Among the most fundamental health tips, “wear sunscreen” is on par with “eat fruits and vegetables.” However, according to Dr. Jenna Lester, an associate professor of dermatology at the University of California, San Francisco, conventional sunscreen—the kind that appears white or cream-colored in the bottle and melts into the skin—misses out on a significant advantage.
More research has been done in the past ten or so years on melasma, a condition where brown or bluish-gray patches appear on the skin, and hyperpigmentation, which can manifest as dark spots or patches. People with darker skin are far more likely to experience these problems.
According to Dr. Adam Friedman, a professor and chair of dermatology at George Washington University, UV rays are not the only source of these disorders. Research indicates that visible light radiation, which reaches deeper into the skin than UV radiation, may be a factor in melasma and hyperpigmentation. Lighter skin types have been demonstrated to experience erythema, or skin reddening, when exposed to visible light.
Visible light radiation is not protected by the majority of sunscreen creams.
“In dermatology, understandably, we have this focus on skin cancer,” adds Lester. “And I think that focus sometimes tends to take people of color out of the discussion because it’s something less likely to occur in people of color,” she continues.
Although “we can’t underestimate the psychosocial emotional impact,” Friedman argues, hyperpigmentation and melasma are not harmful to one’s health.
However, visible light radiation is blocked by tinted sunscreens, which include pigment to match a variety of skin tones.
When it comes to defending against harm from visible light, tinted sunscreens perform better than non-tinted ones, according to a review of research on the topic that was published earlier this summer in the journal Photodermatology, Photoimmunology & Photomedicine.
According to a survey of dermatologists in the United States, more than 90% of practitioners advised their patients to protect themselves from visible light, but only roughly 10% offered evidence-based advice.
Dr. Friedman and the other experts are calling for more studies and established guidelines regarding protection from visible light. And further product options: Some healthcare professionals claimed that their patients’ use of tinted sunscreen was hampered by the absence of an appropriate selection of tints.
Understanding hyperpigmentation and melasma
The skin does not suddenly develop dark patches. The process frequently begins with a bug bite or scratch, or with an inflammatory skin condition, most commonly acne. According to Friedman, melanocytes, which are pigment cells in the skin, might be harmed by the body’s inflammatory reaction, which is intended to cure the lesion.
Melanosomes are the packets that contain these pigment cells. According to Friedman, darker skin tones may be more susceptible to hyperpigmentation, and the packets are bigger and more dispersed in darker skin.
Spots can develop on the skin in a variety of ways besides this inflammatory process associated with UV radiation. For example, sun exposure over time causes age spots, also known as solar lentigo, which are believed to be caused by UV radiation. Seborrheic keratoses are another benign skin development that has nothing to do with light. These and other disorders that aren’t related to visible light are included in some definitions of hyperpigmentation, and research on visible light radiation is continually developing.
“If you are someone with darker skin and you have acne and you’re out in the sun, that’s a recipe for longer lasting and more noticeable dark spots,” Friedman says, adding that people with lighter complexion are not immune to post-inflammatory hyperpigmentation.
Since melasma is an active inflammatory condition rather than a scar, dermatologists are less knowledgeable about it. According to Friedman, sun exposure exacerbates the problem, and hormones play a part.
Want visible light protection? Here’s what to look for on a label
The compounds that shield the skin from UVA and UVB rays are those that are labeled as active ingredients on a bottle of sunscreen or sun protection moisturizer. You must therefore read further down the label to determine whether a product also inhibits visible light emission.
Lester and Friedman both believe that the chemical composition iron oxide is the most important factor to search for when it comes to visible light protection. In addition to giving tinted sunscreen its color, iron oxide is frequently utilized to give concealer and foundation a skin-toned appearance.
“Any tinted mineral sunscreen likely will filter out visible light,” Friedman states.
What is an adequate amount of iron oxide? It’s a difficult one. Since it hasn’t been labeled as an active ingredient yet, the problem is that we don’t really know what concentration is present. The majority of sunscreen companies won’t even tell you if you ask them since it’s secret information,” Lester explains.
According to her, the optimum protection is probably provided by 3% iron oxide. Additionally, she believes it’s reasonable to presume that white or off-white sunscreens don’t contain enough of the ingredient to pass muster. You can sort of eyeball it because, after all, we’re talking about visible light.
According to Friedman, tinted titanium dioxide is also effective at dispersing visible light. There is also a “transparent” form of titanium dioxide. Friedman warns against using sunscreens that are advertised as “ultra-shear or ultrafine.” Zinc oxide and titanium dioxide nanoparticles, which are too small to scatter visible light but block UV rays, are present in such items.
According to Lester, there is some evidence that antioxidants like vitamin C also help protect against visual light.
But will it match my skin?
Originally intended to blend with your skin tone or act as a makeup product that doubles as sun protection, tinted sunscreens were not intended to provide protection from visible light. According to Friedman, they complement darker complexion tones better.
“I tend to hear people talk about ghostly or ashy looks for mineral-based sunscreen, like zinc, titanium,” Lester explains. “Tinted sunscreens containing iron oxide tend to mitigate that problem a little bit, but they certainly don’t cover the diversity of dark skin tones that exist in the world,” she explains.
Lester notes that, like Band-Aids, darker skin-matching tinted sunscreen creams have only recently been accessible. “I would love for companies to develop even more deeply tinted sunscreen,” she continues.
According to Lester, if you are unable to find a tinted sunscreen in a shade that suits you, you can search for an iron oxide-containing foundation and apply non-tinted sunscreen first, followed by the foundation, which should offer some protection from the sun.
All things considered, Dr. Friedman advises patients to wear tinted sunscreen to avoid hyperpigmentation, even if they are unable to obtain the ideal shade.
“Given how disabling dark spots are to, I would say, every single patient that has them, it’s a different mindset with respect to why you would use it versus not,” according to him.
Based in Boston, Andrea Muraskin works as a writer covering science and health. The NPR Health newsletter is written by her.
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