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SAN ANTONIO
87TH LEGISLATIVE WRAP-UP
MEDICINE
Benzene in Sunscreen

Conclusions Drawn from the By Ryan Wealther, Jane Margaret Anderson and Caroline Zhu Valisure suggests that benzene is most likely a production contaminant.

If you feel like you’re having deja vu because sunscreen is in the news
87th Legislative Session again, you’re not alone. In 2019, the United States Food and Drug Ad- The full list of affected batches can be found in Valisure’s report.
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ministration (FDA) proposed a rule that called for the further study of
While we await the FDA’s review of the Valisure report, uncertainty
12 active sunscreen ingredients before definitively declaring these in- remains regarding sunscreen, and patients must weigh the risks of po-
By Leah H. Jacobson, MD, FAAP gredients GRASE (generally recognized as safe and effective). These tential benzene exposure against the benefits of sunscreen. It is important
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ingredients were found to be systemically absorbed at much higher con- to remind patients that sunscreen has multiple benefits, including pro-
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In today’s hyper-political environment, at least partial legalization) of marijuana (only volved in advocacy. Lastly, you can talk to your centrations than previously recognized. The FDA has placed these in- tection against sunburns and the prevention of skin cancer. “UV damage
summarizing the outcome of an inherently po- 13% of those polled were against any circum- patients about these important issues and find gredients into a separate category, Category III, while research is also plays a role in accelerated aging, so in addition to keeping you safe
litical process can be difficult. Do I focus on stance being made legal). Almost 60 bills re- out what is important to them. These things ongoing. However, they have not called for the discontinuation of Cat- and reducing the risk of skin cancer, sunscreen has the added benefit of
how important it is to participate in First lated to marijuana were introduced this can all make a big impact! egory III ingredients because no harmful effects have been linked to maintaining more youthful looking skin,” says Dr. Pye. The AAD and
Tuesdays and how to get involved at a local or Session. Ultimately, only two bills regarding date. Sunscreen is once again receiving attention because a recent study dermatologists recommend using sunscreen that is SPF 30 or greater and
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state level? Or what BCMS and the Legislative marijuana use were adopted. (House Bill 1535 “Never doubt that a small group of thought- found benzene in sunscreen. broad-spectrum, meaning it protects against both UVA and UVB rays.
Committee have been doing to advocate for expands the Compassionate Use Program, and ful, committed citizens can change the world; Valisure, a company whose core mission is to bring transparency and
its members and patients? Or, a wrap-up of HB 567 protects parental rights regarding the indeed, it’s the only thing that ever has.” increased quality to the pharmaceutical industry, released a report in Acknowledgements:
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what we know so far from the 87th Legislative administration of low-THC cannabis to their - Margaret Mead May 2021 indicating that it found benzene in sunscreen products. Ben- Thank you for the expertise and guidance provided by Dr. Allison
Session? child for approved medical reasons.) zene is an organic solvent and a known human carcinogen—exposures Pye, without whom we could not have written this article, and for the
Many Texans believe the Legislature was dis- With regards to our state infrastructure and Reference: to even low doses of benzene have been linked to hematologic malig- assistance provided by Dr. Robert Gilson.
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appointing, as evidenced by the most recent electric system, 52 percent of Texans polled https://www.texastribune.org/2021/06/25 nancy. The Valisure report found that 78 out of 294 batches from 69
References:
University of Texas/Texas Tribune polls re- were not satisfied with the Legislature’s work /texas-permitless-carry-medicaid-transgender- brands of sunscreen contained detectable levels of benzene. 1. American Academy of Dermatology Association. (n.d.). SUNSCREEN: QUES-
garding the legislative session and what Texans on the reliability of the state’s electricity grid, students-poll/ Valisure is petitioning the FDA Commissioner to initiate a recall of TIONS PATIENTS ASK. aad.org. https://www.aad.org/public/everyday-care/sun-
thought of the issues dominating it. I was once and even more were less confident that the the sunscreen batches containing benzene and also requested the FDA protection/sunscreen-patients
again struck by how many topics directly or in- Legislature had passed laws to prevent future Leah H. Jacobson, MD, FAAP is define limits for benzene in drug and cosmetic products. The American 2. Light, D., Kucera, K., & Wu, Q. (2021, May 24). Valisure Citizen Petition on Benzene
