What to know about sunscreen allergy

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Certain sunscreen ingredients can trigger allergic reactions in some people.

According to the American College of Allergy, Asthma, and Immunology (ACAAI), the sunscreen ingredient most likely to trigger an allergic reaction is oxybenzone or benzophenone-3.

Other sunscreen ingredients that are prone to triggering reactions include:

• benzophenones
• cinnamates
• dibenzoylmethanes

Some people may also be allergic or sensitive to the fragrances and preservatives that manufacturers commonly add to sunscreens.

There are two main types of sunscreen: chemical and physical. Chemical sunscreens absorb UV rays, while physical sunscreens contain minerals that deflect UV rays.

• Chemical sunscreens: These sunscreens contain compounds that absorb high energy UV rays and release them as low energy. This prevents the UV rays from reaching the skin.
• Physical sunscreens: These sunscreens contain minerals, such as zinc oxide and titanium dioxide, which reflect or scatter UV rays. Physical barrier sunscreens tend to be less irritating than chemical sunscreens. However, they are also less popular as they tend to leave a white residue on the skin.

Contact dermatitis (CD) is the most common adverse skin reaction to sunscreen. There are three types of CD that may affect people with sunscreen sensitivities and allergies. They are:

• Irritant contact dermatitis: This type is more likely to occur in people who have sensitive skin or conditions such as eczema.
• Allergic contact dermatitis: This type occurs when a person is allergic to a particular product ingredient.
• Photoallergic contact dermatitis: This is a type of allergy that can occur when the sunscreen comes into contact with UV light. Photoallergic reactions sometimes appear similar to a sunburn.

A sunscreen allergy may occur immediately after applying sunscreen, though, in some cases, they may take time to develop.

Symptoms of a sunscreen allergy may include:

• skin redness or swelling
• itching or stinging
• raised bumps or hives
• scaling or bleeding
• rash, or fluid-filled blisters

People with preexisting conditions, such as eczema and psoriasis, are at increased risk of developing a sunscreen allergy.

Other people at increased risk include those who work outdoors and those with previously sun damaged skin.

It is impossible to know how an individual child will react to a sunscreen. When applying a particular sunscreen for the first time, it is sensible to conduct a patch test to check for signs of a reaction.

A patch test involves applying a small amount of sunscreen to the inside of the child’s forearm.

If the patch test does not indicate an allergic reaction, a person can carry out a separate patch test on the child’s face. The facial skin is more sensitive and more prone to allergic reactions. A person should apply the sunscreen twice a day for a week to check for signs of a reaction.

Parents and caregivers should check with a doctor before applying sunscreen to children with sensitive skin, or preexisting skin conditions. They should also seek advice on how to protect the child from UV exposure.

Below are some general recommendations for protecting children from the sun:

• Apply a broad spectrum, mineral-based sunscreen with sun protection factor (SPF) of 30 or higher.
• Be wary of spray sunscreens that are difficult to control and can be inhaled, especially by infants.
• Dress the child in long pants, a long sleeved shirt, and a broad brimmed hat.
• Keep children younger than 6 months of age out of the sun.

Treatment for a sunscreen allergy is similar to that of other allergic skin reactions.

A person who experiences a mild allergic reaction to a sunscreen should remove the sunscreen by rinsing the skin with cool water. They should then stay out of the sun until the skin has fully healed.

If a child develops a mild allergic reaction, a parent or caregiver can apply a thin layer of petroleum jelly to the affected area to moisturize the skin.

For moderate to severe skin allergies, a doctor may recommend one or more of the following treatments:

• cold compresses to alleviate pain and inflammation
• skin moisturizers, such as petroleum jelly, or calamine lotion
• antihistamines to alleviate itching
• topical corticosteroids to reduce skin inflammation

A person who develops a severe or recurring allergic reaction to sunscreen should make an appointment with their doctor. The doctor may refer them to an allergist, who will work to diagnose the ingredient causing the reaction.

An older study from 2008 notes that the sunscreen ingredient benzophenone-3 has the potential to cause the severe allergic reaction anaphylaxis.

However, sunscreen-induced anaphylaxis is rare.

A person should phone 911 if they experience an allergic skin reaction with any of the following symptoms of anaphylaxis:

• tightness in the chest
• difficulty breathing
• wheezing
• swelling of the throat or other parts of the body
• hoarse voice
• difficulty swallowing
• stomach cramps
• nausea
• vomiting
• diarrhea
• paleness or redness of the face and body

Sunscreens help protect people from the damaging effects of UV light, such as premature skin aging, and skin cancer. For this reason, the benefits of wearing sunscreen far outweigh the risks.

However, certain sunscreen ingredients can trigger skin allergies in some people. The risk is particularly high for those who have sensitive skin or preexisting skin conditions, such as eczema or psoriasis.

A person can test for an allergy by carrying out a patch test on the skin of the inner forearm. People who develop a reaction should avoid applying the product. They will also need to stay out of the sun until they have found a suitable alternative sunscreen.

People who experience severe or recurrent sunscreen allergies should see a doctor. The doctor may refer them to an allergist who will work to diagnose the ingredients causing the allergy.