Congress could expand the number and kinds of sunscreens available to buy in the U.S.

A bipartisan effort in the U.S. House and Senate would increase the number and kinds of sunscreens available to buy in this country.

Generally speaking, the U.S. has stricter rules than do other countries about the ingredients that are allowed to be used in over-the-counter sunscreens and the kinds of testing needed to be done on them before they’re allowed to be sold here.

The proposed measure would streamline those issues. Supporters say it would allow Americans to take advantage of advancements in sunscreens from other parts of the world.

Critics, though, worry about whether those new sunscreens are safe to use.

Dr. Josh Tournas, a board-certified dermatologist with Banner Health, joined The Show to talk about it.

Full conversation

MARK BRODIE: Dr. Tournas, what do you make of these efforts to allow the kinds of sunscreens that are sold in other parts of the world to also be sold here?

JOSH TOURNAS: I think it's great. I think it's, you know, it's come back up in the news. The FDA has tried to at times to amend the OTC monograph or sunscreens and or something in the CARES Act where they were trying to make some modifications to it. But we really haven't approved a new sunscreen ingredient for over 20 or 25 years. And, so we are falling a little bit behind the times.

Europe has a lot more sunscreen ingredients approved than we do. Most of them are in the chemical sunscreen category. You know, broadly, we lump sunscreens into two different categories: chemical sunscreens, which are more, absorbers of the UV light, as opposed to your mineral or physical sunscreens, which tend to be reflectors of the UV light.

I think that opening up the possibility for responsible, safe approvals of more ingredients and making that a little bit easier, and kind of leveling the playing field from our partners and other developed countries I think is is only a benefit to patients. Because I think, you know, I tell people, you know, the best sunscreen is the one you're going to use.

So having more choices and more things that people's skin can tolerate is a net benefit for preventing sun damage. And especially what I specialized in: skin cancer.

BRODIE: Well, for people who are inclined to use sunscreen anyway — regardless of, you know, where they can get it or what kind it is. I'm wondering if you think if, for example, we were able to get and use the kinds of sunscreens, for example, they have in Europe, would that make things better for us here? Like would that reduce the incidence, for example, of skin cancer in a sunny place like Phoenix? 

TOURNAS: Absolutely. I think that if you have a wider range of ingredients that are going to be tolerable to patients or people, I call them patients because I'm a physician, but to people that use them. The more choices we have, the more cosmetically elegant and lighter feeling ingredients that we can have that people who are hesitant to use sunscreens that might be a little thicker or a little creamier. Maybe people that have acne-prone skin and things of that nature.

I think the more choices we have and the better filters we have available, the more likely we are to see people use them and use them regularly. And that, in my mind, is going to turn into a decrease of the incidence of skin cancer.

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Banner Health

BRODIE: Is it safe to say that that it's not unheard of that you would have to have a conversation with a patient about how that patient should be wearing sunscreen?

TOURNAS: Absolutely. It's a daily occurrence in my practice of skin cancer surgery. We — especially if it's somebody I'm seeing for the first time with their first skin cancer — we talk about prevention and, you know, good sunscreen use. Because that can certainly lower your risk over time. ... I think it's important to say that, you know, sun damage is something that builds over years. It's not just one sunburn you got. It's not just when you're a kid. It's not just when you're at the beach. So being good with it and using it steadily over time is really going to be a net benefit to you.

BRODIE: Yeah. Well, so what reasons do people give you for not wearing sunscreen? 

TOURNAS: "It's too much work to reapply. It's greasy. I don't like it. It messes with my golf grip. I'm just outside for 30 minutes." You know, it's all of those things. "I spend most of my time in the car." You know, all of these things are things that we hear.

You know, I think it's important that, you know, we cover. Especially living in a place like Arizona. You cover your exposed skin when you leave the house. You know, the windows of your car don't do a great job of blocking cancer-causing ultraviolet A rays. They do a really decent job of blocking ultraviolet B rays. It's probably not a perfect analogy, but I call kind of a UVA your aging and cancer-causing rays and B your burning rays that give you a sunburn.

They both matter for both things, but, you're not going to get a sunburn behind the windows of your car, but you are getting cancer-causing rays, and so sunscreen, you know, when you're in your daily commute, is is something that I recommend to people. You know, and also tinted windows is a great other measure, especially here.

BRODIE: Well, so you kind of alluded to this, but I wonder if you were able to talk to your, your patients about different kinds of sunscreen or maybe, you know, ones that are up until whatever time you're having this conversation, that only been available in other places. 

Do you think that would make your job easier in terms of trying to convince your patients who don't want to wear sunscreen that they should?

TOURNAS: Absolutely. I really prefer and recommend mineral-based sunscreens, which are sunscreens that contain the ingredients titanium dioxide and zinc oxide. That being said, some of the formulations of these products can be a little heavier weight or cast a little bit of a white sheen. So folks that have a little natural pigment to their skin may shy away from those and want to use more, more of the chemical blockers. Which tend to have a little cleaner feel or a little a little more, lighter feel, a little a little clearer going on, if that makes sense.

And I think that there's been some concern about some of these ingredients being absorbed into the bloodstream. I think there's been concern about some of these ingredients damaging, you know, ocean life. And there's some, we talk about one of the ones in Europe that people really want over here is called Tinosorb. There's some, some initial research that might show that because that molecule is bigger than some of the ones we have over here, that there may be less absorption into the blood, for example.

So it may help with some of those concerns that we have on some of the ones that are already available and give us more choices. So, the more the more points I have to say, "Hey, if this one's not working for you, what about this one?" The better off or going to be.

BRODIE: Would you have any concerns about having European or Australian or Asian sunscreens being able to be bought and used here?

TOURNAS: It happens every day already. Mark, I'll be honest. There are a lot of importers. And so the folks that are cosmetically savvy and, you know, some folks are, you know, that you see on Instagram and things like that are already bringing these things in. And, and I think that, you know, some of these that have been approved in — Europe and Australia are both great examples of other developed nations ... with big healthcare systems, for example, and good regulatory frameworks. Where, you know, I think that we would be seeing some of these problems if the problems were going to be seen.

So, I think that we need to have a process to make sure these ingredients are safe, but I think that we've probably done ourselves a disservice by making it a bit too rigorous in this country. There's a lot of other things that we let coming to this country as supplements and things like that with, with very little regulation at all. Where I think there's probably a good middle ground here.