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Sunscreen
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=== Risks === In February 2019, the US [[Food and Drug Administration]] (FDA) started classifying already approved UV filter molecules into three categories: those which are [[generally recognized as safe and effective]] (GRASE), those which are non-GRASE due to safety issues, and those requiring further evaluation.<ref>{{Cite journal |last1=Sabzevari|first1=Nina|last2=Qiblawi|first2=Sultan|last3=Norton|first3=Scott A.|last4=Fivenson|first4=David|date=2020-05-26 |title=Sunscreens: UV filters to protect us: Part 1: Changing regulations and choices for optimal sun protection|journal=International Journal of Women's Dermatology|language=en |volume=7 |issue=1 |pages=28β44 |doi=10.1016/j.ijwd.2020.05.017|pmid=33537394 |pmc=7838247 }}</ref> As of 2021, only zinc oxide and titanium dioxide are recognized as GRASE.<ref>{{Cite journal | author = Center for Drug Evaluation and Research |date=2021-11-16 |title=Questions and Answers: FDA posts deemed final order and proposed order for over-the-counter sunscreen |url=https://www.fda.gov/drugs/understanding-over-counter-medicines/questions-and-answers-fda-posts-deemed-final-order-and-proposed-order-over-counter-sunscreen |archive-url=https://web.archive.org/web/20210924142839/https://www.fda.gov/drugs/understanding-over-counter-medicines/questions-and-answers-fda-posts-deemed-final-order-and-proposed-order-over-counter-sunscreen |url-status=dead |archive-date=September 24, 2021 |journal=FDA |language=en}}</ref> Two previously approved UV filters, para-aminobenzoic acid (PABA) and trolamine salicylate, were banned in 2021 due to safety concerns. The remaining FDA approved active ingredients were put in the third category as their manufacturers have yet to produce sufficient safety data β despite the fact that some of the chemicals have sold in sunscreen products for more than 40 years.<ref name="researchgate.net"/> Some researchers argue that the risk of sun-induced skin cancer outweighs concerns about toxicity and mutagenicity,<ref>{{cite journal | vauthors = Nepalia A, Singh A, Mathur N, Kamath R, Pareek S, Agarwal M | title = Skincare Products as Sources of Mutagenic Exposure to Infants: An Imperative Study Using a Battery of Microbial Bioassays | journal = Archives of Environmental Contamination and Toxicology | volume = 80 | issue = 2 | pages = 499β506 | date = February 2021 | pmid = 33523258 | doi = 10.1007/s00244-021-00814-6 | bibcode = 2021ArECT..80..499N | s2cid = 231746171 }}</ref><ref>{{Cite web | vauthors = Brown J |title=Sunscreen: What science says about ingredient safety |url=https://www.bbc.com/future/article/20190722-sunscreen-safe-or-toxic |access-date=2023-08-02 |website=www.bbc.com |date=July 23, 2019 |language=en}}</ref> although environmentalists say this ignores "ample safer alternatives available on the market containing the active ingredient minerals zinc oxide or titanium dioxide", which are also safer for the environment.<ref>{{Cite web | vauthors = Ige D, Char E |title=State of Hawaii, Department of Health, Testimony Commenting on hb1519, Relating to Sunscreen, House Committee on Energy & Environmental Protection |url=https://www.capitol.hawaii.gov/sessions/Session2022/Testimony/HB1519_TESTIMONY_EEP_02-08-22_.PDF | date = 8 February 2022 }}</ref> Regulators can investigate and ban UV filters over safety concerns (such as [[Para-aminobenzoic acid|PABA]]), which can result in withdrawal of products from the consumer market.<ref name="lim" /><ref>{{cite journal | vauthors = Lim HW, Mohammad TF, Wang SQ | title = Food and Drug Administration's proposed sunscreen final administrative order: How does it affect sunscreens in the United States? | journal = Journal of the American Academy of Dermatology | volume = 86 | issue = 2 | pages = e83βe84 | date = February 2022 | pmid = 34606770 | doi = 10.1016/j.jaad.2021.09.052 | s2cid = 238355497 | doi-access = free }}</ref> Regulators, such as the TGA and the FDA, have also been concerned with recent reports of contamination in sunscreen products with known possible human carcinogens such as [[benzene]] and [[benzophenone]].