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Does sunscreen save skin — or damage it?

/ Source: Allure

I was no different from most college students: During spring breaks, my friends and I applied our competitive streaks — we were teammates on Brown University’s swimming and diving team — to beach tanning. Who could get the darkest over a week in the Caribbean? Being pale, I never could. But that didn’t stop me from trying, or from picking up blistering sunburns as souvenirs. What an idiot — especially considering my father is a dermatologist. Now, after many years as a beauty editor and writer, I’m in medical school, studying to be (you guessed it) a dermatologist. Needless to say, I wear sunscreen religiously.

Which is why a particular piece of research came as a shock: A small but impossible-to-ignore study, published in Free Radical Biology & Medicine, has suggested that while sunscreen prevents free-radical damage to the skin from the sun, it also might cause damage.

According to this 2006 study from the University of California, Riverside, certain sunscreen ingredients may cause more free radicals to form than no sunscreen at all. If the findings are confirmed, the implications will be enormous — and sobering, given that women have been told for decades that regular sunscreen use is one of the best ways to minimize aging and the risk of skin cancer. The whispers started back in 2006, but they’re beginning to grow louder now; it took two years for news of the study to reach the public consciousness, because some doctors have been shying away from discussing the findings, loath to cause panic when the study was neither double blind, randomized, nor conducted on humans — nor has it been repeated. (In other words, don’t toss your sunscreen.)

Here’s the backstory: When we bake in the sun, the skin absorbs ultraviolet radiation (UVA and UVB rays) that can cause instability in the molecules of the body tissue, releasing harmful compounds called free radicals. Free radicals are molecules with an unpaired electron that, in an attempt to locate its electron “mate,” can disrupt the cells’ functions (seriously disrupt — if these electrons were at a bar, there would be smashed glasses, overturned bar stools, you name it).

When sunscreen is slathered on the skin, molecules in the sunscreen — the UV filters — cut down on the amount of radiation that can penetrate the skin. But according to this UC Riverside study, helmed by lead author Kerry Hanson, three commonly used, FDA approved sunscreen filters — octyl methoxycinnamate, octocrylene, and benzophenone-3, which is also known as oxybenzone — can boost the number of free radicals over time when they break down and are absorbed into the skin.

According to my analysis of the study findings, one hour after a ten-minute session of UV exposure, the ingredient benzophenone-3 elevated free radicals by 64 percent compared to the control, while octyl methoxycinnamate and octocrylene boosted free radicals by 33 percent and 16 percent, respectively. The rate of free-radical elevation caused by the sun itself has not been studied, according to several dermatologists.

Ironically enough, failure to reapply frequently seems to compound the damage to skin. “Using sunscreen once in the morning could potentially be worse than not using any at all if you spend a lot of time in the sun,” Hanson says. “Not reapplying every two hours would mean that you would have minimal sun protection, and the sunscreen itself could generate free radicals.” Trouble is, few of us reapply as often as we should (every two hours and after swimming, excessive sweating, and toweling off).

Great. For a medical student like me, this is like discovering the Easter Bunny doesn’t exist — or that it has fangs and claws. But how scared should I be?

Some dermatologists pooh-pooh the free-radical study at UC Riverside as small and inconclusive, noting that it didn’t use actual sunscreen — just individual ingredients. And some point out that the study used epidermal model tissue — genetically engineered skin — rather than a real human sample. “This study uses a skin model, and this sort of thing happens all the time: You get quirky findings that we can’t replicate because those things don’t happen in people,” says James M. Spencer, a clinical professor of dermatology at Mount Sinai School of Medicine in New York.

Hanson’s response to these criticisms? She says the study wasn’t done on people because the free-radical detecting technology is not approved for use on humans — and notes that the fake skin was “irradiated for only about the equivalent of ten minutes of unprotected time in the noonday summer sun” — quite a conservative test, considering the hours that some of us bake out there. Hanson adds that the study builds upon ten-year-old test-tube research that also suggested that some sunscreen ingredients contribute to free radicals.

