What’s Keeping the US From Allowing Better Sunscreens?

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When dermatologist Adewole “Ade” Adamson sees people spritzing sunscreen as if it’s cologne at the pool where he lives in Austin, Texas, he wants to intervene. “My wife says I shouldn’t,” he said, “even though most people rarely use enough sunscreen.”

At issue is not just whether people are using enough sunscreen, but what ingredients are in it.

The Food and Drug Administration’s ability to approve the chemical filters in sunscreens that are sold in countries such as Japan, South Korea, and France is hamstrung by a 1938 U.S. law that has required sunscreens to be tested on animals and classified as drugs, rather than as cosmetics as they are in much of the world. So Americans are not likely to get those better sunscreens — which block the ultraviolet rays that can cause skin cancer and lead to wrinkles — in time for this summer, or even the next.

Sunscreen makers say that requirement is unfair because companies including BASF Corp. and L’Oréal, which make the newer sunscreen chemicals, submitted safety data on sunscreen chemicals to the European Union authorities some 20 years ago.

Steven Goldberg, a retired vice president of BASF, said companies are wary of the FDA process because of the cost and their fear that additional animal testing could ignite a consumer backlash in the European Union, which bans animal testing of cosmetics, including sunscreen. The companies are asking Congress to change the testing requirements before they take steps to enter the U.S. marketplace.

In a rare example of bipartisanship last summer, Sen. Mike Lee (R-Utah) thanked Rep. Alexandria Ocasio-Cortez (D-N.Y.) for urging the FDA to speed up approvals of new, more effective sunscreen ingredients. Now a bipartisan bill is pending in the House that would require the FDA to allow non-animal testing.

“It goes back to sunscreens being classified as over-the-counter drugs,” said Carl D’Ruiz, a senior manager at DSM-Firmenich, a Switzerland-based maker of sunscreen chemicals. “It’s really about giving the U.S. consumer something that the rest of the world has. People aren’t dying from using sunscreen. They’re dying from melanoma.”

Every hour, at least two people die of skin cancer in the United States. Skin cancer is the most common cancer in America, and 6.1 million adults are treated each year for basal cell and squamous cell carcinomas, according to the Centers for Disease Control and Prevention. The nation’s second-most-common cancer, breast cancer, is diagnosed about 300,000 times annually, though it is far more deadly.

Dermatologists Offer Tips on Keeping Skin Safe and Healthy

– Stay in the shade during peak sunlight hours, 10 a.m. to 4 p.m. daylight time.– Wear hats and sunglasses.– Use UV-blocking sun umbrellas and clothing.– Reapply sunscreen every two hours.You can order overseas versions of sunscreens from online pharmacies such as Cocooncenter in France. Keep in mind that the same brands may have different ingredients if sold in U.S. stores. But importing your sunscreen may not be affordable or practical. “The best sunscreen is the one that you will use over and over again,” said Jane Yoo, a New York City dermatologist.

Though skin cancer treatment success rates are excellent, 1 in 5 Americans will develop skin cancer by age 70. The disease costs the health care system $8.9 billion a year, according to CDC researchers. One study found that the annual cost of treating skin cancer in the United States more than doubled from 2002 to 2011, while the average annual cost for all other cancers increased by just 25%. And unlike many other cancers, most forms of skin cancer can largely be prevented — by using sunscreens and taking other precautions.

But a heavy dose of misinformation has permeated the sunscreen debate, and some people question the safety of sunscreens sold in the United States, which they deride as “chemical” sunscreens. These sunscreen opponents prefer “physical” or “mineral” sunscreens, such as zinc oxide, even though all sunscreen ingredients are chemicals.

“It’s an artificial categorization,” said E. Dennis Bashaw, a retired FDA official who ran the agency’s clinical pharmacology division that studies sunscreens.

