in the shade
- By Rachel Shabi
May 8, 2004
may prevent sunburn, but have you ever stopped to think what's in
as we do beneath a giant celestial tap, we might begrudge the
health mantra on overexposure to sunshine, but few of us would
want to dispute it. Only an estimated half of Britons actually
follow the sun-sense edicts, but it is probably safe to say that
we know them by rote: cover up, seek the shade, don't brave the
midday sun and always, always use a sunscreen. Otherwise, we are
told, we face the consequences of prematurely ageing our hides
and of increasing, dramatically, the likelihood of getting skin
Nobody likes wrinkles showing up before they're due, while skin
cancer is the most frequently occurring form of cancer in Britain.
It doesn't kill as often as other cancers, such as lung and breast,
but it nonetheless claims 2,120 lives each year, according to
Cancer Research UK. To suggest, therefore, that the sunscreen
mantra might be suspect just reeks of irresponsibility.
numbers of us are getting skin cancer - it has risen threefold
in the past 20 years - while too few of us are using sunscreens,
you'd think part of the public health mission would be to persuade
even more of us to slather on even greater quantities of those
sun protection factors (SPFs). But here's the curious thing: skin
cancer rates and sunscreen use have both been rising simultaneously.
mitigate that in plenty of perfectly reasonable ways. You could
say that we don't use the stuff properly, and that we now spend
more time on beaches and tennis courts, say, rather than down
mine shafts. You could argue that, since skin cancer takes years
to show up, it is too early to tell if modern, more protective
sunscreens are actually working. Or you could not mitigate at
all and say that the raised levels of both sunscreen use and skin
cancer is a paradox. And it's into that paradox that all the fears
have long been claiming that the chemicals commonly used in those
sunscreens may be more trouble than they're worth. Our use of
sunscreen products is more accurately described as a large-scale
abuse, since we treat them as a licence to sunbake with abandon.
most sunscreens are "broad-spectrum", meaning that they
protect against both ultraviolet-A (UVA) and ultraviolet-B (UVB)
rays. The former pass through clouds and glass, are responsible
for the sort of skin damage that shows up as premature ageing,
and have, in latter years, been linked to sunburn. UVB, meanwhile,
are the far stronger rays; though partly blocked by Britain's
cloud canopy during winter, UVB light is known as the "killer
ray" because it causes sunburn.
products we currently use are either chemical or physical sunscreens,
which, confusingly, are still chemicals. Dr Stephen Antczak, co-author
of Cosmetics Unmasked, a guide to safe and allergy-free products,
explains the distinction: "Physical screens contain reflective
materials that reflect the ultraviolet rays away from the skin;
chemical sunscreens contain UV absorbers that absorb the ultraviolet
rays and reduce their energy," he says.
Even a total
science dunce would guess that chemicals capable of changing ultraviolet
light are both complex and potent. "They all have gigantic
names, some of them going to two or three lines, so that manufacturers
have to invent trade names to fit them on to the labels,"
those names are still confounding: para-amino benzoic acid, cinnamates
and benzophenones are the three most commonly used in sunscreens.
The trouble with these sponge-like chemicals, according to Dr
John Knowland, a biochemist at Oxford University, is precisely
their mopping-up properties.
sunscreen that absorbs energy cannot destroy that energy, it has
to do something with it," he says. Knowland, among others,
is concerned that UV-absorbing screens react with light and then
interfere with the skin, causing DNA damage - one of the possible
causes of cancer.
for Garnier, owned by L'Oréal, which makes Ambre Solaire,
says, "Sunscreens do not cause DNA damage - it is the
UV light from the sun that could cause harm." And Dr
Mike Brown, sun-care scientific adviser for Boots, Britain's biggest
sunscreen manufacturer, says, "All the evidence I have
seen has used non-human DNA that is put in direct contact with
sunscreen, then irradiated. That's a totally unrealistic test."
moreover, reports that sunscreen chemicals, rather like the nicotine
in stop-smoking patches, can penetrate the skin. In Drop-Dead
Gorgeous: Protecting Yourself From The Hidden Dangers Of Cosmetics,
author Kim Erickson cites a lab study in Queensland, Australia,
where the common sunscreen chemical oxybenzone broke through the
skin's protective barrier.
