Debunking Sunscreen Myths: Evidence Vs Misinformation

Sunscreen remains one of the most effective preventive tools in dermatology, with well-established benefits in reducing ultraviolet (UV)-induced photoaging and skin cancer risk. Despite this, a growing wave of skepticism has emerged in both clinical encounters and online platforms, where social media influencers and users promote claims that sunscreen is harmful or unnecessary. This misinformation has accelerated since 2020 and increasingly influences patient attitudes, leading to hesitation or refusal to use sunscreen. Given the strong evidence base for sunscreen efficacy and safety, it is critical for dermatologists to be equipped with accurate information to counsel their patients. This review addresses the most common myths surrounding sunscreen use and provides evidence-based clarification to support clinicians in their daily practice.

Background
The global burden of skin cancer continues to rise, with UV radiation recognized as the primary environmental carcinogen. Daily sunscreen use has been shown to reduce the incidence of melanoma and nonmelanoma skin cancers, as well as delay visible signs of photoaging.^1,2 Despite this evidence, skepticism about sunscreen safety persists. Much of this skepticism can be traced to concerns raised in 2020 regarding systemic absorption of sunscreen ingredients and may be further fueled by subsequent reports of benzene contamination, environmental impact on coral reefs, potential endocrine disruption, and claims of interference with vitamin D synthesis and cancer risk.^3,4

In the United States, the Food and Drug Administration (FDA) classifies sunscreens as over-the-counter drugs, meaning each active ingredient must be included in the FDA sunscreen monograph or undergo the more rigorous New Drug Application process before approval. For an ingredient to be added to the monograph, it must be recognized as generally regarded as safe and effective, a determination that requires extensive toxicology, safety, and efficacy data. This lengthy and costly process has stalled the approval of many newer UV filters, some of which have been available internationally for decades. In contrast, European and Asian countries regulate sunscreens as cosmetics, a framework that permits the faster introduction of filters with broader spectrum coverage and greater photostability.⁵ These differing approaches to regulation have resulted in fewer UVA filter options in the US market and amplified debate around sunscreen safety, efficacy, and global harmonization.

Amid these controversies, dermatologists face patients who encounter conflicting messages online and in the media. A clear understanding of the available evidence is therefore essential to reinforce confidence in sunscreen and counter misinformation.The psychology of misinformation also plays a role, as many patients who question sunscreen safety are motivated by genuine concern for their health and the environment. Their intentions are often well-meaning, but they may be influenced by persuasive narratives on social media. Recognizing this context is important for dermatologists, as it frames opportunities for empathetic communication and patient education.

Common Sunscreen Myths
Systemic Absorption of Sunscreen Ingredients
A frequently-cited concern emerged from a trial by Matta et al. in 2019, which demonstrated that certain chemical sunscreen ingredients, including avobenzone, oxybenzone, octocrylene, and ecamsule, were detectable in the bloodstream under maximal use conditions.⁶ A follow-up study expanded these findings to include additional ingredients, such as homosalate and octinoxate.⁷ While this might spark concern for the general audience, it is essential to consider the clinical context: Systemic absorption does not equate to clinical harm. Further toxicology studies are ongoing to evaluate the exact clinical significance, but the FDA has emphasized that the mere presence of these agents in plasma does not indicate lack of safety. Notably, systemic absorption is not unique to sunscreen. Many topical medications demonstrate measurable plasma concentrations without adverse systemic effects,⁸ reaffirming that despite potential minimal systemic absorption, sunscreen is still safe to use.

Benzene Contamination 
In 2021, independent testing identified benzene, a known carcinogen, in select sunscreen products. Benzene is not an intentional ingredient; its presence was attributed to manufacturing contamination or chemical breakdown. Most reported cases involved aerosol or spray formulations, likely due to propellants used during production. As a result, several brands issued voluntary recalls between 2021 and 2022.⁹ Importantly, this is a manufacturing quality control issue, not an inherent risk of the sunscreen active ingredients themselves. Clinicians can guide patients to minimize risk by favoring lotion or cream formulations over sprays, applying sprays to the hands first before transferring to the skin to reduce inhalation, and staying informed about product recalls. Monitoring labels and choosing reputable brands with robust quality control can further reduce exposure risk. Overall, benzene contamination highlights the importance of manufacturing standards.
 

Environmental Harm
The potential for sunscreen to harm coral reefs has received significant media attention. Laboratory-based studies show that high concentrations of certain UV filters, such as oxybenzone, octinoxate, avobenzone, and octocrylene, have been identified as contributors to coral bleaching and other adverse effects on marine life.¹⁰ However, translating these findings to real-world ocean settings is complex, as concentrations in natural bodies of water are far lower and confounding environmental stressors are numerous. Current evidence does not definitively link human sunscreen use to reef degradation. While “reef safe” is not a regulated term, it is often used to indicate sunscreens formulated without these harmful chemical filters. To minimize environmental impact, clinicians can recommend mineral-based sunscreens that utilize non-nano zinc oxide or titanium dioxide as active ingredients. These formulations are considered safer for marine ecosystems and are less likely to contribute to coral bleaching.¹¹

