When it comes to ensuring safety in the sun, the natural options may not be so natural
When the sun is out, many of us feel we are doing our best to protect our skin by using suncreams. But some scientists believe that sunscreens may, in fact, encourage the dev-elopment of skin cancer. In addition, some of the chemicals in suncreams are oestrogenic and may be toxic to living cells.
Two basic types of creams are available: chemical sunscreens, which absorb ultra-violet (UV) light; and chemical sunblocks (usually based on minerals), which reflect or scatter UV light. In general, the higher the SPF (sun protection factor), the greater the number of chemicals. With more chemicals comes an increased risk of allergic reactions (Contact Dermat, 1997; 37: 221-32).
More worrying are the potential long-term risks. Sunscreen chemicals are easily absorbed into the bloodstream through the skin (Lancet, 1997; 350: 863-4; Br J Clin Pharmacol, 1999; 48: 635-7). Research showing that some sunscreens are toxic to living cells makes this possibility a particular concern. Lab tests by the Norwegian Radiation Protection Authority found that the sunscreen octyl methoxycinnamate (present in more than 90 per cent of suncreams) quickly killed animal cells exposed to light (New Sci, 7 October 2000).
While some believe that mineral sunblocks such as zinc oxide and titanium dioxide are 'better' because they are unlikely to be absorbed, Australian research suggests that microfine titanium dioxide particles can also be absorbed into the skin (Australas J Dermatol, 1996; 37: 185-7). What we don't know is the fate of these particles or their effect on the body once they are absorbed.
Environmental oestrogens and their effect on human health is a growing concern. Recently, Swiss researchers found that the most common UV-screening chemicals are adding to the burden. They tested six such chemicals: benzophenone-3, homo-salate, 4-methylbenzylidene camphor (4-MBC), octyl methoxycinnamate, octyl di-methyl-PABA and butyl methoxydibenzoylmethane (B-MDM).
In the lab, all but B-MDM behaved like oestrogen, making cancer cells grow more rapidly. In animals, 4-MBC had a particularly strong effect, doubling the rate of uterine growth before puberty (Environ Health Perspect, 2001; 109: 239-44).
Japanese research has also confirmed the oestrogenic potential of sunscreens (Toxi-cology, 2000; 156: 27-36). Critics argue that lab tests are not indicative of how the chemicals will behave in humans. Yet, with any other drugs, when a lab test indicates potential harm, it is customary to follow-up with human studies. In the multimillion dollar industry of sun protection, however, no one seems inclined to conduct research that might burst such a profitable bubble.
The melanoma myth
Most people are confused about why we use sunscreens in the first place. Used properly, a sunscreen will prevent sunburn-but the evidence of their effectiveness against most skin cancers is pretty thin (Am J Public Health, 1992; 82: 614-5). While sunscreens might reduce the risk of squamous cell carcinoma (Lancet, 1999; 354: 723-9; JAMA, 1994; 271: 1662-3), their effects on the more serious basal cell carcinoma and the deadly malignant melanoma are less clear.
The latest thinking is that sunscreens and sunblocks may actually increase the risk of melanoma (Int J Cancer, 2000; 87: 145-50; Ann Epidemiol, 1993; 3: 103-10; J Invest Dermatol Symp Proc, 1999; 4: 97-100). Other findings, however, dispute this (Br J Dermatol, 2002; 146 [Suppl 61]: 24-30; Ann Epidemiol, 2000; 10: 467). Also, it is not known whether it's the sunscreens themselves or the false sense of security they offer, encouraging fair-skinned indiv-iduals to stay out longer in the heat of the day, that is responsible for the association (J Natl Cancer Inst, 1999; 91: 1269-70).
Other theories on the skin-damaging effects of suncreams abound. Some resear-chers believe that the breakdown of oxybenzone by UV rays destroys or inhibits the skin's natural defence system against sunlight, leaving skin vulnerable to the skin-ageing free radicals caused by sun exposure (J Invest Dermatol, 1996; 106: 583-6).
Others believe that free radicals generated by the sunscreams themselves may be a problem. And even if your suncream ab-sorbs harmful UV photons, this energy still has to be discharged somewhere-usually directly onto the skin, potentially increasing the risk of sun-related skin damage and cancer (Mutat Res, 1999; 444: 49-60; Biol Rev Camb Philos Soc, 1999; 74: 311-45; FEBS Lett, 1997; 418: 87-90; FEBS Lett, 1993; 324: 309-13).
