Sunscreen Allergy and New FDA Labeling
A lot of attention has been focused over the past week on the new guidelines of sunscreen labeling. Current SPF ratings for sunscreens only reflect the protection against UVB light, which determines how long a person can be in the sun before burning. The higher the rating, the longer a person can stay in the sun. The new guidelines, which will take place over the next 12 months, will require sunscreen labels to be clearer.
Here Are a Few Key Points:
- Sunscreen products that pass FDA’s test for protection against UVA/UVB rays will be labeled as Broad Spectrum.
- Products with SPF values of 15 or higher may state they reduce the risk of skin cancer and early skin aging when used with other sun protection measures, and when used as directed.
- Products with SPF values between 2 and 14 may be labeled as Broad Spectrum if they meet the requirements, but can only say they help prevent sunburn.
- Sunscreen products that do not meet the Broad Spectrum guidelines, or have an SPF of 2 to 14 must include a warning that the product has not been shown to help prevent skin cancer or early skin aging.
- The terms waterproof, sweat-proof and sunblock are not permitted on the packaging.
- Labels may state a sunscreen product is water-resistant, but it must include the amount of time before reapplication (40 or 80 minutes).
- All sunscreens must have a Drug Facts section on the back and/or side of the package that includes Active Ingredients and Use Claims.
These changes will take place over the next 12 months, and you can call the FDA (800) 299-4786 for more info.
Generally, an SPF rating over 30 will block 97% of UVB radiation. However, UVA radiation, which is not currently labeled in sunscreens, maybe the reason for the increase in skin cancers, especially melanoma. Prolonged exposure to the sun, even if the person doesn’t burn, can still cause photodamage to the skin that has lasting consequences. The new Food and Drug Administration guidelines will take into account the sunscreen’s ability to protect against UVA radiation.
Sunscreen Allergies and the Effect of Medications
Many patients come to my office because they developed a severe rash after being in the sun. Some patients develop a rash or itching almost immediately after even a few minutes of sun exposure. My job as an NYC Allergist is to determine if the patient has a sunscreen allergy to chemicals in the product, such as PABA, or if the patient has an underlying medical problem that is causing a photosensitive reaction. In some cases, a patient may be taking a common medication that can be causing a photosensitive reaction. You would be surprised at some of the medications on that list: non-steroidal anti-inflammatory drugs like Motrin or Advil, thiazide diuretics used in many blood pressure pills and even antibiotics, such as tetracycline and ciprofloxacin have been associated with severe reactions.
Additionally, certain foods, if handled in the sun, can cause contact photosensitivity. This happened to me several years ago: I was on vacation in Florida and it was very hot. I was drinking bottled water and squeezing lemons in the water for flavor. A few days later I came back to New York and I discovered this creeping red rash on my right forearm. It was strange – it didn’t itch but it looked terrible. Despite being an NYC Allergy Doctor, I sought out another medical professional who astutely figured out that the rash was due to my using the lemons in the sun. Lemons contain psoralen and this natural photosensitizing chemical can cause ugly rashes. This can also occur with celery, so watch out if you are drinking those Bloody Mary’s at the beach!
The Effect of Perfume
Another area of contact photosensitivity can be from perfumes or colognes. These products can contain parabens and other chemicals that when exposed to sunlight cause rashes. I would strongly advise against putting anything but sunscreen on your skin when going into the sun for several hours. Unfortunately, the sunscreen itself can be another culprit for a photosensitive reaction. The higher the SPF the more likely the more chemicals in the sunscreen. The common chemicals that can cause allergic reactions are PABA, oxybenzone, and cinoxate. In my opinion, the ideal sunscreen with the least allergic potential and the best sun protection are products containing only zinc and titanium dioxide. Many companies make skin tone products with zinc and titanium dioxide and they can match your skin color. My key caveat is to wear old clothing when you use this sunblock because it is messy and I have stained many white shorts with tan-colored sunblock.
My final job as the Allergy Detective is to make sure my patients don’t have an underlying medical problem that is making them sun-sensitive. These conditions may include vitamin deficiencies, such as B6, which can cause skin rashes. Certain liver diseases allow for the accumulation of toxins in the blood and these will be more pronounced after sun exposure. Auto-immune conditions should be checked in anyone with chronic rashes after even mild sun exposure.
The good news is that some sun exposure can be a good thing. Vitamin D deficient patients are recommended to get 20 minutes of sun on their arms and legs without sunscreen to boost their levels of this important vitamin.
I wish you all a wonderful, fun and rash free summer!
The Allergy Detective
Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island