at Sahlgrenska University in Sweden, meanwhile, found that benzophenone-3
(B-3), another chemical UV-absorber, showed up in the urine of
volunteers who had applied the recommended amount of a common
sunscreen - in some cases up to 48 hours later.
researchers testing five common sunscreen chemicals found that
they all behaved like the female hormone oestrogen. One of those
chemicals tested has been found in human breast milk, suggesting,
according to the Women's Environmental Network, that this substance
"is absorbed not just into but through our skin, and is accumulating
in our fatty tissue".
spokesperson says, "We are not aware of any validated
scientific research to support these claims."
Brown at Boots,
meanwhile, says, "Modern analytic techniques are extremely
sensitive at detecting molecules at extremely low levels. Just
because they are there, it doesn't mean they are going to be harmful."
He adds that the sunscreen ingredients used by Boots fall well
below EU guidelines on known no-risk levels.
We don't yet
know how worried to be, if at all. The researchers above are calling
for caution and more research. Similarly, we don't know if finding
these chemicals in fish, animals and water is bad news - although
we instinctively recoil at such information.
there is a similar level of confusion over non-chemical sunscreens,
the ones that diffuse, rather than absorb, UV light.
oxide, a common physical screen. This potent compound is also
used in self-cleaning windows, because it reacts with light to
break down organic matter such as dirt. The worry is that it similarly
breaks down human DNA, although manufacturers say they use a nicer
version of titanium oxide and coat it with silicates to avoid
such a possibility.
commission's scientific advisory body on cosmetics, meanwhile,
advises that titanium oxide, at guideline quantities, is "safe
for use in cosmetic products". More recently, this substance
has become one of the forerunners of nanotechnology, a process
that miniaturises substances so that they are less than a thousandth
of the size of a human hair.
The idea is
to make titanium oxide particles disappear, since in sunscreens
this compound has a habit of sitting visibly and unattractively
on the skin. But whether such shrunken particles could more readily
enter human cells, is an issue that, according to Knowland at
Oxford University, "has not yet been adequately addressed".
natural alternatives to sunscreens? It depends who you ask. The
Swedish researchers who tested UV-absorbing sunscreens recommend
that we switch to light-deflecting products. The Women's Environmental
Network cites Dr Hauschka, Weleda and Green People products as
clean, environmentally aware examples of these physical sunscreens.
The US company
TerrEssentials, meanwhile, makes a range of natural and organic
personal care products - but not sunscreen. One of its founders,
Diana Kay, says "We are not saying you should risk photo-ageing,
but we haven't found anything that we can recommend as a sunscreen."
a popular misconception that sunscreens protect against skin cancer,
although manufacturers never say this. Sunscreens have been shown,
in lab rats, to protect against squamous cell cancer, which is
one of the three types of skin cancer, occurring more frequently
than the potentially deadly melanomas, but far less than basal-cell
cancer - the most prevalent and most treatable form. For these
two skin cancers, even the World Health Organisation, in an obscure
report in 2000, reported insufficient evidence that sunscreen
works as a defence.
conclusion can be drawn about the cancer-preventive activity of
topical use of sunscreens against basal-cell carcinoma and cutaneous
melanoma," reported the WHO research panel, which included
scientists, medics and sunscreen manufacturers.
is that lab rats get only squamous cell cancer, so it's not possible
to test for the other types. Brown at Boots, however, says that
sunscreens are still expected to work to help prevent skin cancer.
Meanwhile, all manufacturers state that they are not responsible
for any misinformation over sunscreen and cancer prevention.
spokesperson says that it "does not and never has claimed
that sunscreens prevent cancer". It's the same story
at Boots: "We do not promote our products with reference
to skin cancer," says Brown, adding that the 1939 Cancer
Act bans such an association. What the products do say is that
they protect against burning UV rays. And, almost universally,
dermatologists advise that even a single case of sunburn will
increase your skin's susceptibility to skin cancer. Such a link,
however, has been questioned.
