Photoprotection for Skin of Color

Abstract

Photoprotection behaviors can mitigate skin damage caused by ultraviolet radiation, and common methods include seeking shade, avoiding sun exposure during peak daylight hours, wearing sun-protective clothing, applying sunscreen, and using sunglasses. While the role of sun protection in preventing sunburns, photoaging, and skin cancer is well established in fair-skinned populations, individuals with skin of color (SOC) are presumed to suffer fewer negative effects from solar radiation. Thus, the importance of photoprotection in this population is understudied and may be underestimated. In SOC populations, sun exposure is known to cause pigmentary disorders, photoaging, and basal cell carcinoma (BCC), highlighting the potential benefits of photoprotection. Although SOC populations tend to practice photoprotection by seeking shade and wearing sun-protective clothing, survey and interview-based studies have consistently found relatively low use of sunscreen among these populations. Common motivators for photoprotection in individuals with SOC include preventing sunburn and pigmentation, with the prevention of skin cancer being a less important reason. As a skin cancer risk behavior, indoor tanning is relatively rare in SOC populations, but its use may increase with acculturation to US norms. While more studies are necessary to clarify whether photoprotection behaviors may decrease skin cancer-related mortality in SOC populations, regular dermatologic care and counseling on photoprotection remain essential in patients with SOC for overall skin health.

Sun exposure behaviours as a compromise to paradoxical injunctions: Insight from a worldwide survey

“…Attitudes towards exposure to sunlight and sun protection were studied in a large population of 17,001 adults throughout 17 countries. While these topics are frequently explored in Caucasian and fair-skinned populations, 26 they remain rarely explored in population of darker skin phototypes, 11 notably from Asian 15 or African countries. 27 Most survey participants, including individuals with dark skin phototypes, had at least some knowledge of UVrelated risks for health and skin photoageing.…”

“…5,10 Expert consensus and guidelines on photoprotection recommend to include all skin tones with a tailored photoprotection approach. [11][12][13] Attitudes towards protection from sunlight and the quest for a tan have evolved over the course of human history 14 and are both closely linked to cultural, sociodemographic and health-related aspects. [15][16][17] The first campaigns of protection against excessive exposure to sunlight were launched in reaction to the alarmingly sharp rise in the number of skin cancers in the 1970s, 14 mainly in Northern America, Europe and Australia.…”

“…Visible light is involved in worsening pigmentary disorders, such as melasma 5,10 . Expert consensus and guidelines on photoprotection recommend to include all skin tones with a tailored photoprotection approach 11–13 …”

Update on Melasma—Part II: Treatment

“…As most sunscreens underperform in real life due to the low amount of product used or insufficient reapplications, especially for UVA and VL protection, behavioral measures and self-awareness regarding sun exposure should be reinforced for patients with melasma [10][11][12]. Additionally, dark-skinned people are less adherent to routine sun protection, sunscreen use, and reapplication, although they are more affected by melasma than fair-skinned individuals, thereby hindering the effectiveness of treatment [13].…”

Solar Ultraviolet Radiation, Skin Cancer and Photoprotective Strategies in South Africa†

“…Despite the high protection to epidermal DNA afforded by darker pigmentation, especially in the basal epidermis, among Black South Africans (21,87), photoprotection for people with deeply pigmented skin could still be important to reduce pigmentary disorders, photoaging and the risk of BCC (88).…”