How to Identify, Prevent, and Treat a Sunscreen Allergy

Summer means sun, and plenty of it. As we spend more time at the pool, park, and beach, lathering up with sunscreen can become a daily activity. And it should — applying sunscreen with SPF 30 or higher every time you go outside reduces your risk of developing squamous cell carcinoma by about 40 percent and your risk of getting melanoma by 50 percent, according to the Skin Cancer Foundation. In addition to reducing your skin cancer risk, there is substantial evidence showing that sunscreen helps reduce your risk of skin aging.

However, for some people, applying certain types of sunscreen can also cause a skin allergy. Sunscreen allergies tend to be uncommon, according to Joshua Zeichner, MD, the director of cosmetic and clinical research in the dermatology department at Mount Sinai Hospital in New York City.

But if you’re prone to skin allergies or concerned that you may have a sunscreen allergy, here’s what to do.

Understand Sunscreen Ingredients That May Cause Skin Allergies

There are two types of sunscreen: chemical sunscreen and physical (or mineral) sunscreen.

Chemical sunscreens are carbon-based compounds, also known as organic molecules, says Dr. Zeichner. They protect the skin from harmful ultraviolet (UV) light by absorbing the energy and preventing it from passing through. The chemical sunscreen ingredients that have been found to most commonly cause allergic reactions in the skin are oxybenzone (benzophenone-3), dibenzoylmethanes, cinnamates, and benzophenones, according to NY Allergy & Sinus Centers. Other ingredients like PABA (para-aminobenzoic acid) have also been shown to cause allergic reactions but are rarely used in sunscreen in the United States, according to the Environmental Working Group.

Sunscreens known as physical, or mineral, sunscreens are free of organic (aka chemical) ingredients, Zeichner says. They contain only zinc oxide or titanium dioxide combined with zinc oxide to block UV light. Mineral sunscreen is quite effective and tends to be less irritating than chemical sunscreen, says Zeichner, but it may be more difficult to spread on the skin and can leave behind a white or ashy appearance. Mineral sunscreen is recommended for young children, because it doesn’t have the chemical filters that are more likely to cause skin irritation or allergies, adds Zeichner.

Choosing between a chemical or mineral sunscreen is a personal preference, but don’t trust any of the natural or homemade sunscreen recipes you might find on the internet. A study warned that these DIY options, which tend to include ingredients like coconut oil, shea butter, zinc, beeswax, olive oil, carrot oil, raspberry oil, lavender oil, and avocado oil, may offer insufficient UV protection and increase your risk of developing skin cancer compared to using commercially available sunscreens.

Signs That You May Have a Sunscreen Allergy

There are two ways you may notice a sunscreen allergy: as a contact allergy or as a contact photoallergy, according to Anna Feldweg, MD, an assistant professor of medicine at Harvard Medical School and an attending physician in allergy and immunology at Brigham and Women’s Hospital in Boston.

With contact allergies, Dr. Feldweg says, “You get a rash where the product is applied.” But with a contact photoallergy, the reaction is due to an interaction between sunscreen chemicals and sunlight, “so you get the rash where the sunscreen was applied but only once the skin has been exposed to the sun,” she says.

A sunscreen allergy may appear when you first start using a sunscreen, or it can develop after years of sunscreen use. You might experience an allergic reaction immediately or several days after applying the sunscreen.

According to Zeichner, these are some signs of a sunscreen allergy:

• Red skin
• Itching
• Swelling
• Rash
• Blisters that are filled with fluid

Other symptoms may include:

• Hives
• Raised bumps
• Bleeding
• Scaling
• Pain

Learn the Risk Factors for a Sunscreen Allergy

If you have a history of eczema or other allergies, you may be more likely to develop an allergy to chemical sunscreen, and the ingredients may elicit a true allergic reaction through your immune system, says Zeichner. If you have generally sensitive skin or a condition like rosacea, chemical sunscreen ingredients may be directly caustic to your skin, he adds. You may also be at an increased risk for a sunscreen allergy if you’ve had contact dermatitis with other products or if sunscreen allergies run in your family.

