF of 30 and a UVA-PF of at least 10 is attainable with zinc oxide alone 22-25%, zinc oxide 15% plus 5% titanium dioxide or encapsulated octinoxate. I like Mexoryl SX ™ is but it is usually combined with undesirable soluble filters. Combinations of zinc oxide and titanium dioxide in adequate concentrations are hard to find. Some products that fly off the shelves in health food stores have inadequate concentrations of these filters- e.g. 1.2% and 3.8% respectively. This cannot have the SPF 30 claimed on the label and likely contains boosters (anti-redness agents) that diminish your erythema reaction from sunburn without actually reducing the UVB radiation passing through the sunscreen to your skin. The filters are safe but at that level cannot provide adequate UVA protection- likely has a UVA-PF < 5 and would be a FAIL in the EU and cannot deliver adequate photoprotection.
• Higher UVA-PF values are possible with the use of either more zinc oxide up to 25%, or the addition of innovative filters like Tinosorb S™, Tinosorb M™ – approved everywhere in the world – except N. America. Most sunscreens here have UVA-PF values of 3-8, despite being labelled as “Broad Spectrum” under our rules that do not actually require this measurement, and rely on an indirect estimate. Most still fail to reach EU standards. The ideal sunscreen would combine 3 or 4 particle filters – encapsulated octinoxate, zinc oxide, titanium dioxide, Tinosorb S™ (bemotrizinol), or Tinosorb M ™ (biscotrizole). Only the first 3 are available to us in ideal combinations. These combinations in optimal concentrations can achieve UVA protection values > 30, and achieve 3-5 X more protection in the UVA1 range than our typical UVB-biased N. American sunscreens.
• For daily or recreational purposes, use SPF 30 – but if you are extremely fair, if you have a condition with extreme sensitivity to sunlight like lupus, or if you have an outdoor occupation, use a SPF 50. Bear in mind that the true SPF may only be 10 and adjust your behaviour accordingly – calculate your safe exposure time from the label SPF and divide by 5. Particle sunscreens appear to come closer to their label values in sunlight. Use the other elements of a photoprotection strategy – avoid sun exposure, wear UV protective clothing, wear head gear and UV protective sunglasses to the extent you can, and use a sunscreen with UVA filters like zinc oxide in adequate concentrations.

Ignore the terms “chemical” versus “natural or mineral”. It is a misconception that there is a real difference – that  “natural” (mineral) filters reflect or bend light like a barrier- whereas the so-called chemical agents react with photons in a chemical reaction. These misconceptions are actually falsehoods. Use of the word natural is a duplicitous marketing tool to imply safer and non- chemical, and therefore better. Organic is not a synonym for safe – merely means carbon based. Many soluble UV filters contain the 6-carbon benzene ring so inimical to humans and the environment, synthetic and pass into blood. The mineral filters zinc oxide and titanium dioxide are still chemicals- albeit inorganic – with a chemical formula but no carbon atoms – made by a geologic system (mother earth) – hence the tendency to think of them as natural.  Mineral filters are now so processed, highly refined, milled, doped and coated that they are really “naturally derived” but so altered, they are semi-synthetic and hardly natural. The most inexcusable misconception is that they protect through the reflection or bending of incident light. Even older pigment grade forms of zinc oxide and titanium dioxide with larger molecules in the micron range and beyond, did not reflect more than 15% of the UV rays. New and more efficient nanoscale sizes, e.g. zinc oxide dispersions at 70- 300 nm and titanium dioxide 20-200 nm, now used in most formulas, still do not reflect light to any degree. They act as semi-conductors and absorb photons with electron shifts to a different valence band so a harmful wavelength is converted to a less harmful or innocuous light. This is simplified but established science, yet the belief persists that mineral filters reflect UV radiation and prevent it passing through the sunscreen to the skin, and are somehow better than “chemical” filters that work through a chemical interaction with the photons. All sunscreen UV filters absorb photons in a certain state of excitation and emit them in a less reactive form. Mineral (natural) denotes naturally derived inorganic chemicals like zinc oxide and titanium dioxide, but since they do not filter or attenuate UV radiation any different from the organic filters, these terms should be avoided. New particle type filters are synthetic organic compounds that are also insoluble. Therefore the only accurate classification of UV filters is soluble versus insoluble and definitely not natural or mineral versus chemical.

