Is sunscreen safe for children?

Recent reports about sunscreen’s absorption into our bloodstreams have many parents wondering if sunscreen is safe for kids. Le Bonheur Children’s Hospital Chief of Pediatric Dermatology, Dr. Teresa Wright, discusses these new findings and important information for parents in the Le Bonheur podcast, Peds Pod. 

Five top questions explored in the podcast have been edited for clarity and brevity below.

Host: A new study released by the Food and Drug Administration found that the active ingredients in sunscreen may soak all the way into our bloodstreams. So, what is significant about this research?

Teresa Wright, MD (Guest): First of all, the important thing to understand when we talk about active ingredients in sunscreen is there are two broad categories. One of those is physical blockers; those are ingredients like zinc oxide and titanium dioxide. Physical blockers sit on the surface of the skin and reflect rays of the sun. The other class of ingredients is chemical and those are, to some degree, absorbed into the skin and they work by absorbing UV radiation and converting that to heat, which is dispersed via the skin. 

So, this study was only looking at chemical ingredients in sunscreens. It looked at four fairly common chemical ingredients and tried to answer the question, “Are these chemicals being absorbed through the skin into the bloodstream, and are they present in the bloodstream?” The study did show some level of those ingredients within the bloodstream and those levels appeared to increase during the few days following. I think it just looked at them over about a four day period with multiple blood samples.

So, basically, all researchers were able to conclude is that the chemicals are indeed present in the bloodstream. It’s still not clear whether it’s really a safety issue. There need to be further studies to determine whether there are any safety concerns. 

Host: What is worse—sunscreen in our bloodstream or the effects of sun on our skin?

Dr. Wright: Well, I think there’s a lot of evidence that the effects of sun on the skin can be dangerous. We know that excess sun exposure contributes to the development of a variety of skin cancers, including the most deadly form, which is melanoma. So, I think that in general, we should think of sunscreen as a good thing, and we should all be using it, but until these questions are answered, it’s really best to just stick with products that contain physical blocking ingredients. So, your active ingredient should be zinc oxide and or titanium dioxide. 

Host: What is the difference between UVA and UVB rays?

Dr. Wright: These are the two main wavelengths or forms of ultraviolet radiation that reach the earth from the sun. Basically, the UVA rays are longer, and they penetrate more deeply into the skin. For a long time, we’ve known that they are very important in photoaging effects of the skin—the wrinkling and sun spots we all see as we get older. Over the last few years, it’s also become apparent that UVA rays actually do contribute to increased risk of skin cancer as well. 

However, UVB rays are shorter rays. They tend to cause problems in the higher layers of the skin. They are ones responsible for sunburn. Those are the rays that are really playing the primary role in increasing your risk of skin cancers. UVB. But they both play a role and it’s important to use products that protect your skin from both those forms of UV radiation from the sun. 

Host: So, there are a lot of different sunscreens with long, long lists of ingredients. When we are standing in the store and we’re looking at the sunscreen, how do we know what is safe and what is unsafe?

Dr. Wright:  I would look for products that contain zinc oxide and or titanium dioxide as their active ingredients. And you want to look for broad spectrum coverage. I recommend an SPF, sun protection factor, minimum of 30. Many products, particularly if they are marketed for children, will be 50 or more. The American Academy of Pediatrics recommends a minimum of SPF 15, but I recommend 30 because you do get somewhat more protection from UVB radiation, particularly when you go from 15 to 30. Once you get above 50, you are really not getting a lot more bang for your buck, so you really don’t need to spend a lot of money for a product that claims to have SPF 100. 

The other thing is look for water resistance. There’s really no such thing as waterproof sunscreen. All are going to be somewhat susceptible to coming off with sweating and swimming, so they do need to be reapplied. We recommend reapplying at least every two hours, more often if you are sweating a lot or swimming.

The other things to look for I would say I typically prefer that you are using a lotion or a cream. Sticks can be good especially for delicate areas like the nose or tops of the ears or the part in the hair on the scalp. But there are also questions about sprays, and I find sometimes parents may not do a good job of applying a good layer with the spray because their kids are running around or jumping around, and you are not getting a good even layer with the spray. But there have also been some safety concerns about sprays and the possibility of inhalation, which could irritate the airways or cause some health problems in children. So, generally, I recommend avoiding sprays, if possible. 

Host: Is sunscreen more important for people with fairer skin and why is it important for people of all ethnicities and skin tones to protect themselves from the harms of UV rays?

Dr. Wright: It’s really important for everyone to pay attention to this and for everyone to be mindful about using sunscreen and not getting too much sun exposure. Definitely people with fairer skin are going to burn more easily than people with more pigment or melanin in their skin. However, the sun can still cause burns and damage in people with darker skin. And we know that those effects can be cumulative and that burns, particularly in childhood, have a significant impact on increasing your risk for skin cancer later in life, particularly melanoma. 

I really emphasize avoid burns at all costs. Never tan deliberately. And try to limit tanning as much as you can because tan skin is damaged skin and regardless of your background complexion, again, the damage from the UV rays of the sun is cumulative and everyone is at risk for skin cancers. Everyone, no matter what the color of their skin. 

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