Americans visiting beaches in France, Spain or Italy often do something that’s illegal back home: They purchase and use European sunscreens for better protection against sunburn and skin cancer. Many dermatologists argue that American sunscreens are far behind the scientific frontier, and they worry that the Food and Drug Administration’s decadeslong delay in approving new sunscreens for purchase in the U.S. is contributing to rising rates of skin cancer.
Americans visiting beaches in France, Spain or Italy often do something that’s illegal back home: They purchase and use European sunscreens.
In the European Union, sunscreens are regulated as cosmetics, which means greater flexibility in approving active ingredients. In the U.S., sunscreens are regulated as drugs, which means getting new ingredients approved is an expensive and time-consuming process. Because they’re treated as cosmetics, European-made sunscreens can draw on a wider variety of ingredients that protect better and are also less oily, less chalky and last longer. Does the FDA’s lengthier and more demanding approval process mean U.S. sunscreens are safer than their European counterparts? Not at all. In fact, American sunscreens may be less safe.
Sunscreens protect by blocking ultraviolet rays from penetrating the skin. Ultraviolet B (UVB) rays, with their shorter wavelength, primarily affect the outer skin layer and are the main cause of sunburn. In contrast, ultraviolet A (UVA) rays have a longer wavelength, penetrate more deeply into the skin and contribute to wrinkling, aging and the development of melanoma, the deadliest form of skin cancer. In many ways, UVA rays are more dangerous than UVB rays because they are more insidious. UVB rays hit when the sun is bright, and because they burn they come with a natural warning. UVA rays, though, can pass through clouds and cause skin cancer without generating obvious skin damage.
The problem is that American sunscreens work better against UVB rays than against the more dangerous UVA rays. That is, they’re better at preventing sunburn than skin cancer. In fact, many U.S. sunscreens would fail European standards for UVA protection. Precisely because European sunscreens can draw on more ingredients, they can protect better against UVA rays. Thus, instead of being safer, U.S. sunscreens may be riskier.
European sunscreens are also more pleasant to apply, and because they work better with makeup they are probably used more often as part of a skin care regimen, which may reduce the prevalence of skin cancer. Once again, the United States’ slower and seemingly more risk-averse approach actually increases risk.
Dangerous precaution should be a familiar story. During the Covid pandemic, Europe approved rapid-antigen tests much more quickly than the U.S. did. As a result, the U.S. floundered for months while infected people unknowingly spread disease. By one careful estimate, over 100,000 lives could have been saved had rapid tests been available in the U.S. sooner.
American sunscreens work better against UVB rays than against the more dangerous UVA rays. That is, they’re better at preventing sunburn than skin cancer.
Americans have also seen their options for treating colds diminished in recent years. In September 2023, an FDA advisory committee concluded that phenylephrine doesn’t work to clear nasal congestion. The FDA is probably correct, but it’s frustrating that options that do work are not available in the U.S. even though they are available in Europe. Ambroxol is an excellent decongestant available nearly everywhere in the world as a generic. It has been in wide use since 1979 and is regarded as both safe and effective. But it’s not available in the U.S. because getting through the FDA process is too costly.
In 2013, then-FDA Commissioner Margaret A. Hamburg told lawmakers that sorting out the sunscreen issue was “one of the highest priorities.” Yet, it still hasn’t been done. Americans have been without good sunscreen and cough medicine for too long. There is a simple solution to these problems. If a medical drug or device has been approved by another developed country, a country that the World Health Organization recognizes as a stringent regulatory authority, then it ought to be fast-tracked for approval in the U.S.
The logic of peer approval is simple: If it’s good enough for the Germans, then it’s good enough for us! Americans traveling in Europe do not hesitate to use European sunscreens, rapid tests or cough medicine, because they know the European Medicines Agency is a careful regulator, at least on par with the FDA. But if Americans in Europe don’t hesitate to use European-approved pharmaceuticals, then why are these same pharmaceuticals banned for Americans in America? As someone who has studied and often critiqued the FDA for many years, I also know the FDA can be timely and efficient. Europe has sometimes made some better choices, but at times so has the FDA. A peer-approval system would work both ways. Europe would also take into account FDA decisions. Peer-approval is more about spreading the burden of review and speeding up good decisions than it is about castigating the FDA. Peer approval is working in other regulatory fields. A German driver’s license, for example, is recognized as legitimate — i.e., there’s no need to take another driving test — in most U.S. states and vice versa. And the FDA does recognize some peers. When it comes to food regulation, for example, the FDA recognizes the Canadian Food Inspection Agency as a peer. Peer approval means that food imports from and exports to Canada can be sped through regulatory paperwork, bringing benefits to both Canadians and Americans. The FDA’s overly cautious approach on sunscreens is a lesson in how precaution can be dangerous. Peer approval has bipartisan support in Congress. Politicians as far apart as Sen. Ted Cruz, R-Texas, and Rep. Alexandria Ocasio-Cortez, D-N.Y., have indicated support for fast-tracking approval in the U.S. for at least some drugs and devices already approved in other developed countries — a rare moment of wise bipartisan agreement. In short, the FDA’s overly cautious approach on sunscreens is a lesson in how precaution can be dangerous. By adopting a peer-approval system, we can prevent deadly delays and provide Americans with better sunscreens, effective rapid tests and superior cold medicines. This approach, supported by both sides of the political aisle, can modernize our regulations and ensure that Americans have timely access to the best health products. It’s time to move forward and turn caution into action for the sake of public health and for less risky time in the sun.
Alex Tabarrok
Alex Tabarrok holds the Bartley J. Madden chair in economics at the Mercatus Center and is a professor of economics at George Mason University. He is known for his work in law and economics, public choice and health economics and co-authors the popular economics blog Marginal Revolution with Tyler Cowen. 
