Sunscreens in pigmentary disorders: time to revise the message.

Abstract

Current sunscreen messaging centres around skin cancer prevention, with an emphasis on mitigating the damaging effects of ultraviolet B (UVB) radiation. Darker skin is believed to be better protected against UVB owing to its higher melanin content, and therefore, this messaging has been largely targeted at people with lighter skin tones. This is reflected by low sunscreen use by people of darker skin types. However, visible light (VL) is now being appreciated as a culprit behind exacerbation of disorders of hyperpigmentation such as melasma and post-inflammatory hyperpigmentation (PIH) which is known to significantly impair quality of life (QoL) of those affected. The role of VL in melanogenesis is not well known to patients nor to dermatologists and is a missed opportunity in the management of pigmentary disorders. We propose that changing the terminology from 'sunscreen' to 'light protection' acknowledges the central role of VL in melanogenesis, underlining the importance of VL protection and making the messaging more inclusive for people of all skin colours.