What active ingredients in United States (U.S.) sunscreens do dermatologists recommend or avoid?

From the Guidelines

Dermatologists generally recommend mineral-based sunscreens containing zinc oxide and titanium dioxide as first-line options for sun protection in the U.S. These physical blockers work immediately upon application, reflect UV rays away from the skin, and are less likely to cause irritation or allergic reactions. For those seeking chemical sunscreens, ingredients like avobenzone, homosalate, octisalate, and octocrylene are considered effective, as per general dermatological guidelines 1. However, dermatologists often advise patients to avoid certain ingredients due to potential side effects, such as para-aminobenzoic acid (PABA) for those who are sensitive to it 1. When selecting a sunscreen, look for:

• Broad-spectrum protection with SPF 30 or higher
• Water resistance if needed
• Formulations appropriate for your skin type, such as oil-free or non-comedogenic options for acne-prone skin, or fragrance-free formulations for sensitive skin The best sunscreen is ultimately one that you'll use consistently, applying approximately one ounce (enough to fill a shot glass) to cover exposed areas, reapplying every two hours or after swimming or sweating. It's also important to be aware of the expiration date of the sunscreen, as some ingredients may degrade over time 1. Additionally, more expensive does not necessarily mean better, and the effectiveness of a sunscreen is not determined by its price 1. It's crucial to follow the guidelines for sunscreen use, especially for individuals undergoing phototherapy, such as PUVA treatment, where sunscreen should not be used on the day of treatment and should be applied after treatment to protect against UV exposure 1. Overall, the key to effective sun protection is to choose a sunscreen that meets your individual skin needs and to use it consistently and correctly.

From the FDA Drug Label

Purpose Skin Protectant Sunscreen Water, Caprylyl Methicone, Methyl Trimethi cone, Butylene Glycol Dicaprylate/Dicaprate, Butyloctyl Salicylate, Ethylhexyl Isononanoate, Propanediol, Diisostearyl Malate, Polyglyceryl-4 Diisostearate/Polyhydroxystearate/Sebacate, Methyl Methacrylate Cross polymer, Alcohol Denat., Acrylates Copolymer, Disteardimonium Hectorite, Magnesium Sulfate, Polyglyceryl-6 Polyricinoleate, Aluminum Hydroxide, Stearic Acid, 1,2-Hexanediol, Triethoxycaprylylsilane, Ethylhexylglycerin, Tocopherol, Centella Asiatica Extract, Melaleuca Alternifolia (Tea Tree) Extract, Melaleuca Alternifolia (Tea Tree) Leaf Water, Melaleuca Alternifolia (Tea Tree) Leaf Extract, Melaleuca Alternifolia (Tea Tree) Flower/ Leaf/Stem Extract, Melaleuca Alternifolia (Tea Tree) Leaf Oil, Chromium Oxide Greens (CI 77288)

Dermatologists tend to recommend ingredients like zinc oxide 2 and titanium dioxide 3 in sunscreens.

• Zinc oxide is a skin protectant.
• Titanium dioxide is used as a sunscreen. However, the provided drug labels do not contain information on ingredients that dermatologists tend to avoid.

From the Research

Recommended Ingredients

• Titanium dioxide (TiO2) and zinc oxide (ZnO) are physical UV filters that are often recommended by dermatologists for their broad-spectrum protection against UVA and UVB radiation 4, 5, 6, 7, 8
• Avobenzone is a chemical UV filter that provides broad-spectrum protection, but its effectiveness can be affected by its photostability 6

Ingredients to Avoid

• Octinoxate (OMC) and oxybenzone are chemical UV filters that have raised concerns about their safety and potential toxicity 4, 7
• Octyl salicylate is another chemical UV filter that has been linked to skin irritation and other adverse effects 4

Safety Considerations

• Nanoparticles of TiO2 and ZnO have been shown to be safe and effective in sunscreens, but further studies are needed to fully understand their potential risks and benefits 5, 7, 8
• The use of nanosized particles in sunscreens has raised concerns about their potential penetration into the skin and their effects on human health 8
• Dermatologists should exercise caution when recommending sunscreens that contain potentially toxic or unstable ingredients 4, 7

Formulation Strategies

• The formulation of sunscreens can affect the stability and effectiveness of their active ingredients, such as avobenzone 6
• The use of photostabilizing agents and other formulation strategies can help to maintain the efficacy of sunscreens and minimize the potential risks associated with their use 6, 7