Natural sun protection?
Many 'natural' suncreams use ingredients such as plant oils and antioxidants such as vitamins E and C, believed to enhance the ability of skin cells to repair cellular and DNA damage due to UV exposure (Mol Car-cinog, 1999; 24: 169-76). There is also some evidence that, added to conventional formulas, vitamins C and E will enhance the effectiveness of chemical sunscreens (Acta Derm Venereol, 1996; 76: 264-8).
While evidence on topical antioxidants is thin, used as a supplement, they may bolster the skin's natural defences against sunlight. In one study, 2 g of vitamin C and 1000 IU of vitamin E daily reduced sunburn reactions. Interestingly, neither supplement on its own gave any protection against UV radiation, suggesting a synergistic relationship that we don't yet understand (J Am Acad Dermatol, 1998; 38: 45-8).
UV exposure depletes beta-carotene, making the skin more prone to sun damage. In a 12-week German study, 20 fair-skinned men and women took supplements of either 25 mg of mixed carotenoids alone or plus 500 IU of natural vitamin E. Tests using UV light showed that the carotenoids plus vitamin E provided the best protection (Am J Clin Nutr, 2000; 71: 795-8). In the US, beta-carotene is considered a safe and effective treatment for those with skin that is overly sensitive to sunlight due to a genetic disorder (JAMA, 1974; 228: 1004-8).
Clearing up SPF confusion
To better enjoy the summer sun, most of us are encouraged to look for products with a high SPF. In theory, the higher the SPF, the longer we can safely stay in the sun. So, an SPF of 15 means that you can sunbathe 15 times longer than without the sunscreen. But research shows that the protection provided by most products is often much less than suggested by the SPF (BMJ, 1996; 313: 942). This may be why sunscreen use is associated with a higher risk of melanoma (Eur J Cancer Prev, 1999; 8: 267-9).
This uncertainty as to whether sunscreens deliver the protection they promise has led some scientists to ask how much sun protection do we really need? Writing in the British Medical Journal (2000; 320: 176-7), Professor Brian Diffey, at Newcastle Gen-eral Hospital, stated his belief that for most people-even children and those who burn easily-a product with an SPF of 10 applied liberally would be more than adequate protection for a holiday without sunburn.
For this road test, we rounded up several 'natural' suncreams. We had no unrealistic expectations that any would contain all-natural ingredients since it is difficult (though not impossible) to make an effective suncream without using some synthetic or semisynthetic chemicals. We were mainly interested to see the context in which these chemicals were used. Was there a mineral or vegetable oil base? Were plasticisers or natural waxes used to help the product stick together and adhere to the body? Were synthetic perfumes or essential oils used?
Many of the products exceeded our expectations in their contents as well as feel-good factors (smell, ease of application), though most of these were more expensive than their high-street equivalents.
Our advice? When buying suncreams, never take marketing claims at face value, but always read the label to be sure of what you're getting.
Edelweiss Sun Lotion SPF 15
Distributor: Weleda (0115 944 8222
Price: lb8.45 for 200 mL
Ingredients: water, sesame oil, carrot extract, titanium dioxide, lysolecithin, Lentopodium alpinum (edelweiss) extract, alcohol, jojoba oil, tapioca starch, xanthan gum, alumina, stearic acid, fragrance (essential oils), limonene, linalool, benzyl benzoate, geraniol, citral, coumarine.
The Weleda water-resistant sun protection range contains absolutely no chemical sunscreens, only traditional mineral UV filters, which form a protective barrier against the sun's rays immediately after application.
The active ingredient in this particular product is titanium dioxide, which reflects both UVA and UVB radiation, Although there arequestions about titanium dioxide, based on the current evidence, it is still probably one of the safer sunblocking agents.
The addition of edelweiss, supposedly an antioxidant, is claimed to provide an extra UV filter, although we could find no published evidence to support this. Carrot extract, however, contains carotenoids, which have proven sun-care benefits. Specifically, carotenoids have been found to enhance the body's immune response to UV, thus decreasing skin damage when exposed to UV radiation.