Still, such concerns were partly fed by the FDA itself after it published a study that said some sunscreen ingredients had been found in trace amounts in human bloodstreams. When the FDA said in 2019, and then again two years later, that older sunscreen ingredients needed to be studied more to see if they were safe, sunscreen opponents saw an opening, said Nadim Shaath, president of Alpha Research & Development, which imports chemicals used in cosmetics.

“That’s why we have extreme groups and people who aren’t well informed thinking that something penetrating the skin is the end of the world,” Shaath said. “Anything you put on your skin or eat is absorbed.”

Adamson, the Austin dermatologist, said some sunscreen ingredients have been used for 30 years without any population-level evidence that they have harmed anyone. “The issue for me isn’t the safety of the sunscreens we have,” he said. “It’s that some of the chemical sunscreens aren’t as broad spectrum as they could be, meaning they do not block UVA as well. This could be alleviated by the FDA allowing new ingredients.”

Ultraviolet radiation falls between X-rays and visible light on the electromagnetic spectrum. Most of the UV rays that people come in contact with are UVA rays that can penetrate the middle layer of the skin and that cause up to 90% of skin aging, along with a smaller amount of UVB rays that are responsible for sunburns.

The sun protection factor, or SPF, rating on American sunscreen bottles denotes only a sunscreen’s ability to block UVB rays. Although American sunscreens labeled “broad spectrum” should, in theory, block UVA light, some studies have shown they fail to meet the European Union’s higher UVA-blocking standards.

“It looks like a number of these newer chemicals have a better safety profile in addition to better UVA protection,” said David Andrews, deputy director of Environmental Working Group, a nonprofit that researches the ingredients in consumer products. “We have asked the FDA to consider allowing market access.”

The FDA defends its review process and its call for tests of the sunscreens sold in American stores as a way to ensure the safety of products that many people use daily, rather than just a few times a year at the beach.

“Many Americans today rely on sunscreens as a key part of their skin cancer prevention strategy, which makes satisfactory evidence of both safety and effectiveness of these products critical for public health,” Cherie Duvall-Jones, an FDA spokesperson, wrote in an email.

D’Ruiz’s company, DSM-Firmenich, is the only one currently seeking to have a new over-the-counter sunscreen ingredient approved in the United States. The company has spent the past 20 years trying to gain approval for bemotrizinol, a process D’Ruiz said has cost $18 million and has advanced fitfully, despite attempts by Congress in 2014 and 2020 to speed along applications for new UV filters.

Bemotrizinol is the bedrock ingredient in nearly all European and Asian sunscreens, including those by the South Korean brand Beauty of Joseon and Bioré, a Japanese brand.

D’Ruiz said bemotrizinol could secure FDA approval by the end of 2025. If it does, he said, bemotrizinol would be the most vetted and safest sunscreen ingredient on the market, outperforming even the safety profiles of zinc oxide and titanium dioxide.

As Congress and the FDA debate, many Americans have taken to importing their own sunscreens from Asia or Europe, despite the risk of fake products.

“The sunscreen issue has gotten people to see that you can be unsafe if you’re too slow,” said Alex Tabarrok, a professor of economics at George Mason University. “The FDA is just incredibly slow. They’ve been looking at this now literally for 40 years. Congress has ordered them to do it, and they still haven’t done it.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Subscribe to KFF Health News’ free Morning Briefing.

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  • Shedding Some Obesity Myths

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Let’s shed some obesity myths!

    There are a lot of myths and misconceptions surrounding obesity… And then there are also reactive opposite myths and misconceptions, which can sometimes be just as harmful!

    To tackle them all would take a book, but in classic 10almonds style, we’re going to put a spotlight on some of the ones that might make the biggest difference:

    True or False: Obesity is genetically pre-determined

    False… With caveats.

    Some interesting results have been found from twin studies and adoption studies, showing that genes definitely play some role, but lifestyle is—for most people—the biggest factor:

    In short: genes predispose; they don’t predetermine. But that predisposition alone can make quite a big difference, if it in turn leads to different lifestyle factors.