To slather or not to slather?

In any case, there is a faction of respected dermatologists who aren’t ready to discount even a small study. “I think the UC Riverside free-radical study is true — fake skin like this is commonly used in studies, and the researchers used advanced methods to image bioengineered skin and measure the amount of free-radical production,” says Leslie Baumann, director of the University of Miami Cosmetic Medicine and Research Institute, who has been at the forefront of many dermatological studies. “We’ve actually been talking about this for a couple of years,” she says.

Sheldon Pinnell, a professor of dermatology at Duke University School of Medicine, also thinks the study has validity. “It’s known that some sunscreens behave in this manner. They get inside the skin and absorb energy, and that energy becomes free radicals, which can potentially cause harm,” he says, naming avobenzone (which the UC Riverside study didn’t test) as one that “can form fairly active free radicals.” While more research is needed, the science has made one thing clear: Adding high-quality antioxidants to sunscreen can counteract any free-radical activity, as long as there are enough of them in the formulation. Antioxidants act like marriage counselors, striving to keep straying electrons from splitting into free radicals. (Fortunately, they are a hell of a lot more successful than marriage counselors.) A few companies, including Coppertone, Murad, Priori, and Topix, have had antioxidant sunscreens for several years. Their standout products, according to Baumann, are Coppertone’s NutraShield Sunscreen Lotion with Dual Defense, Murad Oil-Free Sunblock, Priori Radical Defense Sunscreen, and Topix’s Citrix Antioxidant Sunscreen; they all have hefty amounts of good quality antioxidants, she says.

“We looked at vitamins C and E, and they really do a great job of quenching the free radicals,” says Hanson. “Personally, I look for a sunscreen with an SPF of 30 or above and antioxidants high up on the ingredient list.” (The higher up, the more there are.) And they do not have to be in your sunscreen to work, adds Pinnell, who’s studied the free radical fighters extensively. “Once absorbed into the skin, antioxidants can last about four days. So even if you forget to put them on one morning, they’re still in there working for you.” Baumann herself isn’t as relaxed about her own routine: “I always put on a layer of antioxidants first and then a sunscreen also containing them afterward.”

Still, dermatologists — even ones who believe the study — are adamant about not overstating the dangers. “It would be terrible to give people the message that sunscreen is bad and you shouldn’t use it,” says Amy B. Lewis, an assistant clinical professor of dermatology at Yale School of Medicine. “Right now we have one small, inconclusive study versus huge amounts of data that show that lack of sun protection causes DNA damage, melanoma, basal-cell and squamous cell skin cancer, and horrible deformed moles and wrinkles, and there is great evidence for prolonged use of sunscreen to protect against all of those things. If these chemicals cause something, the sun exposure you’re trading it for is going to cause more free radicals.”

The UC Riverside researchers also insist that their take-home message wasn’t to stop using sunscreen. “Our work supports what the Skin Cancer Foundation recommends, which is to reapply sunscreen often and liberally,” Hanson says. “At first, you could look at our data and say, ‘Should I not wear sunscreen?’ — but the data really says it’s still the best defense we have against sun damage, especially with antioxidants to neutralize any free radicals. We just need to start using it in a smarter way.” And it’s not that there’s a conspiracy by the sunscreen industry, Hanson insists: “I found most companies to be extremely receptive to this data — contacting me, embracing the study, and asking for more information because they want better products. The science is just starting to catch up.”

In a way, it may be good that this issue hasn’t gotten more press. There has been time for sunscreen makers to begin finding solutions. And there has been time to reflect and acknowledge that beauty is no longer a pseudoscience of oils, pigments, and wax. The industry has matured and now produces legitimate science worthy of scholarship.

As a civilian, I’m still using sunscreen — only now I’m more careful about reapplication, and I take the time to slather on an antioxidant cream daily. And as a medical student and daughter of a dermatologist? I’m reading the news. I’m paying attention. And I’m not believing quite so fervently in the Easter Bunny.