This lotion is free of oestrogen-containing preservatives such as parabens as well as other types of chemicals that can irritate your skin. But an aluminium-containing preservative-alumina, or aluminium oxide-is used instead. The company assures us this is not absorbed by the skin, but can we be sure?
Overall, this was a popular product with our panel. The light, milky formula was easy to apply with a lovely summery scent blended from natural essential oils including lavender, palmarosa, sandalwood and ylang-ylang. We were also impressed with the recyclable packaging and, relatively speaking, a good price tag.
Edelweiss Sun Lotion SPF8
Distributor: Green People (01403 740 350 or www.greenpeople.co.uk)
Price: lb13.99 for 200 mL
Ingredients: aloe vera, herbal infusions of: green tea, olive leaf and purple cone flower, palm oil, sunflower oil, olive oil, corn and coconut wax extract, isoamyl p-methoxycinnamate, cetearyl alcohol (plant wax extract), glyceryl stearate (plant-derived), titanium dioxide, green tea extract, carrot seed oil, edelweiss, lavender oil, avocado oil, resin from myrrh, rosemary extract, phenoxyethanol, ethylhexylglycerin, citric acid, linalool, d-Limonene (from essential oil)
Green People has a solid reputation for formulating products with organic ingredients and using a minimum of synthetic chemicals. This product certainly lives up to that reputation. It is a rich blend of natural oils and plant extracts that rubs in easily, and has a light and pleasant fragrance.
Its sunscreens are based on cinnamates (semisynthetics derived from balsam of Peru, cocoa leaves, cinnamon leaves and storax trees) and titanium dioxide. Skin reactions to cinnamates are rare, but not unheard of, and cinnamates were among the oestrogenic compounds found in the Swiss study.
Nevertheless, this product is marketed as suitable for sensitive skins (aloe vera and lavender are both well known for their soothing properties). However, phenoxyethanol (a preservative) and ethylhexylglycerin (a preservative enhancer) may cause allergic/sensitivity reactions in some (Contact Dermatitis, 2002; 47: 169; Ceska Slov Farm, 2004; 53: 151-6).
The full range of Green People sun products includes creams with a variety of SPFs, a tan-accelerating lotion and a range of products just for children.
Sunscreen Lotion SPF 8
Distributor: Dr Hauschka (0138 679 1022 or www.drhauschka.co.uk)
Price: lb10 for 100 mL
Ingredients: water, alcohol, shea butter, sweet almond oil, jojoba oil, quince seed extract, horse chestnut bark extract, peanut oil, sucrose stearate, lecithin, hectorite, fragrance (essential oil), linalool, citral, citronellol, geraniol, limonene, farnesol, benzyl benzoate, xanthan gum, esculin, propolis wax, stearic acid, aluminium hydroxide; active ingredient: titanium dioxide
Dr Hauschka lies at the luxury end of the natural cosmetics market, so we were surprised at our first impression-it feels great, but smells odd, like the herbs it contains, especially the traditional herbal sunscreen horse chestnut. This carefully formulated product has lots of natural oils, making it a good moisturiser, few synthetic ingredients and no chemical sunscreens. It also contains esculin, a component of horse chestnut, which is known to reduce inflammation and improve circulation. For sun protection, it uses titanium dioxide.
The only downside is the use of aluminium hydroxide - to coat the titanium dioxide and allow for even application. As with aluminium antiperspirants, there's a question mark over whether this is absorbed into the bloodstream.
This is a highly rated product-and the only one to recommend a variety of other ways to protect against sun damage on the packaging.
Daily Light Guard SPF 15
Distributor: Aveda (020 7297 6350)
Price: lb16 for 150 mL
Ingredients: aqueous extracts of Aloe barbadensis leaf, lavender, calendula, cone flower and bladderwrack, ethylhexyl methoxycinnamate, C12-15 alkyl benzoate, benzophenone-3, caprylic/capric triglyceride, steareth-21, glycerin, steareth-2, titanium dioxide, cetyl alcohol, glyceryl stearate, shea butter, jojoba oil, hazelnut oil, panthenol, bisabolol, oryzanol, tocopheryl acetate, xanthan gum, fragrance (parfum), polyhydroxystearic acid, glyceryl laurate, dimethicone, magnesium aluminum silicate, alumina, silica, disodium EDTA, benzyl alcohol, sodium benzoate, methylparaben, propylparaben, butylparaben, isobutylparaben, isopropylparaben, sorbic acid, chlorphenesin
Another high-end product, preferred by those willing to spend a little more to feel a little more pampered, this pleasant-to-use product is based on semisynthetic fatty acids derived from natural sources as well as silicones and natural oils, with plant ex-tracts to help repair sun damage.