    But upon seeing those papers centering BMI, let’s consider…

    True or False: BMI is a good, accurate measure of health in the context of bodyweight

    False… Unless you’re a very large group of thin white men of moderate height, which was the demographic the system was built around.

    Bonus information: it was never intended to be used to measure the weight-related health of any individual (not even an individual thin white man of moderate height), but rather, as a tool to look at large-scale demographic trends.

    Basically, as a system, it’s being used in a way it was never made for, and the results of that misappropriation of an epidemiological tool for individual health are predictably unhelpful.

    To do a deep-dive into all the flaws of the BMI system, which are many, we’d need to devote a whole main feature just to that.

    Update: we have now done so!

    Here it is: When BMI Doesn’t Measure Up

    True or False: Obesity does not meaningfully impact more general health

    False… In more ways than one (but there are caveats)

    Obesity is highly correlated with increased risk of all-cause mortality, and weight loss, correspondingly, correlates with a reduced risk. See for example:

    Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer: systematic review and meta-analysis

    So what are the caveats?

    Let’s put it this way: owning a horse is highly correlated with increased healthy longevity. And while owning a horse may come with some exercise and relaxation (both of which are good for the health), it’s probably mostly not the horse itself that conveys the health benefits… it’s that someone who has the resources to look after a horse, probably has the resources to look after their own health too.

    So sometimes there can be a reason for a correlation (it’s not a coincidence!) but the causative factor is partially (or in some cases, entirely) something else.

    So how could this play out with obesity?

    There’s a lot of discrimination in healthcare settings, unfortunately! In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.

    Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”

    Other things may be more systemic, for example:

    When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.

    That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:

    • Surgeons being untrained (and/or unwilling) to operate on fat people
    • Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
    • MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place

    …and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.

    It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.

    True or False: to reduce obesity, just eat less and move more!

    False… Mostly.

    Moving more is almost always good for most people. When it comes to diet, quality is much more important than quantity. But these factors alone are only part of the picture!

    But beyond diet and exercise, there are many other implicated factors in weight gain, weight maintenance, and weight loss, including but not limited to:

    • Disrupted sleep
    • Chronic stress
    • Chronic pain
    • Hormonal imbalances
    • Physical disabilities that preclude a lot of exercise
    • Mental health issues that add (and compound) extra levels of challenge
    • Medications that throw all kinds of spanners into the works with their side effects

    …and even just those first two things, diet and exercise, are not always so correlated to weight as one might think—studies have found that the difference for exercise especially is often marginal:

    Read: Widespread misconceptions about obesity ← academic article in the Journal of the College of Family Physicians of Canada

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  • Staying Strong: Tips To Prevent Muscle Loss With Age

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Andrea Furlan, specialist in physical medicine and rehabilitation with 30 years of experience, has advice:

    Fighting sarcopenia

    Sarcopenia is so common as to be considered “natural”, but “natural” does not mean “obligatory” and it certainly doesn’t mean “healthy”. As for how to fight it?

    You may be thinking “let us guess, is it eat protein and do resistance exercises? And yes it is, but that’s only part of it…

    Firstly, she recommends remembering why you are doing this, or because understanding is key to compliance (i.e. your perfect diet and exercise program will mean nothing if you don’t actually do it, and you won’t do it enough to make it a habit, let alone keep it up, if the reasons aren’t clear in your mind).

    Sarcopenia comes with an increased risk of falls, reduced physical capacity in general, resultant disability, social isolation, and depression. Of course, this is not a one-to-one equation; you will not necessarily become depressed the moment your muscle mass is below a certain percentage, but statistically speaking, the road to ruin is laid out clearly.

    Secondly, she recommends being on the lookout for it. If you check your body composition regularly with a gadget, that’s great and laudable; if you don’t, then a) consider getting one (here’s an example product on Amazon), and b) watch out for decreased muscle strength, fatigue, reduced stamina, noticeable body shape changes with muscle loss and (likely) fat gain.

