Photoaging in darker skin types
Preventing dyspigmentation is of more concern than wrinkling in dark skin (1,200 words, 6 minutes)
The skin of Black patients may show aging differently from that of White patients, Dr. Marissa Joseph reported during a presentation at the 9th annual Skin Spectrum Summit.
Black patients may display more dyspigmentation from photoaging, and fewer textural changes, she said. While increased melanin does increase protection from UV-accelerated aging, it also makes skin more vulnerable to dyspigmentation, noted Dr. Joseph, an academic dermatologist at the University of Toronto and medical director of the Schachter Dermatology Centre at Women's College Hospital.
Dr. Joseph said UV light leads to immediate darkening, persistent pigment darkening, and delayed tanning. But exposure to visible light is important as well. It has very little effect on skin texture, which may help explain why filters have developed less to block visible light.
Sunscreens and filters that block UV light do not protect against visible light, which is especially important for patients with conditions such as melasma, which can be worsened by visible light.
Dr. Joseph had several recommendations to help protect themselves from visible light:
Avoid direct sun exposure
Wear photoprotective clothing
Tinted sunscreens containing iron oxide pigments can also offer some protection against visible light
Bottom line: Darker skin is more likely to show photoaging in the form of dyspigmentation. Protecting against these pigment changes requires protection from both ultraviolet and visible light. Good sun-protective behaviours, plus the use of sunscreens containing iron oxide pigments, are recommended.
From the literature on photoprotection
Photoprotective measures among adolescents stratified by region: An analysis utilizing the National College Health Assessment
In this paper, researchers utilized data provided by the American College Health Association's National College Health Assessment to evaluate photoprotective behaviours among adolescent populations in the U.S.
They found Black or African American respondents had the lowest association of practicing photoprotective behaviours in comparison to White respondents (p<0.05). When comparing U.S. geographic regions, the south had the lowest association of photoprotective measures (p<0.05).
The authors note two limitations to the study. First, the response rate of each institution varied, although there was still a large quantity of respondents. Second, they could not discern the specific reasoning for adolescents not using sunscreen.
Guide to tinted sunscreens in skin of colour
The authors of this paper review the role of visible light in disorders of hyperpigmentation and that of tinted sunscreens in protecting against visible light.
They suggest tinted sunscreens containing iron oxides should be recommended over non-tinted sunscreens for patients prone to hyperpigmentation disorders, as iron oxides protect against visible and ultraviolet light. The authors note tinted sunscreens are more effective than non-tinted sunscreens in preventing melasma relapses and reducing hyperpigmentation, and they may also enhance the depigmenting efficacy of topical hydroquinone.
In the article, they list several product characteristics that should be considered when selecting an ideal tinted sunscreen for a particular patient, including:
Broad spectrum with adequate coverage of both ultraviolet and visible light
Tint matching
Formulation texture
Active ingredients
Cost
The importance of photoaging prevention in all skin types: An update on current advancements
This article reviews the mechanisms of photoaging from various light forms, the implications of these damaging effects on skin of colour, and innovative approaches that can advance how patients practice photoprotection.
The authors expand upon the latest innovations in photoprotection that hold the potential to increase patient adherence and improve skin health across all skin types.
Assessment of prevalence of sunscreen use and related practices among people living in Saudi Arabia: A cross-sectional survey-based study
Researchers conducted this cross-sectional, survey-based study with a diverse population sample in Saudi Arabia. They asked participants about their sunscreen usage habits, motivations, and knowledge of proper application techniques. The investigators also collected demographic information, including age, gender, and skin type.
A total of 2,321 individuals participated in the study. More than two-thirds of the participants reported using sunscreen either always, regularly, or often, primarily to maintain a light skin colour and prevent skin cancer. Factors associated with sunscreen use included younger age (18 to 40 years old), female gender, history of sunburn, and fair skin. Despite the majority reporting healthy sun exposure habits, several shortcomings were identified in sunscreen practices, including incorrect application and suboptimal reapplication frequency.
