**Author details**

Another potential health and safety concern with the general use of sunscreens is the potential of vitamin D deficiency. Appropriate vitamin D synthesis necessitates certain levels of UVB exposure and the American Academy of Dermatology has recently revised its position on sunscreen effects on adequate vitamin levels. They note several populations are at higher risk for vitamin D deficiency including the elderly, darker skinned those who live in areas of low sunlight exposure, the obese, and the photosensitive. It is generally recommended that individuals obtain 1000 international units of vitamin D daily and some may have to supplement

Unlike other organic sunscreens, the inert nature of titanium dioxide sunscreens makes it one of the least likely compounds to cause irritation and sensitization of the skin. In fact, because of its chemical inertness and lack of photoreactivity, it is often the preferred sunscreen for individuals with sunscreen allergies and children [3]. However, in recent years an interesting interaction between gold allergic patients and titanium dioxide has been proposed and studied. In 2005, Nedorost and Wagman hypothesized that patients with facial and eyelid dermatitis may be experiencing reactions due to an interaction between their gold jewelry (earrings, bracelets, etc.) and the titanium dioxide in their cosmetic products. Mechanistically, titanium dioxide was thought to adsorb gold particulate matter which then caused contact dermatitis in the locations of makeup application. Their results demonstrated a subgroup of

benefiting from gold jewelry avoidance, lending credence to the interaction theory [22]. In 2015, Danesh and Murase published a clinical pearl in the Journal of the American Academy of Dermatology regarding a trial of gold avoidance in patients presenting with eyelid allergic contact dermatitis. They noted that the North American Contact Dermatitis Group implicated gold as the most common allergen to cause eyelid dermatitis most likely through a mechanism in which eyelid cosmetics containing titanium dioxide particles adsorbed gold particles

The American Academy of Dermatology has set forth guidelines for appropriate sunscreen use and sun protection. They recommend using sunscreen with broad-spectrum properties (protection against both UVA and UVB radiation) daily. These include sunscreens with sun protection factors greater than 30. Sunscreen should be applied 15–30 min prior to sun exposure and be reapplied as needed when environmental factors (swimming and sweating) cause

In conclusion, titanium dioxide sunscreens are effective agents against UV radiation. They also have an advantage as they protect against multiple wavelengths of energy

**7. General recommendations on appropriate sunscreen use**

containing makeup on areas then affected by contact dermatitis,

this through oral formulations [3].

68 Application of Titanium Dioxide

individuals who used TiO2

from elsewhere on the body [23].

sunscreen removal [3].

**8. Conclusions**

Megha Trivedi1,2\* and Jenny Murase2,3

\*Address all correspondence to: mtrivedi41@gmail.com

1 University of Michigan Medical School, Ann Arbor, MI, USA


### **References**


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