Can sunscreen cause cancer?

I belong to a group. You may too. I belong to the group of more than one million cases of skin cancer diagnosed in this country every year. I'm sure it didn't help that, growing up, I spent five hours a day baking in baby oil on a raft in our family's pool most summers. But what about the SPF 4 (!) my mom insisted I wear? I remember a strong-smelling clear liquidy product that sealed into a plastizoid layer on my face. Could that have actually contributed to me losing part of my nose, in addition to the hours I spent baking in the sun?

I just reviewed The Environmental Working Group's (EWG) "Fourth annual Sunscreen Guide" to look for some answers. My friends often debate whether to apply sunscreen to avoid cancer or to forgo sunscreen to avoid cancer. So what did the EWG find? I want to be armed with facts for the next beachside chat.

Interestingly, they only recommend 8% of sunscreen products on the market today, a mere 39 products out of  1,400 products with SPF, including beach and sports lotions, sprays and creams, moisturizers, make-up and lip balms. The main reasons are that popular chemical ingredients such as oxybenzone have been linked to cancer, and a form of vitamin A called retinyl palmitate - found in 41 percent of sunscreens to prevent free radical damage - has recently been shown to actually create more cancer-causing free radicals in the presence of sunlight. In addition, the EWG says that many of these sunscreens make exaggerated SPF claims. FDA scientists say SPF claims above 50 cannot be reliably substantiated.

The EWG report found that few people use enough sunscreen to benefit from the SPF protection promised on the label. Studies show that people typically use about a quarter of the recommended amount (which for an adult is about one ounce). Because sunscreen effectiveness drops off precipitously when under-applied, in everyday practice a product labeled SPF 100 actually performs like SPF 3.2, an SPF 30 rating equates to a 2.3 and SPF 15 translates to 2! No wonder my kid comes home red after spending hours on the beach, even though sunscreen has been dutifully applied.

The best sunscreen? A hat and long-sleeved shirt. No toxic effects, no chance of inhaling or ingesting any suspect ingredients, no pollution of the reef and no need to reapply. And seek shade during the peak midday hours. Common sense. We've come to rely on sunscreen, but studies show that folks who use it stay out in the sun longer and have higher rates of the deadly melanoma skin cancer. Sunscreen can provide a false sense of security, especially in Hawaii's summertime heat.

Reportedly taking their research further than Consumer Reports, the EWG looked not only at whether or not products provide broad-spectrum UV protection (UVA & UVB), but also at which sunscreens quickly lose effectiveness, and at the full range of potentially hazardous sunscreen ingredients that can absorb through the skin and into the body to pose other risks.

This may be old news to some of our savvy readers, but I was pleased to have some clear information. For example, if the sunscreen leaves a white residue, that's good. That means the zinc and titanium dioxide mineral particles which block sunlight are larger than a nanoparticle. These ingredients have been micronized in some products, so that they aren't visible when applied to your skin. Many consumers may prefer that their sunscreen be invisible, but the danger is that nanoparticles can more easily penetrate into the body and disrupt certain hormonal functions.

What's a nano particle you may ask? I first reported on them in food here last March.

Nano-scale particles are measured in nanometers (nm), or billionths of a meter. Relative to larger particles, nano-scale materials can be more chemically reactive and more easily absorbed into the body. A number of studies raise concerns about potential health risks when these particles are inhaled or are absorbed through the skin or gut. Nevertheless, they are already widely used in products, including sunscreens, with no requirement that their presence be disclosed.

The EWG wants mandatory labeling of products containing nano particles so the consumer can choose. They investigate them extensively in their report.

Particular sunscreen ingredients or formulations may be more damaging to skin than others. Both nano-size zinc oxide and titanium dioxide, including forms extracted from sunscreen, react strongly with UV light (Dunford 1997) and may damage skin cells (Sharma 2009).

Yet they found that sunscreens without any size zinc and titanium particles are likely to expose the user to more UV radiation and greater numbers of hazardous ingredients. So it appears the larger size zinc and titanium particles that leave a white residue on the skin may be the best way to go at present. Without the whites, sunscreens use chemicals such as octinoxate and oxybenzone that absorb into healthy skin, causing in some allergic reactions, hormone-driven uterine damage, and can act like estrogen in the body, raising potential concerns for breast cancer. Yikes. I've already been diagnosed as having higher than ideal estrogen levels.

Their findings:

"Sunscreens without zinc or titanium contain an average of 4 times as many high hazard ingredients known or strongly suspected to cause cancer or birth defects, to disrupt human reproduction or damage the growing brain of a child. They also contain more toxins on average in every major category of health harm considered: cancer (10% more), birth defects and reproductive harm (40% more), neurotoxins (20% more), endocrine system disruptors (70% more), and chemicals that can damage the immune system (70% more) (EWG 2006)."

So I took my basket of assorted sunscreen goop out of the closet and the fridge, and scanned the ingredients. Luckily only two contained the suspect ingredients octnoxate and oxybenzone, and made their way into the waste basket. The newest ones in my arsenal against skin cancer I bought at Down to Earth. The Super Salve Co. creates a SPF 30 sun cream in a tub, and a SPF 27 herbal sun stick to go on nose, ears, lips, etc. They contain a soothing-sounding blend of olive oil, aloe, shea butter, jojoba oil and zinc, along with bees wax, vitamin E and other natural ingredients. I keep them in the fridge at home, and when I go out I bring them in a cooler to maintain their effective properties. Heat breaks them down. They go on smoothly and have proven their effectiveness to me, even in the water. While not included in the EWG's study, I found them to contain no potentially dangerous chemicals, utilizing zinc oxide along with many herbal ingredients including lovely smelling essential oils.

My SPF daily moisturizers didn't fare as well. I chucked two along with a lip balm, and kept one the EWG advises to use with "Caution".

Interested? You can read about how the FDA has been drafting sunscreen safety legislation for the past 32 years.

The FDA first issued draft sunscreen regulations in 1978 and last updated the draft in 2007. The regulations are still not final, despite multiple announcements of impending completion. Until the agency formally issues its rule, companies are not required to verify that their sunscreens work, including testing for SPF levels, checking waterproof claims or providing UVA protection. Nearly 1 in 8 sunscreens does not block UVA rays. UVA rays, while not causing skin redness, lead to premature aging of the skin and skin cancer. Buyer beware!

Go to the EWG site to find your sunscreen and how it rates in safety. It's fun and easy. There's even a Hall of Shame. Find those without nano-particles if you wish. Like genetically modified organisms, the jury is still out in America about their safety. And like GMOs in America, they're approved for use until proven dangerous. Sounds a little backward to me….do you want to be the FDA's guinea pig? Well, unfortunately you are.

Read FAQs such as:

• There’s no consensus on whether sunscreens prevent skin cancer.
• The common sunscreen ingredient vitamin A may speed the development of cancer.

• When consumers apply too little sunscreen or reapply it infrequently, behaviors that are more common than not, sunscreens can cause more free radical damage than UV rays on bare skin.
• Powdered or spray forms of sunscreen, while easy to apply, are not recommended as potentially toxic ingredients can be ingested or inhaled.
• And not surprisingly, read how Europe has better sunscreen than the U.S.

Now don't avoid the sun altogether! We need about 15 minutes of solid sun daily, on average, to develop Vitamin D. Supplements aren't enough. Just be smart. Be informed and spread your knowledge! And when you have to be out for prolonged periods and are in doubt, white sunscreen currently looks like your best option if the hat and shirt aren't practical.