CMAJ News

Canadians confused and conflicted over sun protection products

Published at www.cmaj.ca on July 6

hile most Canadians know that sun exposure can cause W , many are con- fused over other damage the sun, and potentially , can do to their bodies. A new study by the Canadian Der- matology Association shows that Cana- dians remain unaware of the true toll the sun can take on their skin and are unwilling to take the full range of pre- cautions necessary to protect them- selves from its harmful rays. Meanwhile, an American report crit- icizing the industry’s use of toxic ingre- dients and inflated efficacy claims has prompted debate over the safety of Canadian sunscreens. The 2010 Photoaging Study sum- mary report asserts that 8 in 10 Canadi- ans don’t know that the major contribu- tor to skin aging is repeated exposure to . Photoaging (premature aging of the skin through sun exposure), is the cause of up to 90% of the skin changes often mistaken as the ravages of time: wrinkles, sagging, liver spots, spider veins, uneven colour and leathery tex- ture. According to the study, two-thirds of Canadians cannot accurately describe what photoaging is; almost a quarter of study participants thought it was a kind of computer software used to give pho- tographs a vintage look (www.derma tology.ca/photoaging/PhotoagingSumm aryReport_May19.pdf).

The study also found that while Corp. Jupiterimages 2010 © most Canadians are willing to slap on some (67%) or slip on a pair The 2010 Photoaging Study summary report asserts that 8 in 10 Canadians don’t know of sunglasses (66%) to protect them- that the major contributor to skin aging is repeated exposure to sunlight. selves from sun damage, fewer were willing to adopt other recommended and efficacy by the Environmental States market, recommending only 39, precautions, like avoiding outdoor tan- Working Group, a Washington, DC- or 8%, of 500 beach and sport sun- ning (39%) or wearing more clothing to based nonprofit environmental research screens as safe for consumer use (www cover the skin (31%). and advocacy organization. .ewg.org/2010sunscreen/full-report/). But consumer faith in sunscreen In their fourth annual Sunscreen The group cited sunscreens’ poten- may be unwarranted, according to a Guide, the group gave low marks to the tially toxic or unstable ingredients, as recent report on the products’ safety current crop of sunscreens on the United well as exaggerated and often unsub-

CMAJ•AUGUST 10, 2010 • 182(11) E507 © 2010 Canadian Medical Association or its licensors News stantiated sun protection factor (SPF) American study to a Canadian context. As regulated drugs in Canada, sun- and broad spectrum protection claims “We have totally different products in screens are required to undergo premar- as reasons for the panning. Canada. We’re much more cautious ket authorization to demonstrate safety “Products with high SPF ratings sell than other countries in endorsing any- and efficacy. Most meet the criteria for a false sense of security,” says Dave thing, and when people make claims acceptable active ingredients, permitted Andrews, senior scientist for the group. they pretty well have to live by them. I concentrations, directions for use, and “We know people who use these prod- would be much more positive and look required warning statements outlined in ucts stay out in the sun longer, so they for things that are good in sunscreens, the 1995 Protectant mono- still get burned, and because most of rather than look for things that are bad.” graph. Oxybenzone is currently among these products provide a low ratio of Lycka says that while it’s “probably the ingredients generally recognized as UVA [ A] to UVB [ultraviolet true” that only 8% of sunscreens protect safe by Health Canada. B] protection, they also end up getting against UVA radiation, UVB protection Under the monograph, sunscreens overexposed to UVA radiation, the type is the “major component” Canadians can have an SPF rating no higher than of sunlight that doesn’t burn but has should be looking for in a sunscreen. 60 and can only make limited UVA been linked to skin damage and cancer.” Others dismiss the group’s concern protection claims. But sunscreens don’t Common sunscreen ingredients like over the use of oxybenzone in sun- have to meet the monograph criteria, as oxybenzone, used as a UVA/UVB screens. manufacturers can present additional absorber, and a form of vitamin A “There have been animal studies evidence to Health Canada to bring sun- called retinyl palmitate, hawked for its that show there might be endocrine screens with higher SPFs, new ingredi- anti-aging benefits, also came under effects, but there’s nothing conclusive ents and different claims to market. fire for potential toxicity and photoin- in human studies,” says Dr. Cheryl Smith says many sunscreens stability. Rosen, national director of the Cana- approved by Health Canada wouldn’t “Oxybenzone is a known hormone- dian Dermatology Association’s sun pass muster under the Environmental disrupting compound found in about awareness program. “It’s something we Working Group’s criteria. “Virtually 60% of the sunscreens we looked at, should watch the literature on, but that all the brands the group looked at are and retinyl palmitate, found in about doesn’t mean we have to stop using also available here in Canada. We use 40% of the sunscreens, is under investi- these products now. Oxybenzone has the same ingredients in our sunscreens, gation by the federal Food and Drug been used in sunscreen for years, and the average SPF rating is still climbing, Administration [FDA] because data as far as I know there haven’t been albeit at a slower pace than in the US, suggests it may become carcinogenic in reported problems in humans.” and there’s still no consensus on how sunlight,” Andrews explains. “While But environmentalists are disap- best to test for UVA protection. Super- the evidence isn’t conclusive, as long pointed by the ready dismissal of the ficially, it may seem we’re ahead of as compounds like these are suspect, report and say there’s no reason for the game, but the same problems with it’s only prudential to avoid them.” industry to use hormonally-active sunscreen you see in the US apply here The group’s report is the latest in a ingredients when safer alternatives are in Canada.” recent spate of studies that have ques- available. The FDA has yet to finalize regula- tioned the safety of sunscreens. Some “There are something like 80 000 tions for sunscreens promised since have even linked sunscreen use to an synthetic chemicals in commerce at the 1978, but says regulations may be elevated risk for melanoma, the dead- moment. Only 5% of those have been issued in October. Health Canada last liest form of skin cancer, says Andrews. adequately safety tested, and oxyben- updated its monograph in 2006, and The Environmental Working zone is not one of them,” says Rick says it is “exploring methods by which Group’s report has divided Canadian Smith, executive director of Environ- to better communicate to Canadians the experts over what dangers, if any, lurk mental Defence Canada, an environ- importance and level of UVA protec- on sunscreen shelves. mental and human health advocacy tion on sunscreens, as well as which Dr. Barry Lycka, founder of the group. “It’s glib to tell consumers not UVA protection-test methods are the Canadian Skin Cancer Foundation, is to worry about oxybenzone because it’s most appropriate for use.” — Lauren quick to dismiss the report as “erro- been deemed safe by the government Vogel, CMAJ neous” and “misleading.” He argues regulator, because once upon a time that it is “hazardous” at best to adapt an tobacco was deemed safe, too.” DOI:10.1503/cmaj.109-3309

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