    Thirdly, she recommends more than just regular resistance training and good protein intake. Yes, she recommends those things too, but also getting enough water (can’t rebuild the body without it), avoiding a sedentary lifestyle (sitting leads to atrophy of many supporting and stabilizing muscles, you know, the kind of muscles that don’t look flashy but stop you falling down), and getting good sleep—vital for all kinds of body maintenance, and muscle maintenance is no exception (there’s a reason bodybuilders sleep 9–12 hours daily when in a gaining phase; you don’t need to do that, but don’t skimp on your 7–9 hours, yes, really, even you, yes, at any age).

    Lastly, she recommends continuing to learn about the topic, as otherwise it’s easy to go off-track.

    For more information on all of the above and more, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • Regular Nail Polish vs Gel Nail Polish – Which is Healthier?

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    Our Verdict

    When comparing regular nail polish to gel nail polish, we picked the regular.

    Why?

    This one’s less about what’s in the bottle, and more about what gets done to your hands:

    • Regular nail polish application involves carefully brushing it on.
    • Regular nail polish removal involves wiping with acetone.

    …whereas:

    • Gel nail polish application involves deliberately damaging (roughing up) the nail to allow the color coat to adhere, then when the top coat is applied, holding the nails (and thus, the attached fingers) under a UV light to set it. That UV lamp exposure is very bad for the skin.
    • Gel nail polish removal involves soaking in acetone, which is definitely worse than wiping with acetone. Failure to adequately soak it will result in further damage to the nail while trying to get the base coat off the nail that you already deliberately damaged when first applying it.

    All in all, regular nail polish isn’t amazing for nail health (healthiest is for nails to be free and naked), but for those of us who like a little bit of color there, regular is a lot better than gel.

    Gel nail polish damages the nail itself by necessity, and presents a cumulative skin cancer risk and accelerated aging of the skin, by way of the UV lamp use.

    For your interest, here are the specific products that we compared, but the above goes for any of this kind:

    Regular nail polish | Gel nail polish

    If you’d like to read more about nail health, you might enjoy reading:

    The Counterintuitive Dos and Don’ts of Nail Health

    Take care!

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  • What are heart rate zones, and how can you incorporate them into your exercise routine?
  • Healthy Hormones And How To Hack Them

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Healthy Hormones And How To Hack Them!

    Hormones are vital for far more than they tend to get credit for. Even the hormones that people think of first—testosterone and estrogen—do a lot more than just build/maintain sexual characteristics and sexual function. Without them, we’d lack energy, we’d be depressed, and we’d soon miss the general smooth-running of our bodies that we take for granted.

    And that’s without getting to the many less-talked-about hormones that play a secondary sexual role or are in the same general system…

    How are your prolactin levels, for example?

    Unless you’re ill, taking certain medications, recently gave birth, or picked a really interesting time to read this newsletter, they’re probably normal, by the way.

    But, prolactin can explain “la petite mort”, the downturn in energy and the somewhat depressed mood that many men experience after orgasm.

    Otherwise, if you have too much prolactin in general, you will be sleepy and depressed.

    Prolactin’s primary role? In women, it stimulates milk production when needed. In men, it plays a role in regulating mood and metabolism.

    Read: What Causes High Prolactin Levels in Men?

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  • Make Your Negativity Work For You

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What’s The Right Balance?

    We’ve written before about positivity the pitfalls and perils of toxic positivity:

    How To Get Your Brain On A More Positive Track (Without Toxic Positivity)

    …as well as the benefits that can be found from selectively opting out of complaining:

    A Bone To Pick… Up And Then Put Back Where We Found It

    So… What place, if any, does negativity usefully have in our lives?

    Carrot and Stick

    We tend to think of “carrot and stick” motivation being extrinsic, i.e. there is some authority figure offering is reward and/or punishment, in response to our reactions.

