UNDER THE SUN
Those with dark skin don’t need sun protection, right? Well, the answer’s more complicated than you might think...
Why darker skin’s natural protection doesn’t eliminate the need for sunscreen
sk any dermatologist for their skincare non-negotiable and, before they launch into the game-changing power of retinol, before they’ve even extolled the virtues of sinking enough H²O, there are three letters that will inevitably pass their lips. SPF is now to beauty what gut health is to nutrition: billed as the component that everything else hinges on; the intervention without which all the other positive steps you take in the name of good health would be rendered redundant. And yet, for Black women, the SPF story isn’t quite that simple.
Data on SPF use among Black women is hard to come by but, anecdotally, take-up is low. Rihanna, who recently released an SPF suitable for dark skin revealed that, growing up, she thought sunscreen was ‘a tourist thing’ and ‘not for Black people’. Author of Palette: The Beauty Bible For Women Of Colour Funmi Fetto said in her Vogue column that 95% of the Black women she knows never wear sun cream. But while it’s true that darker skin is more protected from the sun’s rays than lighter skin, some risk remains. What’s more, melanomas aren’t the only threat to skin health that UVA and UVB rays pose. As dermatologists call for clarity on the issue, it’s time to answer the question once and for all: just how important is it for Black skin to wear SPF?
WHAT THE SPF
Historically, those with darker skintones have largely been left out of the SPF conversation. The first tanning oil (Ambre Solaire) was launched in 1935, but it wasn’t until the 1970s that the focus shifted towards sun protection, as the link between sun exposure and skin cancer became clear. By the 1990s, products with an SPF of 15 were widely available, closely followed by the SPF30 and SPF50 formulas we use today. And as awareness of the damaging effects of UV rays grew, so, too, did the focus on sun protection. And yet, SPF adverts almost exclusively featured Caucasian faces and bodies. ‘It wasn’t just SPF marketing that those with dark skintones didn’t feature in, but skin cancer awareness campaigns, too,’ says Dr Ifeoma Ejikeme, aesthetic doctor and founder of the Adonia Medical Clinic. ‘Because of this lack of diversity, the idea that dark skintones don’t need to bother with SPF has stuck.’
So is there any truth to this idea? To answer that question, you need to understand how SPF works. Dr Ejikeme explains that UV radiation from the sun is transmitted in three wavelengths, but only two penetrate the earth’s atmosphere. ‘UVB rays have a shorter wavelength and are associated with skin burning, while UVA rays have a longer wavelength and are associated with skin ageing.’ This is where SPF comes in. ‘SPF stands for sun protection factor, while the number tells you how long the sun’s UVB radiation would take to burn your skin when using the product versus the amount of time without it,’ she adds. It means that if you’re wearing SPF30, it would take 30 times longer for you to burn than if you went without.
So far, so straightforward. Only, some skintones have a higher level of natural protection than others, with Black skin able to absorb 50% to 70% more of the sun’s ultraviolet light than paler tones. ‘It’s thought that Black people have a natural protection rating of SPF13, compared with SPF3.4 for those with white skin,’ says Dr Bav Shergill, consultant dermatologist and chair of the Skin Cancer Prevention Committee. This, he explains, is down to melanin. It’s the pigment that makes hair, skin and eyes appear darker; those with dark skin have much more productive melanocytes, which are the cells that
‘Black skin has a natural sun protection rating of SPF13’
produce melanin. ‘Its role is to absorb UV light, turn it into heat and dissipate it so that it can’t attack DNA and cause mutations that lead to skin cancer,’ he adds.
It’s for this reason that the incidence of skin cancer is much lower among Black people than it is among Caucasians. According to Cancer Research UK, the skin cancer rate among white women is 15 per 100,000, while it’s 1.1 per 100,000 for Asian women and 3.6 per 100,000 for Black women. What’s more, adds Dr Anjali Mahto, dermatologist and WH columnist, UVA and UVB protection only tell one part of the story. ‘The type of melanoma that’s most prevalent in Black skintones is a subtype know as acral lentiginous melanoma, and it affects the palms, soles of the feet and nail beds,’ she says. ‘Crucially, it’s thought this type of skin cancer has little to do with UV light, so wearing SPF isn’t likely to make a difference.’ That doesn’t mean those with dark skin can’t get Uv-induced melanoma, but the risk is much lower, around one in 100,000.
