Ask the Expert: Elnaz Firoz, MD
Last summer, US Rep. Alexandria Ocasio-Cortez called for an unexpected revolution: an overhaul in the regulation of sunscreen, because the products in Europe and East Asia are more “advanced,” and “we deserve better.” Elnaz Firoz RES’13, MD, an assistant professor of dermatology and the medical director of inpatient and outpatient dermatology at The Miriam Hospital, says while consumers in other countries do have more sunscreen choices, they’re not necessarily better: “The good news is that we do have good options here.” Firoz is also the director of the Skin of Color Clinic, and stresses that regular sun protection is important for all skin types.
There are two kinds of sunscreens, mineral and chemical. Mineral sunscreens—zinc oxide and titanium dioxide—are physical blockers: they sit on the top layer of your skin and reflect UV rays. In the US, we have excellent mineral blockers that block both UVA and UVB rays, and different formulations that are meant to go on easily.
Europe and Asia have several different chemical sunscreens that we unfortunately do not have approval to use here. The FDA regulates sunscreen as a drug because it claims to impact health outcomes, whereas in many other countries, cosmetic industries don’t have to worry about approval before incorporating a sunscreen into an over-the-counter product. In 2021 the FDA said that, aside from mineral sunscreens,
there was not sufficient data to say with certainty that chemical sunscreens are safe or unsafe. The concern is that chemical sunscreen can be detected in the bloodstream due to absorption through the skin.
There’s also a different rating system internationally for sun protection. SPF only indicates a sunscreen’s ability to block UVB radiation; other countries’ sunscreens carry an additional rating for UVA. I advise my patients to find a broad-spectrum sunscreen that blocks both UVA and UVB, that’s at least SPF 30. Zinc oxide, a largely inert and photostable mineral, is both broad spectrum and safe. Chemical sunscreens are less photostable, meaning they degrade over time as they are exposed to UV radiation, and they absorb UV instead of reflect it.
