Sun Safety for All: Addressing Sunscreen Challenges in POC Communities

Skin cancer is the most common malignancy in the United States, prompting the widespread use of topical sunscreens as a crucial defense against harmful sun exposure. While skin cancers are less prevalent among people of color (POC), their occurrence often leads to higher mortality rates compared with their White counterparts.

The American Academy of Dermatology (AAD) recommends reapplication of a broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or higher every 2 hours when outdoors to help reduce the risk of skin cancer. However, several barriers inhibit POC from implementing these sunscreen guidelines. Let’s explore 5 such obstacles.

1. Lack of awareness

The first barrier that prevents POC from using sunscreen stems from a pervasive lack of awareness regarding its importance within communities of color. Skin cancer campaigns, educational materials, and research frequently overlook POC in their messaging and medical images. This exclusion contributes to the myth that POC do not get skin cancer and, therefore, do not need to use sunscreen. Furthermore, the lack of diverse representation in medical education is a significant contributor to racial inequalities in health care experiences and outcomes. 

2. Cosmetic concerns

It’s a longstanding issue that some sunscreens leave behind a noticeable white residue. This is particularly common with physical (also referred to as mineral) sunscreens, which act as a protective barrier to shield the skin using active ingredients like zinc oxide and titanium dioxide. This type of sunscreen usually has a white residue that sits on the surface of the skin and deflects the sun’s rays; the residue can be especially visible on darker skin colors. To address this, some companies have introduced tinted versions of physical sunscreens. However, these typically come in a single shade and may not suit all darker skin colors. As a result of these aesthetic concerns, POC may be advised to use chemical sunscreens or a hybrid of both chemical and physical, as they tend to blend more seamlessly in darker skin colors.

3. Controversial ingredients

Chemical sunscreens function like a “sponge” by absorbing the sun’s rays through a chemical reaction. This type of sunscreen tends to be easier to apply, leaving no visible white residue. However, concerns have arisen about the unknown long-term effects of some active ingredients, such as oxybenzone and octinoxate, and how they are absorbed by the body. More study is needed to evaluate potential risks and benefits, particularly in different populations (age groups, skin colors).

In addition, a common concern among patients of color visiting dermatologists is pigmentary disorders. Unfortunately, chemical sunscreen formulas can irritate the skin and inadvertently trigger hyperpigmentation. This is another reason that POC may choose to avoid chemical sunscreens altogether, further limiting the options available.

4. Decreased counseling

Did you know that compared with Black patients, White patients are 9 times more likely to receive counseling from physicians on sunscreen use? Additionally, a 2020 study found that more than half of dermatologists discussed sunscreen less frequently with patients with darker skin colors. This gap in counseling contributes to the health disparities relating to skin cancer.

Dermatology remains one of the least diverse medical specialties, with only 4% of dermatologists identifying as Hispanic and 3% identifying as Black or African American. More representation and greater emphasis on the unique needs of POC are necessary to combat health inequities.

5. Cost

The cost of sunscreen use year-round contributes to the lack of compliance with sunscreen guidelines. Sunscreen prices vary, and it was found that sunscreens marketed toward POC tend to be more expensive. This may be due to factors such as a perceived smaller customer base, limited availability of products marketed for skin of color, and higher manufacturing and distribution costs sustained by smaller companies. This financial burden further deters POC from using sunscreen on a daily basis.

In conclusion, the current sunscreen market is failing to serve POC. There is a need for more affordable sunscreen options that keep all skin colors and skin types in mind. In addition, increased research and medical training regarding skin of color is essential so dermatologists can provide knowledgeable and culturally competent care to their diverse patient population. Systemic changes must occur before we can expect POC to follow the current sunscreen guidelines recommended by the AAD.