Detailing Photo-protection Methods for Skin of Color

Anna L. Chien, MD

A new report into the benefits of photoprotection behaviors detailed ways in which people with skin of color could mitigate skin damage caused by ultraviolet radiation.

Investigators noted that while the role of sun protection is well established among fair-skinned populations, people with skin of color are often presumed to suffer fewer negative effects from solar radiation, making the importance of photoprotection in this population understudied and underestimated.

Previous studies observed that skin of color populations have been associated with low use of sunscreen and other sun protective measures.

An investigative team led by Anna L. Chien, MD, Department of Dermatology at Johns Hopkins University School of Medicine, Baltimore, detailed pigmentation and pigmentary disorders associated with sun exposure as well as photoprotection methods that people with skin of color could benefit from.

Pigmentation and Pigmentary Disorders

In previous studies, black epidermis was estimated to have a sun protection factor (SPF) of 13.4, which is nearly 4 times greater than that of white epidermis. As such, individuals with darker skin pigmentation are less likely to experience sunburns and more likely to experience tanning after exposure to UV radiation.

Despite increased protection, people with skin of color are more susceptible to developing pigmentary disorders including post-inflammatory hyperpigmentation and melasma, in addition to photoaging and photo carcinogenesis.

Photoprotection for Skin of Color

Despite a decreased risk of sunburns, photoaging, and photo carcinogenesis, investigators still recommended that patients with darker skin practice multimodal photoprotection behaviors routinely.

Among the traditional recommendations such as sunscreen, sun-protective clothing could prove especially important in patient with skin of color given the aforementioned limitations associated with sunscreens.

Vitamin D deficiency was also noted in the current review, as national data in the US have shown racial and ethnic disparities in the prevalence of vitamin D deficiency, affecting Hispanics and Black individuals in particular.

The use of photosensitizing drugs could also increase a patients’ susceptibility to skin photodamage. Drugs that have been implicated include tetracycline, doxycycline, hydrochlorothiazide (HCTZ), amiodarone, naproxen, piroxicam, chlorpromazine, and thioridazine.

Previously data found increased susceptibility to recent sunburn in non-Hispanic Black patients taking HCTZ, particularly among non-Hispanic Black women, which investigators believed highlighted the importance of inquiring and counseling on photoprotection behaviors in these populations.

While the findings discussed in this review article are not generalizable to all skin of color populations and geographic regions, they highlight the unique considerations and challenges to photoprotection that need to be further examined,” the team wrote. “As we learn more, counseling remains the critical piece in skin of color patients and this will only become more important as the relative sizes of skin of color populations continue to increase over the next decades in the US”