Special to The Dallas Examiner
Having a darker skin tone gives African Americans some natural protection against the sun’s rays, but shielding your skin is still the smartest choice.
Some may think their skin color exempts them from having to worry about sun protection, dermatologists have a message. However, doctors warn the sun’s damaging rays do not discriminate.
“Ultraviolet rays are color-blind, so they hit all skin with equal strength,” said Maritza Perez, M.D., a clinical professor of dermatology at the Mount Sinai Icahn School of Medicine and a member of the Skin of Color Society Board of Directors.
“Darker skin contains more melanin – pigment that gives skin its color – than lighter skin, and that helps block the rays from penetrating and doing as much damage. But even the darkest Black skin provides only about an SPF 13. If you get enough sun exposure, you’ll get skin damage, and possibly even skin cancer.”
And for those who identify as Black, Asian or Hispanic but have skin on the lighter end of the spectrum, the risk might be nearly equal to that of many Whites.
Sun, sunburn and skin damage
A history of sunburn is linked to a higher risk of developing skin cancer, and people of all ethnicities are susceptible to burning. In a 2018 study published in JAMA Dermatology, researchers surveyed 31,162 people about their sun protection habits. They found that 13% of Black people and 30% of Hispanics have experienced sunburn in the past year.
Redness, the telltale sign of sunburn for White peoples, may not be as evident on darker skin, but skin can still feel hot, tight and painful.
And even if people with naturally tanned skin don’t burn, unprotected time in the sun can still result in damage.
“Any acquired tan, either in white or brown skin, is a sign that the skin is being damaged by the sun,” said Mona Gohara, M.D., an associate clinical professor of dermatology at Yale School of Medicine.
The UV rays that cause a tan or burn can also make the skin look older.
“Photodamage in people of color leads to sagging of the skin, loss of volume in the face, and hyperpigmentation,” said Jeanine Downie, M.D., a dermatologist in private practice in Montclair, N.J. “While people with lighter skin tones tend to see fine lines, and wrinkles show up first, people of color will see changes in pigmentation that lead to dark patches [melasma] and uneven skin tone as a result of sun damage.”
Asians, Blacks and Hispanics do have a significantly lower incidence of skin cancer compared with Whites. But they aren’t immune.
For example, in a study published in the journal Cancer Causes & Control, Asian men who had the most sun exposure in childhood had a risk of developing squamous cell carcinoma – a type of skin cancer than isn’t usually fatal but can be disfiguring – that was about three times greater than those who got the least sun exposure.
And the rate of melanoma, a potentially fatal type of skin cancer, is still 5 in 100,000 for Hispanics and 1 in 100,000 for non-Hispanic Blacks, Asians and Pacific Islanders, compared with 28 in 100,000 for Whites, according to the American Cancer Society.
Skin cancer is often diagnosed at a later stage in people of color than in Whites. That’s partly because of a lack of awareness about the risks, and because skin cancer can look much different and be found in different places on the body – such as the palms and soles of the feet.
“Even doctors often don’t think about skin cancer when they’re treating people of color,” Downie acknowledged.
The outcome is that skin cancer can be harder to treat and, in the case of melanoma, be more deadly in non-Whites.
“I think perhaps the most important conversation to have around skin cancer is the disparities that exist within it,” said Jenna Lester, M.D., an assistant professor of dermatology and director of the Skin of Color Program at the University of California San Francisco. “Why are there such drastic differences between mortality rates even though skin cancer is much less common in Blacks, Hispanics and Asians versus in Whites?”
Find a sunscreen that suits you
In the United States, 61% of Blacks and 23% of Hispanics said they never wear sunscreen, according to a recent Consumer Reports nationally representative survey of 2,007 adults.
Most experts agree that’s not a good move. The American Academy of Dermatology has recommended that everyone use a broad-spectrum sunscreen with an SPF of 30 or higher every day.
People who have darker skin – and the slight protection that extra melanin provides – might be tempted to skimp. But even if you don’t burn and aren’t worried about skin cancer, sunscreen is the key to keeping skin healthy.
“The bulk of the benefit to wearing sunscreen in patients with brown skin is that it helps minimize skin discoloration and premature wrinkling,” said Crystal Aguh, M.D., director of the Ethnic Skin Program at Johns Hopkins School of Medicine. “Skin discoloration is among the most common complaints in patients with brown skin, and regular use of sunscreen is critical component of the treatment regimen.”
One barrier to sunscreen use is finding one that works for your skin.
“The biggest concern I hear from my patients with darker skin is about the cosmetic appearance of the sunscreen once it’s applied,” Lester said. “Too many products give their skin a light cast.”
“It may take a bit of trial and error,” she said.
For that reason, she suggests sampling less expensive drugstore brands so that you can try several options.
In CR’s sunscreen tests, our professional panel of sensory testers found that the following highly protective sunscreens in our ratings left little film on skin and didn’t leave it looking chalky: Banana Boat Simply Protect Sport Spray SPF 50, Hawaiian Tropic Sheer Touch Ultra Radiance Lotion SPF 30 and Hawaiian Tropic Island Sport Ultra Light Spray SPF 30.
Neutrogena offers a variety of sunscreens for all ages and live styles.
Some recent studies have called into question the safety of certain chemical active sunscreen ingredients, particularly oxybenzone. This UV filter can be absorbed through the skin, and there’s some evidence – all of it from animal studies – that it’s an endocrine disruptor, meaning it can mimic or interfere with the body’s own hormones.
Experts caution that this news shouldn’t dissuade you from using sunscreen.
“We know that UV exposure is a risk factor for developing certain types of skin cancer, whereas we don’t know the implications of these studies yet,” Lester stated.
An option is to seek out a natural sunscreen, which contains mineral ingredients such titanium dioxide and zinc oxide that aren’t absorbed through the skin. But for people with darker skin, mineral sunscreens can leave them with a whitish, ashy tone. Plus, in our testing, mineral sunscreens consistently rate lower for sun protection.
If you do prefer a mineral sunscreen, the highest-scoring product in CR’s tests that didn’t leave a white cast on skin was Thinkbaby Lotion SPF 50+ with zinc oxide. But it did leave a slight greasy film on skin. It wasn’t among our top performers, however. In our testing, it provided less than half the SPF listed on the label, but it did offer top-notch protection against UVA rays, which are primarily responsible for skin cancer and skin aging.
Whether you use sunscreen or not, though, you should take other sun protective measures. Cover up with clothing and a wide-brimmed hat, seek shade, and whenever possible, avoid the sun at midday when it’s at its peak strength.