    In those cases when it really is extrinsic, the “stick” can still work for most people, by the way! At least in the short term.

    Because in the long term, people are more likely to rebel against a “stick” that they consider unjust, and/or enter a state of learned helplessness, per “I’ll never be good enough to satisfy this person” and give up trying to please them.

    But what about when you have your own carrot and stick? What about when it comes to, for example, your own management of your own healthy practices?

    Here it becomes a little different—and more effective. We’ll get to that, but first, bear with us for a touch more about extrinsic motivation, because here be science:

    We will generally be swayed more easily by negative feelings than positive ones.

    For example, a study was conducted as part of a blood donation drive, and:

    • Group A was told that their donation could save a life
    • Group B was told that their donation could prevent a death

    The negative wording given to group B boosted donations severalfold:

    Read the paper: Life or Death Decisions: Framing the Call for Help

    We have, by the way, noticed a similar trend—when it comes to subject lines in our newsletters. We continually change things up to see if trends change (and also to avoid becoming boring), but as a rule, the response we get from subscribers is typically greater when a subject line is phrased negatively, e.g. “how to avoid this bad thing” rather than “how to have this good thing”.

    How we can all apply this as individuals?

    When we want to make a health change (or keep up a healthy practice we already have)…

    • it’s good to note the benefits of that change/practice!
    • it’s even better to note the negative consequences of not doing it

    For example, if you want to overcome an addiction, you will do better for your self-reminders to be about the bad consequences of using, more than the good consequences of abstinence.

    See also: How To Reduce Or Quit Alcohol

    This goes even just for things like diet and exercise! Things like diet and exercise can seem much more low-stakes than substance abuse, but at the end of the day, they can add healthy years onto our lives, or take them off.

    Because of this, it’s good to take time to remember, when you don’t feel like exercising or do feel like ordering that triple cheeseburger with fries, the bad outcomes that you are planning to avoid with good diet and exercise.

    Imagine yourself going in for that quadruple bypass surgery, asking yourself whether the unhealthy lifestyle was worth it. Double down on the emotions; imagine your loved ones grieving your premature death.

    Oof, that was hard-hitting

    It was, but it’s effective—if you choose to do it. We’re not the boss of you! Either way, we’ll continue to send the same good health advice and tips and research and whatnot every day, with the same (usually!) cheery tone.

    One last thing…

    While it’s good to note the negative, in order to avoid the things that lead to it, it’s not so good to dwell on the negative.

    So if you get caught in negative thought spirals or the like, it’s still good to get yourself out of those.

    If you need a little help with that sometimes, check out these:

    Take care!

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  • Allen Carr’s Easy Way to Quit Emotional Eating – by Allen Carr

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve reviewed books before on quitting drinking; is this book about emotional eating so different?

    There are overlaps, but important points of contrast, too. After all, alcohol and junk food are both often unhealthy coping mechanisms for other things, though:

    • Alcohol has in principle the stronger grip (making it harder to give up)
    • Junk food is so much easier to justify (making it harder to give up)

    Author Allen Carr is of course most well-known for his debut book about quitting smoking, and he brings a lot of that expertise to bear on the slightly different beast that is emotional eating.

    Focused on reframing quitting as being less about self-denial and more about self-liberation, he helps readers to understand that giving up a substance (in this case, junk food) does not mean giving up happiness—rather, it means finding happiness beyond it.

    If this book has a downside, it’s that some parts can be a little repetitive, and it can sometimes seem like one of those “this book could have been an article” situations.

    On the other hand, many people benefit from repeated messages to truly inculcate an idea, so this could be a positive for a lot of readers.

    Bottom line: if you’ve tried to eat more healthily but find that you keep reaching for an unhealthy comfort food, then this book may make a difference that other methods didn’t.

    Click here to check out The Easy Way To Quit Emotional Eating, and find your own freedom!

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