Kristine Kucera, PA-C, MPAS, DHS
Sunscreen in Skin of Color
Ultraviolet Radiation (UVR) from the sun can damage the DNA in skin cells, which can lead to premature aging and skin cancer. In the US, more than 9,500 people are diagnosed with skin cancer every day, and at least one in five Americans will develop skin cancer by age 70. Studies show that populations with skin of color in the United States, particularly Hispanics and African Americans, do not regularly wear sunscreen or take other steps to protect themselves from the sun. However, no matter an individual’s skin tone, all skin tones are susceptible to sunburn, premature aging, skin cancer, and other health issues as a result of too much exposure.
Skin color depends on the amount of melanin in the skin, but melanin can only provide a natural sun protection factor (SPF) of up to 13. This does allow dark-skinned people some intrinsic protections. Yet this added degree of protection against UVR for dark-skinned individuals provides a minimal protective benefit against photodamage and photoaging. Most importantly, high levels of melanin in the skin do not replace the need for sunscreen. High levels of melanin in the skin do not replace the need for sunscreen.
Although skin cancer incidence is highest among non-Hispanic Whites, minority populations are often diagnosed with more advanced stage disease and are more likely to experience poor outcomes. Statistics show that 1-2% of all skin cancers occur in Blacks, 2-4% occur in Asians, and 4-5% in Hispanics. Squamous Cell Carcinoma is the most common skin cancer in patients with dark skin.
Most skin cancers are preventable. Proactive approaches to sun protection are essential. These include consistent use of effective sun protection strategies, including application of broad-spectrum sunscreen, wearing protective clothing, seeking shade, and avoiding indoor tanning. The American Academy of Dermatology suggests using at least an SPF 30, but higher is better. It is important to reapply every 2 hours, especially if out in the sun or spending time in the water. Of note, there are concerns associated with some sunscreen formulations leaving a visible sheen on the skin, but the number and type of sunscreens on the market continues to expand. Many formulations now are intended to leave no residue or even include pigments to blend into skin and be used in place of foundation make-up.
Kristine Kucera, PA-C, MPAS, DHS, is Assistant Clinical Professor, University of Texas Southwestern, Medical Center PA Program, Dallas, TX. She is a member of the DEF Advisory Council.
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