<ref>{{Cite web |title=Sunscreens - ensuring products are effective and safe for the 2021-22 summer |url=https://www.tga.gov.au/news/news/sunscreens-ensuring-products-are-effective-and-safe-2021-22-summer |website=TGA (Therapeutic Goods Administration)|date=June 21, 2022 }}</ref> Independent laboratory testing carried out by Valisure found benzene contamination in 27% of the sunscreens they tested, with some batches having up to triple the FDA's conditionally restricted limit of 2 parts per million (ppm).<ref>{{Cite web |title=Valisure |url=https://www.valisure.com/valisure-newsroom/valisure-detects-benzene-in-sunscreen |access-date=2023-09-01 |website=www.valisure.com |language=en}}</ref> This resulted in a voluntary recall by some major sunscreen brands that were implicated in the testing, as such, regulators also help publicise and coordinate these voluntary recalls.<ref>{{Cite web | author = Center for Drug Evaluation and Research |date=2023-01-30 |title=Edgewell Personal Care Issues Voluntary Nationwide Recall of Banana Boat Hair & Scalp Sunscreen Due to the Presence of Benzene |url=https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/edgewell-personal-care-issues-voluntary-nationwide-recall-banana-boat-hair-scalp-sunscreen-due |access-date=2023-09-01 |website=www.fda.gov |language=en}}</ref> VOC's (Volatile Organic Compounds) such as benzene, are particularly harmful in sunscreen formulations as many active and inactive ingredients can increase permeation across the skin.<ref>{{cite journal | vauthors = Pal VK, Lee S, Kannan K | title = Occurrence of and dermal exposure to benzene, toluene and styrene in sunscreen products marketed in the United States | journal = The Science of the Total Environment | volume = 888 | pages = 164196 | date = August 2023 | pmid = 37201845 | doi = 10.1016/j.scitotenv.2023.164196 | pmc = 10330564 | bibcode = 2023ScTEn.88864196P}}</ref> Butane, which is used as a propellant in spray sunscreens, has been found to have benzene impurities from the refinement process.<ref>{{cite news |title=What is benzene, and why does it keep causing beauty product recalls? |url=https://www.washingtonpost.com/wellness/2023/02/01/benzene-aerosol-recalls-sunscreen-shampoo/ |access-date=3 September 2023 |newspaper=The Washington Post |date=1 February 2023}}</ref> There is a risk of an allergic reaction to sunscreen for some individuals, as "Typical allergic contact dermatitis may occur in individuals allergic to any of the ingredients that are found in sunscreen products or cosmetic preparations that have a sunscreen component. The rash can occur anywhere on the body where the substance has been applied and sometimes may spread to unexpected sites."<ref>{{Cite web |url=https://www.dermnetnz.org/topics/sunscreen-allergy/ |title=Sunscreen allergy |website=DermNet NZ |access-date=2019-09-17 |archive-date=October 31, 2020 |archive-url=https://web.archive.org/web/20201031201843/https://www.dermnetnz.org/topics/sunscreen-allergy/ |url-status=live }}</ref> ==== Vitamin D production ==== There are some concerns about potential [[vitamin D deficiency]] arising from prolonged use of sunscreen.<ref>{{cite journal | vauthors = Pfotenhauer KM, Shubrook JH | title = Vitamin D Deficiency, Its Role in Health and Disease, and Current Supplementation Recommendations | journal = The Journal of the American Osteopathic Association | volume = 117 | issue = 5 | pages = 301β305 | date = May 2017 | pmid = 28459478 | doi = 10.7556/jaoa.2017.055 | s2cid = 19068865 | doi-access = free }}</ref><ref>{{Cite web|date=2017-05-03|title=Sunscreen may cause vitamin D deficiency, says study|url=https://www.medicalnewstoday.com/articles/317278|access-date=2021-10-27|website=www.medicalnewstoday.com|archive-date=October 27, 2021|archive-url=https://web.archive.org/web/20211027150118/https://www.medicalnewstoday.com/articles/317278|url-status=live}}</ref> The typical use of sunscreen does not usually result in vitamin D deficiency; however, extensive usage may.<ref>{{cite journal | vauthors = Norval M, Wulf HC | title = Does chronic sunscreen use reduce vitamin D production to insufficient levels? | journal = The British Journal of Dermatology | volume = 161 | issue = 4 | pages = 732β736 | date = October 2009 | pmid = 19663879 | doi = 10.1111/j.1365-2133.2009.09332.x | s2cid = 12276606 }}</ref> Sunscreen prevents ultraviolet light from reaching the skin, and even moderate protection can substantially reduce vitamin D synthesis.