At the intersection of skin and society
As part of the new Certificate in Black Canadian Studies offered through the University of Toronto’s University College, Funké Aladejebi, an assistant professor of history in the university’s Faculty of Arts & Science, is teaching a year-long Black Canadian History course.
“So many people educated in Canada, or external to Canada, don't know about the long-standing presence of Black people in this country,” said Aladejebi in a press release from the university.
“This breadth of knowledge on Black Canadian history often gets ignored or is not often inserted into broader courses on Canadian history.”
The course examines history beginning in 1604 when the earliest records of persons of African descent in Canada occurred. Aladejebi said the goal of the course is to give students a broad overview of the movements and migrations of persons of African descent into the land that is now called Canada and for students to think in complex ways about how people were living and existing in this country.
Also explored in the course are the experiences of Black Loyalists (people of African descent who sided with the British during the American Revolutionary War), passengers of the Underground Railroad, as well as lesser-known movements to the West Coast, the Prairies, and the Maritimes.
“We tend to forget about these regions where Black people resided in smaller numbers,” said Aladejebi. “But it's our responsibility as historians to show the breadth of where Black people have been and where they still are.”
She gave the example of the more than 500 Maroons—descendants of Africans in the Americas and Islands of the Indian Ocean who escaped from slavery and formed their own settlements—forcibly transported from Jamaica to Halifax in 1796 after a series of wars fighting for freedom from British control in Jamaica.
Despite an inhospitable reception, the Maroons flourished and maintained a strong sense of community in exile, said Aladjebi, adding that they were connected to the city’s larger community, having been involved in the construction of the Halifax Citadel. However, many in the community spent years petitioning the colonial government to leave Nova Scotia. In 1800, most of them left for the free Black colony of Sierra Leone in West Africa.
“But it’s widely believed some Maroons stayed behind and their continued presence is reflected in the surnames, accents, idioms, customs, oral histories and traditions of African Nova Scotians,” Aladejebi said.
The second half of the course deals with more contemporary issues such as racial violence, anti-Black racism, immigration trends, equity and inclusion for Black communities, and injustice in Canada.
This week
March is Nutrition Month in Canada
March 6 is World Lymphedema Day
March 8 is International Women’s Day
Something to think about in the week ahead. . .
—Hosea Ballou, American clergyman (1771 to 1852)
Next week
Toronto-based dermatologist Dr. Renita Ahluwalia provides insights into the burden of acne in patients with skin of colour.
If you like Skin Spectrum Weekly, why not check out other publications, podcasts, and portals from Chronicle?
Established in 1995, The Chronicle of Skin & Allergy is a scientific newspaper providing news and information on practical therapeutics and clinical progress in dermatologic medicine. The latest issue features:
Drs. Lauren Lam (Calgary), Sam Hanna (Toronto), Benjamin Barankin (Toronto), and Renée A. Beach (Toronto) discuss many of the new therapeutic options that arrived in 2023.
Dr. Andrew F. Alexis (New York) details pigmentary disorders in patients with skin of colour.
An essay from Dr. Sheila Wang (Montreal) submitted to the 2022 Dermatology Industry Taskforce on Inclusion, Diversity and Equity (DiTiDE) short essay contest. Dr. Wang wrote about the development of new imaging technology to detect and assess ‘beneath-the-skin’ inflammation, perfusion, and tissue oxygenation in any skin phototype.
Plus regular features, including the popular column “Vender on Psoriasis” by dermatologist Dr. Ron Vender
Read a recent digital edition of The Chronicle of Skin & Allergy here. To apply for a complimentary* subscription or to receive a sample copy, please email health@chronicle.org with your contact information.
The Women in Dermatology e-newsletter updates new findings concerning dermatologic issues that affect women and the female dermatologists who care for them. Read the current issue here.
Season three of the Vender on Psoriasis podcast with Dr. Ron Vender has begun. Listen to the new season here. In episode five, Dr. Vender discusses whether or not vitamin D has any impact on psoriasis severity, sex differences in psoriatic inflammation itch, and the risk of psychiatric disorders associated with acitretin.
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