Mark Herz: This is GBH's Morning Edition. Every month we check in with the state's top public health official, Robbie Goldstein. Today we're talking sunscreen. On Beacon Hill, lawmakers are weighing a bill that would let the state’s public school students and summer campers carry and apply their own sunscreen without a doctor's note, something 29 other states already allow. And an anti-sunscreen movement that started last summer is continuing to circulate on social media. Good morning, Dr. Goldstein. Help us get to the facts on all of this.

Robbie Goldstein: Good morning. It's great to be with you again.

Herz: So this was surprising to me -- the Beacon Hill part that I mentioned, when I first heard about it. Public school students and campers not allowed to carry or apply sunscreen without a doctor's note, what's this all about?

Goldstein: You know, I think we should first take a big step back and recognize how important sunscreen is. We want our children to be able to have access to sunscreen. It's really a great way to prevent sun damage and help prevent skin cancers. The way that the laws are written right now, sunscreen is considered a medication and medications in schools need to be prescribed. They need to go through a nurse's office and they're controlled through a regulatory process. There's reasons for that, right? We want to make sure that parents are consenting to a child having sunscreen put on. We want make sure that sunscreen is safe for the child -- they don't have an allergy to one of the components in the sunscreen. So there are a lot of reasons for us to have some guardrails on this. But at the end of the day, what we really want is for children to have sunscreen applied to prevent any sun damage.

Herz: Okay. I did want to get to social media influencers and some of their -- shall we say-- interesting claims. Here's some of the most popular ones: let's just run through them and have you help straighten this out. Sunscreens use chemicals that leak into your bloodstream -- here is an example.

[INFLUENCER SOUND] After a single application of sunscreen, blood concentrations of oxybenzone, are more than 180 times the FDA's level of concern.

Goldstein: Well, I don't know what particular study that person is talking about, but I think we have to be really careful about extrapolating from animal studies and laboratory studies, and then seeing what that impact would be on humans in the real world who are applying sunscreen. What we know is that skin cancer is the fifth leading cause of cancer in this country. We know that sunscreen reduces the risk of skin cancer. What we don't is whether that particular study that person was talking about, actually was measuring the right chemicals, was measuring it in the right person who applied sunscreen in the right way. There's a lot of unknowns there, but the knowns are that sunscreen is beneficial and sunscreen reduces skin cancer.

Herz: Yeah. And I think you bring up something interesting. I think there's a lot of people who just feel like: “chemicals, bad, natural stuff, good.” And there's a thread of this with the influencers as well with people saying you can build up sun protection with certain food.

[INFLUENCER SOUND] So I can soak up more of those healthy rays. Foods rich in healthy fats and carotenoids like lycopene, astaxanthin, and beta-carotene.

Herz: What's that all about?

Goldstein: Well, you know, I want to first just comment on what you said about “chemicals bad, natural, good.”

Herz: OK, yes.

Goldstein: Water is a chemical. Water is good for us. All chemicals are not bad. And all natural things aren't good for you. Cyanide is a natural chemical that's out there. And I'm pretty sure we don't want cyanide in our water. We don't want it in our food. But I think what this individual is talking about is whether you can eat a healthy diet, and that can help protect you from the sun. And the science just doesn't support that. We know that UVA rays, UVB rays in particular get into the skin, they increase your risk of cancer, they age your skin faster. The best way to prevent that is to block it, and the only way to block is to apply something to your skin.

Herz: And now there is something good that you can get from sun exposure, and that's vitamin D. Yes, of course. So some of these influencers are saying, “don't use sunscreens, they're going to keep you from producing vitamin D.”

Goldstein: Well, we get vitamin D from a lot of different sources. Yes, when UVB rays hit our skin, that can help produce some vitamin D, but we also get vitamin B from milk and from other food products. There are a lot ways to get vitamin D in your diet. We know that folks who use sunscreen all the time still have enough vitamin D in their system simply by eating a healthy diet.

Herz: Okay, so tell us what are the best sunscreens, the most effective ones, and what's the best way to use them?

Goldstein: So we, in particular, want folks to look for a sunscreen that is broad spectrum, meaning it will block both UVA rays and UVB rays. We really recommend that folks use at least an SPF 30. And then folks should be applying it about 15, 20 minutes before they go outside in the sun. And then every two or so hours when you're out in the sun, reapply sunscreen.

Herz: Commissioner of the Massachusetts Department of Public Health, Dr. Robbie Goldstein. Thank you again for your expertise.

Goldstein: Thanks for having me on.

Herz: This is GBH.

On Beacon Hill, lawmakers are considering a bill that would let Massachusetts’ public school students and summer campers carry and apply their own sunscreen without a doctor’s note — which is currently allowed in 29 other U.S. states.

It comes as an anti-sunscreen movement has been circulating on social media since last year — with some influencers suggesting people ditch the method of sun protection altogether.

Robbie Goldstein, the commissioner of the Massachusetts Department of Public Health, spoke with GBH’s Morning Edition about the myths and truths about sunscreen.

Why does sunscreen currently require a doctor’s note for the state’s public school students?

“The way that the laws are written right now, sunscreen is considered a medication and medications in schools need to be prescribed,” Goldstein said. “They need to go through a nurse’s office and they’re controlled through a regulatory process.”

He added that one of the reasons for that guardrail is a child having allergies to one of the components in the product.

“But at the end of the day, what we really want is for children to have sunscreen applied to prevent any sun damage,” Goldstein said.

Does sunscreen use harmful chemicals that can leak into your bloodstream?

When advocating against sunscreen, some influencers have cited a 2020 study that links sunscreen to absorption of the chemical oxybenzone in the bloodstream at unsafe levels.

The Center for Drug Evaluation and Research, an arm of the FDA that conducted the study, has clarified that the research is not suggesting that people stop using sunscreen — but rather calling for further industry testing for certain ingredients in sunscreen to determine their safety.

Goldstein said when it comes to lab studies, it’s important to read the research carefully and not jump to conclusions about the impacts on humans in the real world who are applying sunscreen.

“What we know is that skin cancer is the fifth leading cause of cancer in this country,” he said. “There’s a lot of unknowns [with certain studies], but the knowns are that sunscreen is beneficial and sunscreen reduces skin cancer.”

Can eating certain foods provide “natural” sun protection?

Some articles cited by influencers suggest that certain foods like blueberries, watermelon and seeds can help take an “inside out” approach for sun protection. While many articles conclude by saying not to skip sunscreen — posts have circulated on social media that peddle the foods as a “natural” and “chemical free” alternative to SPF.

“Water is a chemical. Water is good for us. All chemicals are not bad,” Goldstein said. “And all natural things aren’t good for you. Cyanide is a natural chemical.”

He added that the science “just doesn’t support” the notion that a healthy diet can protect from UVA and UVB rays.

Does sunscreen prevent humans from getting their daily dose of vitamin D?
 
Sunscreen protects us from UVB rays, which can also slightly lower vitamin D levels, according to Harvard Health. However, an NIH study out of Australia showed no difference in vitamin D levels for adults that used sunscreen compared to a placebo cream.

Furthermore, Goldstein said vitamin D can come from a variety of sources other than sun exposure.

“We also get vitamin D from milk and from other food products,” he said. “Folks who use sunscreen all the time still have enough vitamin D in their system simply by eating a healthy diet.”

What are the most effective sunscreens to use, and how should they be applied?

Goldstein says to look for a sunscreen that is broad spectrum, meaning it will block both UVA rays and UVB rays, and at least SPF 30.

It is recommended to apply it every 15-20 minutes before going outside in the sun, and then reapplying every 2 hours.