<ref>{{cite journal | vauthors = Holick MF | title = Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease | journal = The American Journal of Clinical Nutrition | volume = 80 | issue = 6 Suppl | pages = 1678Sβ1688S | date = December 2004 | pmid = 15585788 | doi = 10.1093/ajcn/80.6.1678S | doi-access = free }}</ref><ref>{{cite journal | vauthors = Sayre RM, Dowdy JC | title = Darkness at noon: sunscreens and vitamin D3 | journal = Photochemistry and Photobiology | volume = 83 | issue = 2 | pages = 459β463 | year = 2007 | pmid = 17115796 | doi = 10.1562/2006-06-29-RC-956 | s2cid = 23767593 }}</ref> However, adequate amounts of vitamin D can be obtained via diet or supplements.<ref>{{Cite web|date=2017-10-23|title=Vitamin D|url=https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/|access-date=2022-02-17|website=nhs.uk|language=en|archive-date=December 22, 2021|archive-url=https://web.archive.org/web/20211222112245/https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/|url-status=live}}</ref> Vitamin D overdose is impossible from UV exposure due to an equilibrium the skin reaches in which vitamin D degrades as quickly as it is created.<ref>{{cite journal | vauthors = Holick MF |date=February 2002 |title=Vitamin D: the underappreciated D-lightful hormone that is important for skeletal and cellular health |journal=Current Opinion in Endocrinology, Diabetes and Obesity |volume=9 |issue=1 |pages=87β98 |doi=10.1097/00060793-200202000-00011|s2cid=87725403 }}</ref><ref>{{cite journal | vauthors = Holick MF | title = Sunlight and vitamin D: both good for cardiovascular health | journal = Journal of General Internal Medicine | volume = 17 | issue = 9 | pages = 733β735 | date = September 2002 | pmid = 12220371 | pmc = 1495109 | doi = 10.1046/j.1525-1497.2002.20731.x }}</ref><ref>{{cite journal | vauthors = Holick MF | title = Vitamin D deficiency | journal = The New England Journal of Medicine | volume = 357 | issue = 3 | pages = 266β281 | date = July 2007 | pmid = 17634462 | doi = 10.1056/NEJMra070553 | s2cid = 18566028 }}</ref> High-SPF sunscreens filter out most UVB radiation, which triggers vitamin D production in the skin. However, clinical studies show that regular sunscreen use does not lead to vitamin D deficiency. Even high-SPF sunscreens allow a small amount of UVB to reach the skin, sufficient for vitamin D synthesis. Additionally, brief, unprotected [[sun exposure]] can produce ample vitamin D, but this exposure also risks significant DNA damage and skin cancer. To avoid these risks, vitamin D can be obtained safely through [[Diet (nutrition)|diet]] and supplements. Foods like [[Oily fish|fatty fish]], fortified milk, and orange juice, along with supplements, provide necessary vitamin D without harmful sun exposure. <ref>{{cite web |title=Does Sunscreen Use Lead to Vitamin D Deficiency? |url=https://www.skincancer.org/blog/sun-protection-and-vitamin-d/#:~:text=UVB%20wavelengths%20happen%20to%20be,maintain%20their%20vitamin%20D%20levels. |website=The Skin Cancer Foundation | date=March 14, 2019 |access-date=2024-07-19}}</ref> Studies have shown that sunscreen with a high UVA protection factor enabled significantly higher vitamin D synthesis than a low UVA protection factor sunscreen, likely because it allows more UVB transmission.<ref>{{Cite web|url=https://www.genengnews.com/news/are-vitamin-d-levels-jeopardized-by-sunscreen/|title=Are Vitamin D Levels Jeopardized by Sunscreen?|date=2019-05-10|website=GEN - Genetic Engineering and Biotechnology News|access-date=2019-05-18|archive-date=November 8, 2020|archive-url=https://web.archive.org/web/20201108002757/https://www.genengnews.com/news/are-vitamin-d-levels-jeopardized-by-sunscreen/|url-status=live}}</ref><ref>{{cite journal | vauthors = Young AR, Narbutt J, Harrison GI, Lawrence KP, Bell M, O'Connor C, Olsen P, Grys K, Baczynska KA, Rogowski-Tylman M, Wulf HC, Lesiak A, Philipsen PA | display-authors = 6 | title = Optimal sunscreen use, during a sun holiday with a very high ultraviolet index, allows vitamin D synthesis without sunburn | journal = The British Journal of Dermatology | volume = 181 | issue = 5 | pages = 1052β1062 | date = November 2019 | pmid = 31069787 | pmc = 6899952 | doi = 10.1111/bjd.17888 | s2cid = 148570356 }}</ref>
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