Sunscreen recommendations for patients with skin of color in the popular press and in the dermatology clinic

Background: Patients with skin of color are at risk for skin cancer, pigmentary disorders, and photo-exacerbated conditions but find it challenging to use sunscreens on the market that leave an obvious residue on their skin. Objective: The objective of this study was to examine sunscreen recommendations from the popular press and from practicing dermatologists for patients with skin of color. Methods: We queried the Google search engine with the following search terms: “Sunscreen” with “skin of color,” “dark skin,” “black skin.” For comparison, we also searched for “sunscreen” with “white skin,” “pale skin,” and “fair skin.” We conducted an anonymous survey regarding sunscreen recommendations among dermatology trainees and board-certified dermatologists. Results: Websites with recommendations on sunscreens for patients with skin of color compared with sunscreens for white or fair skin were more likely to recommend chemical sunscreens (70% vs. 36%) and more expensive products (median: $14 vs. $11.3 per ounce), despite the lower sun protection factor level (median: 32.5 vs. 50). In our survey study, dermatologists were overall cost-conscious and felt that sun protection factor level, broad spectrum (ultraviolet A/B protection), and price were the most important features of sunscreens for their patients. Cosmetic elegance was deemed least important. Dermatologists overall counseled patients with skin of color less on sunscreen use, and 42.9% reported that they either never, rarely, or only sometimes take patients’ skin type into account when making sunscreen recommendations. Conclusion: These data represent an area for growth within dermatology to improve culturally competent care by gaining familiarity with sunscreen types and formulations that are geared toward patients with skin of color.