The Medical Letter on Drugs and Therapeutics
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ISSUE 1731
ISSUE 1731
June 23, 2025
Issue 1731
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Sunscreens
June 23, 2025 (Issue: 1731)
Excessive exposure to ultraviolet (UV) radiation can
cause erythema, photoaging, and skin cancer.
Sunscreens are widely used to reduce these risks, but
questions remain about their effectiveness and safety.
In 2021, the FDA proposed a rule that...more
- U Panich et al. Ultraviolet radiation-induced skin aging: the role of DNA damage and oxidative stress in epidermal stem cell damage mediated skin aging. Stem Cells Int 2016; 2016:7370642. doi:10.1155/2016/7370642
- M Arnold et al. Global burden of cutaneous melanoma attributable to ultraviolet radiation in 2012. Int J Cancer 2018; 143:1305. doi:10.1002/ijc.31527
- FDA. Proposed Order (OTC000008): Amending over-the-counter (OTC) monograph M020: sunscreen drug products for OTC human use. September 24, 2021. Available at: https://bit.ly/3SVWg3n.gov. Accessed June 2, 2025.
- RE Neale et al. Environmental effects of stratospheric ozone depletion, UV radiation, and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2020. Photochem Photobiol Sci 2021; 20:1. doi:10.1007/s43630-020-00001-x
- F Wang et al. Dermal damage promoted by repeated low-level UVA-1 exposure despite tanning response in human skin. JAMA Dermatol 2014; 150:401. doi:10.1001/jamadermatol.2013.8417
- US Preventive Services Task Force. Behavioral counseling to prevent skin cancer: US Preventive Services Task Force recommendation statement. JAMA 2018; 319:1134. doi:10.1001/jama.2018.1623
- American Academy of Dermatology. Shade, clothing, and sunscreen. Available at: https://bit.ly/4kqHQ7q. Accessed June 2, 2025.
- S Moradi Tuchayi et al. Sunscreens: misconceptions and misinformation. J Invest Dermatol 2023; 143:1406. doi:10.1016/j.jid.2023.03.1677
- H Ou-Yang et al. High-SPF sunscreens (SPF ≥70) may provide ultraviolet protection above minimal recommended levels by adequately compensating for lower sunscreen user application amounts. J Am Acad Dermatol 2012; 67:1220. doi:10.1016/j.jaad.2012.02.029
- LL Guan et al. Sunscreens and photoaging: a review of current literature. Am J Clin Dermatol 2021; 22:819. doi:10.1007/s40257-021-00632-5
- A new sunscreen agent. Med Lett Drugs Ther 2007; 49:41.
- CD D'Ruiz et al. Preliminary clinical pharmacokinetic evaluation of bemotrizinol – a new sunscreen active ingredient being considered for inclusion under FDA's over-the-counter (OTC) sunscreen monograph. Regul Toxicol Pharmacol 2023; 139:105344. doi:10.1016/j.yrtph.2023.105344
- SL Schneider and HW Lim. A review of inorganic UV filters zinc oxide and titanium dioxide. Photodermatol Photoimmunol Photomed 2019; 35:442. doi:10.1111/phpp.12439
- JB Mancuso et al. Sunscreens: an update. Am J Clin Dermatol 2017; 18:643. doi:10.1007/s40257-017-0290-0
- AB Lyons et al. Photoprotection beyond ultraviolet radiation: a review of tinted sunscreens. J Am Acad Dermatol 2021; 84:1393. doi:10.1016/j.jaad.2020.04.079
- S Abdel Azim et al. Sunscreens part 1: mechanisms and efficacy. J Am Acad Dermatol 2025; 92:677. doi:10.1016/j.jaad.2024.02.065
- A Jesus et al. Antioxidants in sunscreens; which and what for? Antioxidants (Basel) 2023; 12:138. doi:10.3390/antiox12010138
- L Rabinovich and V Kazlouskaya. Herbal sun protection agents: human studies. Clin Dermatol 2018; 36:369. doi:10.1016/j.clindermatol.2018.03.014
- M Sander et al. The efficacy and safety of sunscreen use for the prevention of skin cancer. CMAJ 2020; 192:E1802. doi:10.1503/cmaj.201085
- AR Young et al. Sub-optimal application of a high SPF sunscreen prevents epidermal DNA damage in vivo. Acta Derm Venereol 2018; 98:880. doi:10.2340/00015555-2992
- CG Watts et al. Sunscreen use and melanoma risk among young Australian adults. JAMA Dermatol 2018; 154:1001. doi:10.1001/jamadermatol.2018.1774
- AC Green et al. Reduced melanoma after regular sunscreen use: randomized trial follow-up. J Clin Oncol 2011; 29:257. doi:10.1200/jco.2010.28.7078
- LK Dennis. Cumulative sun exposure and melanoma in a population-based case-control study: does sun sensitivity matter? Cancers (Basel) 2022; 14:1008. doi:10.3390/cancers14041008
- KA McDonald et al. Review on photoprotection: a clinician's guide to the ingredients, characteristics, adverse effects, and disease-specific benefits of chemical and physical sunscreen compounds. Arch Dermatol Res 2023; 315:735. doi:10.1007/s00403-022-02483-4
