Sunscreens in pregnancy – Why & What ?

Using any skin care product in pregnancy needs to be a decision balancing the risk with the benefit. With that principle firmly in place, let us answer the questions one by one.

Why should sunscreen be used in pregnancy?

The single most common and troublesome problem that your skin faces during pregnancy is hyperpigmentation, which can be seen in up to 90% of pregnant women. While for most women this physiological pigmentation clears up very well after delivery, conditions like melasma tend to persist or recur. In fact, occurrence of melasma is very high, almost 70% in pregnancy.

We already know that sun exposure is the main cause of pigmentation for our skin types, something that we explored when learning about why sunscreens are essential for our skin type. And this applies to pigmentation occurring in pregnancy as well. Therefore, the most important skin care product to use in pregnancy is your sunscreen!

The next question naturally is this: are sunscreens safe to use in pregnancy?
I’ll rephrase this as: what kind of sunscreens are safe to use in pregnancy?

The simple answer has traditionally been this: mineral sunscreens are pregnancy safe. At this point, there are two mineral UV filters commonly used - zinc oxide and titanium dioxide. For years, these have been the preferred choice when recommending a pregnancy safe sunscreen.

Zinc is a naturally occurring mineral used by the body in multiple biological functions, which adds to its strong safety profile. Plus, it is my favourite UV filter overall, given that it protects much better against UVA compared to titanium.

Chemical sunscreens were generally not recommended during pregnancy for two main reasons:
First, several older chemical UV filters were shown to be systemically absorbed in a way that raised safety concerns during pregnancy. Second, many chemical filters lacked robust absorption and reproductive safety data, making it difficult to confidently recommend them for use during pregnancy.

This understanding has now begun to evolve.

Recent FDA reviewed absorption studies have shown that bemotrizinol is the first and currently the only chemical UV filter to remain below the FDA’s systemic absorption threshold, even when tested under maximum usage conditions. Because of this, bemotrizinol is now under consideration for GRASE (Generally Recognized As Safe and Effective) status - a milestone no chemical sunscreen filter has reached since 1999.

So, alongside mineral filters, bemotrizinol becomes a new, evidence backed addition to the list of pregnancy safe UV filters.

But we could refine that a little more.

1. Look for something that is specifically non nano. Nano filters, especially, titanium have been detected in the placenta, so would be good to stay clear from nano materials. 
2. Look for sunscreens that are free of silicones and other microplastics, exposure in the placenta to these chemical agents have been reported to have potential consequences on long term health. Silicones can be relatively easily identified by names ending with ‘cone’, ‘conol', ‘silane’ or ‘siloxane’.
3. Ideally use a durable sunscreen, which does not need to be reapplied every 2 to 3 hours. This way you end up using less product per day, which translates to the least possible exposure for your baby.
4. Avoid fragrances and additives in your sunscreen and stick to straightforward sunscreens, with a lesser number of total ingredients. Our early research has shown that number of allergens in a sunscreen increases with increasing number of ingredients.
5. Avoid essential oils where possible. Some of them are photosensitizers and may be counterproductive. For example, lemon oil seems so natural and simple to understand but is a very well known photosensitizer with known phototoxicity.
6. Between zinc, titanium and bemotrizinol, choose zinc or bemotrizinol for its ability to cover UVA more effectively. This part of the solar spectrum is specifically known to cause pigmentation in our skin types. And zinc oxide or bemotrizinol is a better choice here.

If these basics are in place, you should be able to use sunscreen, both safely and effectively in pregnancy, without worrying about your baby. 

More sunscreen topics for you to explore:

1. Why do people have different skin colours?

2. Do we really need to use sunscreens?