One way to check if you have a sunscreen allergy is through a process called patch testing. In patch testing, specific ingredients are applied to the skin and left in place for 48 hours to determine whether you develop an allergic reaction, Zeichner says. You can do a patch test at home by applying sunscreen to a small area of skin to make sure you do not develop a reaction.

How You Can Prevent and Treat a Sunscreen Allergy

If you know which ingredients you’re allergic to, you can select sunscreens that don’t contain these ingredients and avoid getting a reaction, says Zeichner. If you have a known history of skin allergies or sensitive skin, stick to mineral-only sunscreens to avoid a potential reaction, he suggests. Zeichner recommends Neutrogena Sheer Zinc, which is a zinc-oxide-only formula that’s appropriate for all skin types and is unlikely to cause a skin reaction.

If you develop a sunscreen allergy, immediately clean your skin, says Zeichner. If necessary, you can use over-the-counter 1-percent hydrocortisone to calm the inflammation (in less severe cases, you can just leave the skin alone or apply a bland moisturizer, he adds). Stay out of the sun until your skin has healed, as sun exposure can exacerbate an existing allergic reaction, says Zeichner. This may take a few days.

If you think you have a sunscreen allergy and you have any systemic symptoms (such as fever, chills, nausea, or difficulty breathing) or blistering, open, or raw skin, or if you’re treating your reaction and it isn’t getting better, you should visit a dermatologist for evaluation, says Zeichner.

Other Possible Risks of Using Sunscreen

A study published in JAMA showed that chemical sunscreen ingredients are absorbed through the skin, producing blood concentrations that surpass the threshold established by the Food and Drug Administration. But the study authors concluded that additional research is needed to determine the effects of absorption of sunscreen ingredients into the bloodstream and advised that people should continue to wear sunscreen.

Plus, the study had some limitations, says Zeichner. “In the study, high levels of sunscreen were applied to 75 percent of the body,” he says. “In the real world, consumers do not apply as much sunscreen as they should and they do not typically reapply every two hours. So it’s unclear whether there is absorption with everyday, real-world use. We need more data to understand this issue fully.”

Currently, there’s no data showing that sunscreen use is associated with harmful health effects, and based on what we know today, the benefits of wearing sunscreen in protecting the skin against skin cancer and premature aging outweigh the potential risks, Zeichner adds. “If anyone is concerned with the use of chemical-blocker sunscreens, mineral options that contain zinc oxide alone or in combination with titanium dioxide are a great option.” And citing “an abundance of caution,” the Skin Cancer Foundation advises pregnant and nursing women to consider using mineral sunscreen as well.

Summary: The Importance of Sunscreen and Sun Safety

Wearing sunscreen is an important part of protecting the health of your skin, so if you’re allergic to a chemical in sunscreen, your doctor can help you find one that doesn’t contain that chemical. In addition to sunscreen, people with sunscreen allergies can also use the following methods to protect their skin from the sun, according to Zeichner:

• Avoid the sun between the peak hours of 10 a.m. and 2 p.m.
• Wear sunglasses with UV protection.
• Wear a wide-brimmed hat.
• Wear sun-protective clothing labeled with UPF (ultraviolet protection factor), which means it has been proven to protect the skin from UV rays.
  

Wearing sunscreen is extremely important to protect your skin from harmful UV rays. However, some people may be allergic to sunscreen itself. An allergic reaction to sunscreen can occur from the sunscreen itself, which is called a contact allergy, or after sunlight makes contact with skin that has sunscreen applied, which is called a contact photo allergy. Signs of an allergic reaction include a rash, itching, blisters, and swelling. People with eczema or other skin conditions may be more likely to develop a sunscreen allergy. If you are aware of previous reactions, use a mineral-only sunscreen to eliminate the risk of contact with the chemicals that are often the cause of the allergy. If you experience an allergic reaction to sunscreen, stay out of the sun. If symptoms worsen, you can treat them with over-the-counter 1 percent hydrocortisone cream. See a doctor if symptoms don't improve.

Additional reporting by Jennifer D’Angelo Friedman.