However, it contains three sunscreening/ blocking agents-two with oestrogenic potential-and we wonder if this is overkill. Like the Weleda and Dr Hauschka products, it also contains aluminium. Applied in large quantities over much larger areas of the body, is this absorbed? We can only hope someone will one day bother to find out for sure.
We were also disappointed by the inclusion of so many potentially oestrogenic and skin-irritating preservatives.
Nice, but there are simpler mixtures that are just as effective-and cheaper.
Protect it! Sun lotion spf 6
Distributor: The Body Shop
Price: lb2.25 for 150 mL
Ingredients: water, isononyl isononanoate, octyl stearate, cyclopentasiloxane, cetyl PEG/PPG-10/1 dimethicone, sorbitan olivate, zinc oxide, decyl olive esters, glycerin, aluminium/magnesium hydroxide stearate, cetyl dimethicone, phenoxyethanol, titanium dioxide, PEG-10 dimethicone, sodium chloride, tocopheryl acetate, methylparaben, propylparaben, parfum, dimethicone, bisabolol, xanthan gum, methicone alumina, olea europaea, limonene, hexyl cinnamal, linalool, hydroxyisohexyl 3-cyclohexene carboxaldehyde, butylphenyl methylpropional, geraniol, citronellol, hydroxycitronellal, citral, farnesol, cinnamyl alcohol
The Body Shop has made its name on a reputation for natural products, but there is nothing particularly natural about this one. On the upside, it contains antioxidants vitamin E and olive leaf extract, and uses 100 per cent mineral sunscreens - zinc oxide (a good broad-spectrum sunblock) and titanium dioxide. But there are loads of preservatives, including methylparaben, propylparaben (both oestrogenic) and phenoxyethanol (potentially allergy-inducing). It also includes PPG (propylene glycol) and PEG (polyethylene glycol) - synthetic petrochemical emulsifiers that can cause allergic reactions - plus aluminium.
Although the product goes on the skin well, the use of silicone as a water-binding agent can inhibit the skin's ability to breathe and moisturise itself.
This was the least expensive product we tested, but it was also one of the least appealing.
How much is enough?
The average adult should be applying around 35 mL (equivalent to 7 tsp) per whole body application. But many consumers only apply a thin layer of cream per application, another reason why the SPF can be misleading. The manufacturer's SPF is based on a standard thickness test that doesn't resemble its use in the real world-usually around a quarter of what is needed to provide protection. The high price of sunscreens is cited as one reason for this. A recent Consumers Association report (Which?, 2001; June: 8-10) found that buying name-brand suncreams was prohibitively expensive-as much as lb60 per person for a week's holiday. Nevertheless, this underuse phenomenon has been observed even when the sunscreens are given away free (J Natl Cancer Inst, 1999; 15: 1304-9). The recent development of 'once-a-day' sun products is unlikely to help reverse this trend.
We need sun. As little as 15 minutes of exposure triggers the synthesis of valuable vitamin D in the body that is necessary to prevent diseases such as osteoporosis, diabetes, arthritis, depression, obesity and even autoimmune diseases. According to a recent review, sunlight exposure may even prevent death from a range of reproductive and digestive cancers (Cancer, 2002; 94: 1867-75). Most sunscreens block this synthesis. If you intend to be out in the sun for extended periods of time, in addition to suncream, consider staying out of the sun between 11 am and 3 pm, and wearing protective clothing.
Specially designed clothing (reputed to block ultraviolet rays), however, is expensive and not necessary. Most summer clothes provide an SPF of more than 10. According to one report, measurements of over 5000 fabrics submitted for testing to the Australian Radiation Laboratory showed that 97 per cent of fabrics fell into this category. In fact, more than 85 per cent of the fabric samples had an SPF of 20 or higher (Gies HP et al. , Textiles and sun protection, in: Volkmer B et al. , eds, Environmental UV Radiation, Risk of Skin Cancer and Primary Prevention , Stuttgart: Gustav Fischer, 1996: 213-34).