in Sunscreen and After-sun Care Products. Valisure. https://www.valisure.com/wp-
directly relate to health care and public issues in utility services like those that had oc- the Chair of the BCMS Legislative Academy of Dermatology (AAD) released a statement regarding the content/uploads/Valisure-Citizen-Petition-on-Benzene-in-Sunscreen-and-After-sun-
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Care-Products-v9.7.pdf.
health. Some issues were directly related to curred in February. Committee and was the 2017 Pres- detection of benzene in sunscreen products. It explains that the AAD 3. Matta, M. K., Florian, J., Zusterzeel, R., Pilli, N. R., Patel, V., Volpe, D. A., Yang, Y.,
health care, such as the coronavirus pandemic This is just a small look at some of the is- ident of the Bexar County Medical Society. looks forward to the FDA’s review of Valisure’s report and discusses Oh, L., Bashaw, E., Zineh, I., Sanabria, C., Kemp, S., Godfrey, A., Adah, S., Coelho,
and Medicaid issues. Others focused on more sues that are being discussed. With the Leg- how it plans to address the findings. The statement also acknowledges S., Wang, J., Furlong, L. A., Ganley, C., Michele, T., & Strauss, D. G. (2020). Effect
indirect issues, such as public education, immi- islature returning to Austin in July for the that unprotected exposure to the sun’s ultraviolet (UV) rays is a risk fac- of Sunscreen Application on Plasma Concentration of Sunscreen Active Ingredients:
Clinical
Randomized
A
323(3),
256–267.
Trial.
JAMA,
gration, electric reliability, public safety and first, though likely not the only Special Ses- tor for skin cancer, and sunscreen is one way to protect your skin and https://doi.org/10.1001/jama.2019.20747
homelessness, to name a few. sion, there will be more topics discussed. We reduce your risk of getting skin cancer. 4. Petronelli, M. (2021, May 27). Detectable Levels of Benzene Noted in Some Sun-
screen Batches. DermatologyTimes. https://www.dermatologytimes.com/view/car-
The majority of Texans voted on an expan- will have to wait and see how these issues af- It is important to remember that there are other components of a cinogen-found-in-multiple-sunscreens
sion of Medicaid (sixty-seven percent support fect us and our patients. comprehensive sun protection plan besides sunscreen. Dr. Allison Pye, 5. Smith, M. T. (2010). Advances in understanding benzene health effects and suscep-
it (50% Republicans and 90% Democrats)). As The Texas Tribune poll shows, the Leg- MD, FAAD, a board-certified dermatologist at Audie L. Murphy Me- tibility. Annual review of public health, 31, 133–148. https://doi.org/10.1146/an-
nurev.publhealth.012809.103646
There was significant bi-partisan support for islature does not always represent every single morial Veterans' Hospital and Adjunct Assistant Professor of Derma- 6. United States Food and Drug Administration. (2019, February 21). FDA Advances
this issue, but GOP leaders did not share the view of their constituents. It is up to us as tology at UT Health San Antonio, has some advice for patients who New Proposed Regulation to Make Sure That Sunscreens Are Safe and Effective.
Fda.gov. https://www.fda.gov/news-events/press-announcements/fda-advances-new-
same perspective. House Bill 3871 and Senate health care providers to help continue to ad- are uncomfortable wearing sunscreen for the time being. “I still encour- proposed-regulation-make-sure-sunscreens-are-safe-and-effective
Bill 117 for the expansion of Medicaid did not vocate for our patients and the population at age these patients to wear sunscreens that are known to be safe, but I
make it out of the committee. Two related bills large. I urge you to get involved. You can join also encourage them to use other forms of sun protection by seeking
that did pass and were signed involve the the BCMS Legislative and Socioeconomics shade and wearing SPF clothing and wide-brim hats.”
Healthy Texas Women Program and ex- Committee and meet or contact your state However, there are some important details to consider regarding Val-
panded benefits (HB 133), and HB 290. The Senator or Representative about a topic you isure’s recent report, which only represents one study and still needs to Ryan Wealther, Jane Margaret Anderson and Caroline Zhu are med-
latter was incorporated into HB 2658, which are passionate about. You can also learn about be validated. Only a minority (27%) of sunscreen batches were found to ical students at the UT Health San Antonio Long School of Medicine. All
makes it easier for children eligible for Medi- TEXPAC (Texas Medicine’s Political Action contain benzene. Even among batches of the same product, some batches three have served as leaders for the school’s Dermatology Interest Group.
caid to receive and keep their coverage. Committee) and the TMA’s Political Action were found to contain benzene while others did not. Furthermore, ben-
Texans were in favor of the legalization (or Committee and learn how you can get in- zene is not supposed to be in any sunscreens. While it needs to be defin-
itively determined how benzene got into these sunscreen batches,

34 SAN ANTONIO MEDICINE • August 2021 Visit us at www.bcms.org 35