SHEDDING SOME LIGHT
Such figures don’t tell the whole story, though. While it’s true that those with darker skin are less likely to be diagnosed with skin cancer, they’re also less likely to survive it than a Caucasian person. In the US, the average five-year melanoma survival rate is 65% in Black people, versus 91% in white people. And while there are no such statistics available on survival rates in the UK, Dr Shergill believes that UK figures would likely mirror those in the US. Dr Ejikeme points to the disproportionate targeting of white people in skin health campaigns for leading to lower levels of awareness of melanomas among people of colour. ‘There’s often information about checking your moles but, even as I say this, you’re likely to be picturing a mole on Caucasian skin,’ she says. ‘So when women of colour do have changes to their skin, they’re less likely to recognise it on themselves, making them less likely to act on it. This means they may present to a GP later, which can lead to poor outcomes. My rule for skin changes? If you see anything new on your skin that’s still there after two weeks, take a photo of it. If it’s still there after four weeks, contact your healthcare provider and show them the photos so they can see how it’s changed. It may be nothing, but there’s no harm in getting it checked.’ Considered in the context of broader health inequalities, too, the lower survival rate begins to make sense. ‘When it comes to skin cancer, we know that those in lower socio-economic groups tend to have a poor prognosis because they’re less likely to have access to care or to seek help from doctors,’ adds Dr Shergill. Indeed, in the UK, those from Black, Asian and minority ethnic
households are twice as likely to live in poverty as those from white households.
What complicates the situation further is a historic lack of research on skin cancer among people of colour. The dominance of Caucasians in clinical trials and inconsistencies in the way data has been collected both equate to a situation in which we know less about the way UV rays interact with darker skintones. Dr Mahto gives the example of the Fitzpatrick scale – a skin colour chart widely used by dermatologists to make an assessment of skin cancer risk. ‘It breaks skintones into six categories based on colour and how easily it tans versus burns when exposed to sunlight.’ This can be problematic, she explains, since it leaves no room for nuance. ‘The question is where that leaves people of dual heritage,’ she says. ‘Essentially, collecting data this way subjects it to huge limitations because it will be inconsistent.’
But as to the question of who should be using SPF, dermatologists are clear: everyone. ‘When it comes to preventing issues such as skin sagging, pigmentation and wrinkles, Black skin absolutely needs SPF,’ says Dr Mahto. Moreover, she adds, using popular exfoliants such as acids or retinol, or brightening actives such as vitamin C, means that deploying an SPF is all the more important. ‘These treatments work by removing the top layers of dead skin, revealing new and healthy skin cells that are more sensitive to sunlight,’ says Dr Mahto. ‘By skipping SPF, you’re effectively undoing all the good work of these actives. Fine lines and discoloration issues will, at best, remain unchanged, and, at worst, intensify.’ Dr Ejikeme points out, too, that SPF is key in preventing the occurrence of hyperpigmentation, an issue that is more likely to affect women of colour because they have more melanin.
CREAM OF THE CROP
It adds up to a compelling case for SPF forming a fundamental part of your skincare regime. Only, if your skin is darker, that’s easier said than done.
‘In the past, when those with dark skin have tried to wear SPF, they’ve found that some mineral formulas left a white tinge that caused their complexion to look ashy, thanks to the zinc oxide and titanium dioxide,’ adds Dr Ejikeme. But just as brands have diversified their make-up ranges, they’re increasingly becoming more inclusive when it comes to SPF. Attempts began in the early 2010, when brands started using nanotechnology to make zinc oxide particles incredibly small so they didn’t show up on the skin. But two studies that raised questions about the influence of these particles in the body sent brands back to the drawing board.
The latest wave of launches use a non-nano, blendable zinc oxide mineral, which is both invisible and safe for all skin types. La Roche-posay’s latest launch, Anthelios SPF50+, £17.50, relies on netlock technology – a process that combines water and oil molecules in such a way that, when applied to the face, it forms a layer of sun protection. This results in a less greasy finish compared with traditional formulas. ‘Brands are also adding beneficial ingredients, such as niacinamide and hyaluronic acid, to help with acne, skin brightening or pigmentation,’ adds Dr Ejikeme.
Beyond SPF, the experts WH spoke to for this piece agreed that more work needs to be done to reduce the health inequalities that persist across so many conditions. ‘First, clinicians need to be aware that any unidentified skin lesion needs a diagnosis, regardless of skin type,’ says Dr Shergill, while at pains to stress that Black people have a low risk of being diagnosed with skin cancer. ‘We don’t want to worry a section of society unnecessarily, but we want to make sure everyone has the tools to feel confident about asking for help if something untoward appears on their skin.’ Skin health, much like nutrition and fitness, is in your hands.
‘By skipping SPF, you’re undoing all the good work of your skincare actives’