Berwick, head of the epidemiology and cancer prevention unit at
the University of New Mexico, reviewed the literature on sunburn
and skin cancer, and conducted her own, large-scale population
study, she found that, put simply, people couldn't be trusted.
we asked the same question at different times, people often gave
inconsistent answers about their sunburn history." Berwick
concludes that it is not the sunburn in itself, but the exposure
to UV light, even while wearing sunscreen, that is more likely
to be the risk factor. So why do we believe that sunscreens may
protect us from skin cancer? Because it's easier to, says professor
of dermatology Gasparro, who argues that the universal advice
on this subject assumes we are all going to react to the sun like
the mice used in lab tests. But in reality, the only categorically
mice-like people are fair-skinned, fair-haired and light-eyed.
biggest issue with skin cancer is your genes," he says.
"Some people may be able to stay out in the sun for longer
than others - but you can't give that out as a public health message."
The idea of conveying some kind of simple, cover-all-bases
message is, he says, what informs dermatologists' recommendations
on sunscreen use. However, in recent years dermatologists and
cancer research groups have demoted sunscreen to a third line
of defence - for occasions when you absolutely cannot cover up
or get out of the sun.
It might sound
obvious, but SPF ratings are accurate only if you apply the lotions
in the prescribed quantities of 2mg per cm squared - that's about
a sixth of a bottle each time you slap it on all over. And who
does that? Though we in Britain spend £168m on suncare products
per year, that more likely breaks down to a third of a bottle
each, per year.
simply say 'use more' is a daft thing to do, because people use
as much as they feel comfortable with," says Professor
Brian Diffey, clinical director of regional medical physics at
Newcastle general hospital. He suggests manufacturers should reduce
the amount of product used in test cases to reflect what people
use on the beach. But Brown says they can't - those SPF quantity
ratings are the same the world over and, while the EU is OK with
changing them, the US is not.
In any case,
the message our confused ears are hearing is that if we wear an
SPF of, say, 15, we can loll about in the sun for 15 times as
long as we ordinarily could without getting burned. The worry
is that we view sunscreen as some kind of invincible shield -
even though we don't know for sure that it is any such thing.
think that SPF ratings encourage us to see what we can get away
with in the sun. However, Brown counters, "We make a
lot of effort to say that sunscreens are just a part of your sun
defence strategy. We have changed the way we explain SPF and no
longer talk about it in terms of the '10 times longer in the sun'
those SPFs are popping up all over the place, in foundations,
moisturisers and lipsticks. Perhaps manufacturers stick the sunscreens
into these pots and potions just because they think we like it
- and will pay for it. But Antczak suggests a few alternate reasons.
First, loading moisturisers with sunscreens corroborates any product
claims on wrinkle management, since it is known that these screens
offer protection against the kind of premature ageing brought
on by exposure to UV light. Meanwhile, many everyday moisturisers
are actually skin peelers, which is how they make good the claim
of bestowing younger, fresher skin upon the user.
outer layer of skin cells is the one that protects you from UV
light," Antczak explains. "If you strip those
away with skin peelers, the light can penetrate into the skin
and cause damage such as premature ageing. SPFs are there to put
back the protection that the peelers strip away."
point on which there is any consensus, in a field seemingly saturated
with conflicting opinion, is this: in the dead of winter, there
is little reason to use sun-screen-enriched moisturiser or make-up
- and not just because the very idea of being 15 times more resistant
to a nonexistent sun is aggravating.
winter, we spend so much time indoors, and the amount of UV around
is dramatically less, so that there is no need to be using daily
SPF moisturisers," says Brown. Of course, the opinion
split emerges again from there on. Wearing sunscreen in winter
"is not going to do you any harm, but you are wasting
your money", claims Brown, while others pronounce it
unwise to overburden your face with chemicals about which very
little is known with any degree of certainty.
Kay at TerrEssentials
eschews the sunscreen-all-year-round approach and instead takes
the cover-up cotton shirt, wide-brimmed hat and shade-seeking
path to sun protection for precisely this reason: "I
would rather take my chance with Mother Nature than expose myself
to the chemicals of man."
sunscreen does not contain toxic chemicals and is endorsed by the
Cancer Prevention Coalition.