Hormone Disruption
Organic UV filters such as oxybenzone have been labeled as endocrine disruptors in popular discourse. These claims are largely derived from animal studies in which extremely high systemic doses were administered, often through oral ingestion. For example, in rat models, oxybenzone was fed at levels thousands of times greater than typical human topical exposure, which is not physiologically relevant to sunscreen application.¹² Human data remain limited, and no definitive link between sunscreen use and hormonal dysfunction has been established. The FDA currently considers both mineral and chemical sunscreens safe for routine use.¹³

Sunscreen and Vitamin D Synthesis
Another common myth is that sunscreen use significantly impairs vitamin D production. Although sunscreens can reduce UVB-mediated vitamin D synthesis in theory, in practice most individuals apply sunscreen inconsistently and at lower than recommended quantities. As a result, sufficient incidental sun exposure usually occurs to maintain vitamin D levels. For patients at  risk for deficiency, dietary supplementation provides a safer and more reliable means of maintaining adequate vitamin D without increasing skin cancer risk.¹⁴

Sunscreen and Skin Cancer Risk
Finally, the claim that sunscreen causes skin cancer is based on flawed interpretations of observational data. Some studies have reported higher rates of skin cancer among sunscreen users, but these individuals were often sunbathers or vacationers with inherently higher UV exposure. When controlling for exposure randomized controlled trials and prospective studies consistently show that sunscreen decreases cancer risk. A landmark Australian trial found daily sunscreen use reduced melanoma incidence by 50%, while a Norwegian study demonstrated that regular use of SPF 15 or higher reduced melanoma risk by 30%.^15,16

Discussion
The persistence of sunscreen myths underscores the influence of misinformation in shaping patient beliefs and behaviors. Dermatologists are uniquely positioned to counter these misconceptions with evidence-based guidance. Understanding the origins of these myths is essential, as many are rooted in laboratory findings, preliminary data, or flawed interpretations of epidemiologic studies that were amplified through social media (Table).

Systemic absorption, for example, has been widely mischaracterized as evidence of harm, despite the lack of toxicologic data demonstrating clinical consequences. Similarly, the benzenerecalls were tied to manufacturing contamination rather than the  inherent properties of sunscreen ingredients. Patients can minimize potential risk by favoring lotion or cream formulations over sprays, checking for recent product recalls, and choosing brands with established quality control standards. In both cases, nuanced interpretation of the data is necessary to provide patients with accurate reassurance.

Concerns about environmental harm and endocrine disruption highlight areas where public perception may outpace scientific certainty. Although laboratory studies have demonstrated potential effects of certain UV filters, particularly oxybenzone, octinoxate, and octocrylene, on coral and hormonal systems, real-world evidence remains inconclusive or absent. These gaps present opportunities for further research, but current data do not justify discouraging sunscreen use given the well-documented benefits in cancer prevention. For patients interested in minimizing environmental impact, clinicians can recommend mineral-based sunscreens containing non-nano zinc oxide or titanium dioxide, which are less likely to contribute to coral bleaching. Choosing products from brands with transparent manufacturing practices and avoiding aerosol sprays may further reduce environmental and inhalation concerns while maintaining effective photoprotection.

The vitamin D debate illustrates how myths often oversimplify complex physiologic processes. Although UVB radiation does drive vitamin D synthesis, the amount blocked by typical sunscreen use is minimal, and oral supplementation offers a safe and effective alternative for individuals at risk for deficiency. Finally, claims that sunscreen increases skin cancer risk reflect confounding by indication, whereas randomized controlled trials and large prospective studies consistently demonstrate the protective effects of sunscreen.

From a clinical standpoint, addressing sunscreen skepticism requires clear, empathetic communication. Providing practical, evidence-based explanations and offering product recommendations tailored to skin type, cosmetic preferences, and lifestyle can help build trust and reinforce adherence. Educational tools, including infographics and patient handouts, may also aid in bridging the gap between research and patient understanding. Recognizing that most patients are not acting out of defiance, but from a place of uncertainty or fear, can help dermatologists frame conversations in a constructive and collaborative way.

Conclusion
Sunscreen remains a cornerstone of dermatologic care, with robust evidence supporting its role in preventing skin cancer and photoaging. Although myths regarding systemic absorption, benzene contamination, environmental harm, endocrine disruption, vitamin D deficiency, and cancer risk continue to circulate, current data consistently affirm the safety and efficacy of sunscreen use.

Dermatologists should be prepared to address these concerns with accurate, accessible information. By contextualizing the science behind each claim and emphasizing the proven benefits of sunscreen, clinicians can counter misinformation and strengthen patient confidence. Ongoing research into sunscreen safety, regulation, and environmental impact will further refine our understanding, but the prevailing evidence strongly supports sunscreen as a safe, effective, and essential tool for skin health.

Kianna Vires is a fourth-year medical student at Ohio University Heritage College of Osteopathic Medicine in Athens, OH. Sumrah Jilani is a fourth-year medical student at Johns Hopkins University School of Medicine in Baltimore, MD. Dr Trotter is an assistant clinical professor at Ohio University Heritage College of Osteopathic Medicine in Athens, OH, and serves as faculty for the OhioHealth Dermatology Residency Program in Columbus, OH.

Disclosure: The authors report no relevant financial relationships.

References
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