- T Breakell et al. Ultraviolet filters: dissecting current facts and myths. J Clin Med 2024; 13:2986. doi:10.3390/jcm13102986
- S Suh et al. The banned sunscreen ingredients and their impact on human health: a systematic review. Int J Dermatol 2020; 59:1033. doi:10.1111/ijd.14824
- MK Matta et al. Effect of sunscreen application under maximal use conditions on plasma concentration of sunscreen active ingredients: a randomized clinical trial. JAMA 2019; 321:2082. doi:10.1001/jama.2019.5586
- MK Matta et al. Effect of sunscreen application on plasma concentration of sunscreen active ingredients: a randomized clinical trial. JAMA 2020; 323:256. doi:10.1001/jama.2019.20747
- JA Ruszkiewicz et al. Neurotoxic effect of active ingredients in sunscreen products, a contemporary review. Toxicol Rep 2017; 4:245. doi:10.1016/j.toxrep.2017.05.006
- H Kang et al. Urinary metabolites of dibutyl phthalate and benzophenone-3 are potential chemical risk factors of chronic kidney function markers among healthy women. Environ Int 2019; 124:354. doi:10.1016/j.envint.2019.01.028
- Australian Government Department of Health. Therapeutic Goods Administration. Literature review on the safety of titanium dioxide and zinc oxide nanoparticles in sunscreens. Scientific review report. Version 1.1, August 2016. Available at: https://bit.ly/4dBLx7P. Accessed June 2, 2025.
- YH Mohammed et al. Support for the safe use of zinc oxide nanoparticle sunscreens: lack of skin penetration or cellular toxicity after repeated application in volunteers. J Invest Dermatol 2019; 139:308. doi:10.1016/j.jid.2018.08.024
- A Hudspeth et al. Independent sun care product screening for benzene contamination. Environ Health Perspect 2022; 130:37701. doi:10.1289/ehp10386
- FDA. FDA alerts drug manufacturers to the risk of benzene contamination in certain drugs. February 24, 2025. Available at: https://bit.ly/4jHf55D. Accessed June 2, 2025.
- MS Chang et al. Sunscreen use is not associated with increased blood concentrations of benzene among adults in the United States: data from the National Health and Nutrition Examination Survey 2003-2006 and 2009-2018. J Am Acad Dermatol 2022; 87:440. doi:10.1016/j.jaad.2021.09.003
- CA Downs et al. Toxicopathological effects of the sunscreen UV filter, oxybenzone (benzophenone-3), on coral planulae and cultured primary cells and its environmental contamination in Hawaii and the U.S. Virgin Islands. Arch Environ Contam Toxicol 2016; 70:265. doi:10.1007/s00244-015-0227-7
- FDA. Environmental Impact Statement (EIS) for certain sunscreen drug products. October 13, 2021. Available at: https://bit.ly/3weZrFT. Accessed June 2, 2025.
- SL Schneider and HW Lim. Review of environmental effects of oxybenzone and other sunscreen active ingredients. J Am Acad Dermatol 2019; 80:266. doi:10.1016/j.jaad.2018.06.033
- D Fivenson et al. Sunscreens: UV filters to protect us: part 2-increasing awareness of UV filters and their potential toxicities to us and our environment. Int J Women's Dermatol 2021; 7:45. doi:10.1016/j.ijwd.2020.08.008
- FDA. Sunscreen: how to help protect your skin from the sun. August 16, 2024. Available at: https://bit.ly/4mAxbc1. Accessed June 2, 2025.
- M Ghazipura et al. Exposure to benzophenone-3 and reproductive toxicity: a systematic review of human and animal studies. Reprod Toxicol 2017; 73:175. doi:10.1016/j.reprotox.2017.08.015
- H Teiri et al. The association of prenatal exposure to benzophenones with gestational age and offspring size at birth. Environ Sci Pollut Res Int 2022; 29:24682. doi:10.1007/s11356-021-17634-9
- JC DiNardo and CA Downs. Can oxybenzone cause Hirschsprung's disease? Reprod Toxicol 2019; 86:98. doi:10.1016/j.reprotox. 2019.02.014
- RE Neale et al. The effect of sunscreen on vitamin D: a review. Br J Dermatol 2019; 181:907. doi:10.1111/bjd.17980
- T Passeron et al. Sunscreen photoprotection and vitamin D status. Br J Dermatol 2019; 181:916. doi:10.1111/bjd.17992
- AR Young et al. Optimal sunscreen use, during a sun holiday with a very high ultraviolet index, allows vitamin D synthesis without sunburn. Br J Dermatol 2019; 181:1052. doi:10.1111/bjd.17888
- Skin Cancer Foundation. Sun-protective clothing. April 2025. Available at: https://bit.ly/43ASyBa. Accessed June 2, 2025.
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