The concern from animal studies is that high amounts of titanium dioxide have increased inflammation and colon tumor formation, said Dr. Johnson-Arbor. A 2021 review, meanwhile, suggested that using titanium dioxide as a food additive weakens the gut lining and worsens the progression of inflammatory bowel disease.

As mentioned above, these oxide NPs are harmful in part because both anatase and rutile forms are semiconductors and produce ROS. Particularly, P25 kind has band-gap energies estimated of 3.2 and 3.0 eV, equivalent to radiation wavelengths of approximately 388 and 414 nm, respectively. Irradiation at these wavelengths or below produces a separation of charge, resulting in a hole in the valence band and a free electron in the conduction band, due to the electron movement from the valence to conduction bands. These hole–electron pairs generate ROS when they interact with H₂O or O₂ [43,44]. It was described that they can cause an increase in ROS levels after exposure to UV-visible light [45]. The NBT assay in the studied samples showed that bare P25TiO₂NPs produce a large amount of ROS, which is drastically reduced by functionalization with vitamin B2 (Fig. 5). This vitamin, also known as riboflavin, was discovered in 1872 as a yellow fluorescent pigment, [46] but its function as an essential vitamin for humans was established more than sixty years later, and its antioxidant capacity was not studied until the end of the XX century [47,48]. This antioxidant role in cells is partially explained because the glutathione reductase enzyme (GR) requires it for good functionality. This enzyme is the one in charge of the conversion of oxidized glutathione to its reduced form which acts as a powerful inner antioxidant and can quench the ROS [49,50]. The cost of this action is that the glutathione is converted to the oxidized form and needs to be recovered by the GR. Consequently, the cells need more vitamin B2. Another glutathione action is the protection against hydroperoxide. This activity is also mediated by riboflavin. Therefore, local delivery of this vitamin seems to significantly help the cells in their fight to keep the oxidative balance, once they are exposed to high levels of ROS.

Lithopone was discovered in the 1870s by DuPont. It was manufactured by Krebs Pigments and Chemical Company and other companies.^[2] The material came in different seals, which varied in the content of zinc sulfide. Gold seal and Bronze seals contain 40-50% zinc sulfide, offering more hiding power and strength.^[3] Although its popularity peaked around 1920, approximately 223,352 tons were produced in 1990. It is mainly used in paints, putty, and in plastics.^[1]

Titanium dioxide as used in sunscreens is commonly modified with other ingredients to ensure efficacy and stability. Examples of what are known as surface modifier ingredients used for titanium dioxide include stearic acid, isostearic acid, polyhydroxystearic acid, and dimethicone/methicone copolymer.

Among the raw materials for coating production, titanium dioxide is more ideal, followed by lithopone. The covering power of lithopone is only that of titanium dioxide, and the price of lithopone is much lower than that of titanium dioxide, so lithopone still occupies a large market share.