SUMMARY

I believe The Precautionary Principle is being ignored where soluble sunscreen filters are concerned. The case for banning them is much stronger than BPA. This shifts the burden of protection against harm from the government to you. Selecting your family sunscreen is actually quite simple – just avoid those filters that enter blood regardless of the level, and use  those large insoluble particle type filters – safer and more effective from better UVA1 protection.  In Canada and the USA- we have limited access to UVA filters – only avobenzone and zinc oxide. I do not recommend avobenzone – it enters blood to a “limited” degree and is not photostable. Industry adds other chemicals that also pass into blood to “stabilize” it. Yet looking at extinction curves (which consumers never see), informs  us that some formulas may still allow the transmission of over 35% of incident UVA1 through the sunscreen and damaging the skin.

Most zinc oxide sunscreens on the market have low levels that cannot provide optimal UVA protection. Our new sunscreens will provide UVA values > 15-40, unmatched anywhere.  Remember to look for 20% or more of zinc oxide. Many of these products have poor esthetic qualities- whitening on skin, oily or greasy feel on skin, and funny odors. At CyberDERM – we only use particles that remain on your skin- transparent zinc oxide and encapsulated octinoxate – titanium dioxide is a safe alternative – we do not use it as it adds to the white appearance on skin. Both of our sunscreens are EWG recommended Top Products. We are proud of our accomplishments, as  a small Canadian company. Others share our enthusiasm.

Every Morning Sun Whip™ with 15% zinc oxide and 7.5% encapsulated octinoxate applies in a transparent film with a matte finish perfect for daily use under make-up. It receives widespread acclaim :

“As The Editor of New You, I have been asked to try numerous sunscreens over the years. I reviewed the material provided by Dr. Dudley in preparing my article. I appreciated his concepts  and after using the CyberDERM Every Morning Sun Whip, I became a huge fan of the formula that I now use exclusively – I feel it is a Goldilocks formulation – not too thick and not too thin – just right.   I am loving the CyberDERM sunscreen- it feels so good on the skin and I now trust his ingredients.”

Ruchel Louis, Executive Editor, NEW YOU, The Voice of Health and Beauty.

Simply Zinc ™ with 22% clear zinc oxide was named as sunscreen of the year 2015 by The Beauty Editor.  “I prefer to use mineral sunscreens, not chemical ones, and Cyberderm Simply Zinc Sun Ship SPF 30 is the best one I’ve ever found.“ http://beautyeditor.ca/2016/01/01/favourite-beauty-products-2015. It was also selected by ELLE and Canadian Living magazines as a favourite product.

Both Every Morning Sun Whip™ and Simply Zinc™ are preferred for photosensitive disorders “Zinc oxide has long been on my radar of excellent sunscreen ingredients. I was  eager to try CyberDERM’s Sun Whips – I am now a huge fan of Every Morning Sun Whip.  I tested their products in the blazing New Mexican sun. I have  a medical photosensitivity due to lupus, nearly translucent skin that if unprotected burns in a few minutes and freckles in mere seconds. I live at high altitude, nearly a mile above sea level, in the New Mexican desert. Because of lupus, I require the utmost in UV protection for the sake of my overall health. Patients with photosensitive lupus demand and deserve a truly high-performance sunscreen, and  as we need to wear it religiously, it ought to be pleasant to use. With CyberDERM, I have finally found my Holy Grail sunscreens. They have achieved the rare feat of preventing me from freckling, making it the one and only North American sunscreen company I have tried that keeps me from freckling.  Although freckles are cute, they indicate a degree of sun damage. With all this in mind, CyberDERM Sun Whips have exceeded my hopes and expectations. They provide powerful, lasting and balanced UVA/UVB protection I trust, combined with an unexpected, but delightful blendability and aesthetic elegance.  In my vast sunscreen experience to date, CyberDERM Sun Whips are unparalleled.  I also exclusively use CyberDERM Sun Whips on my young daughters, to protect their delicate skin with efficacy and purity I trust. Simply Zinc Sun Whip is a joy to use.  These are simply the best zinc based sunscreens I have ever found and I use them daily.”

Melissa M. Davis PhD, Licensed Clinical Psychologist and Photosensitive Lupus Patient.

Denis K. Dudley MD, President of CyberDERM, Sharyn Laughlin MD, Board Certified Dermatologist (Canada & USA), Medical Director at Laserderm, Ottawa, Ontario, Canada. Co- Founders of CyberDERM- www.thesunscreencompany.com.

All rights reserved, June 2017.