Do Black people need sunscreen? What the AAD says

Many people with brown or Black skin grew up hearing that sunscreen was for people with pale skin. The American Academy of Dermatology (AAD) addresses that idea directly. On its page about skin cancer in darker skin tones, it asks whether people with brown or Black skin need sunscreen. Its answer: "Yes. Dermatologists recommend sunscreen for everyone." This guide explains why, which sunscreen dermatologists suggest for darker skin, and the warning signs of skin cancer that are easy to miss. It is part of Skinli's guide on how to choose a sunscreen for your face.

Darker skin has some protection, and it has limits

It is true that darker skin has more natural protection from ultraviolet light. The NHS says, "If you have naturally brown or black skin you are less likely to get skin cancer, as darker skin has some protection against UV rays." The FDA says skin cancer "is less common in those with darker skin tones."

Both sources then add the limit. The NHS continues: "you should still avoid burning and take care in the sun as people of all skin tones can get skin cancer." The National Cancer Institute says, "people of all skin tones can develop skin cancer, including those with dark skin." The FDA says people of all skin colors are at risk for sunburn and other harm from ultraviolet light.

No source Skinli read gives darker skin an SPF number, so it is best not to rely on any figure you may see online.

Three reasons dermatologists recommend sunscreen for darker skin

1. Skin cancer is often found late. The AAD says, "When someone who has a darker skin tone develops skin cancer, the cancer is often advanced by the time it's diagnosed. This can make treatment difficult." It also says squamous cell carcinoma is "the most common type of skin cancer in Blacks and Asian Indians."

2. The sun causes dark spots and patches. The AAD's sunscreen label guide says, "The darker your skin tone, the higher your risk that UV rays and visible light from the sun will cause dark spots, also known as hyperpigmentation, on your skin." Visible light is the light we see. An AAD news release adds that new research shows visible light can darken skin in people with darker skin, but not in people with lighter skin. The AAD also says visible light contributes to melasma, a condition that causes brown patches on the face.

3. The sun ages skin. The AAD says, "If you have brown or Black skin, the sun can speed up how quickly your skin ages."

The AAD says sun protection, which includes sunscreen, "can reduce the likelihood of developing these conditions," and "can also help fade dark spots."

The sunscreen dermatologists suggest for darker skin

The AAD's advice for darker skin is a tinted sunscreen. On its darker skin tones page, it recommends a tinted sunscreen "that offers broad-spectrum protection, SPF 30 or higher, and water resistance," and adds two more features:

• A non-comedogenic formula, meaning it will not clog pores, if you have oily skin
• The ability to blend with your skin tone, which avoids a white cast

Why tinted? Tinted sunscreens contain iron oxide. The AAD says iron oxide "helps to protect your skin from the sun's visible light (a cause of dark spots)." The AAD recommends tinted sunscreen for this reason. An AAD news release says iron oxides increase protection against visible light and against the ultraviolet A rays that age skin.

How to find iron oxide. Look at the inactive ingredients on the label. The AAD explains that iron oxide is listed as an inactive ingredient because it protects against visible light, while only ingredients that protect against ultraviolet light count as active ingredients.

Finding a shade. The same news release says the right shade depends on skin tone and undertone, the hue under the surface of the skin, and that tinted sunscreens labeled "universal shade" suit most skin tones.

How sunburn looks on darker skin

Sunburn can look different on darker skin, so it is easy to miss. The FDA says that "if your skin tone is medium to dark you may not notice any obvious physical signs until several hours later." Early signs include skin that feels tender, painful or warmer than usual.

The AAD describes the signs of sunburn in babies as "redness in lighter skin tones or darker areas of skin in darker skin tones." The same applies to adults: burned skin may look darker instead of red.

Where to check your skin

The AAD says skin cancer in darker skin "may show up in areas that receive little, if any, sun." These include the palms, the soles of the feet, fingers and toes, nails, the inside of the mouth or the lips, the buttocks, and the genital area. It can also appear on the face and neck.

The AAD lists warning signs to look for:

• A bump, spot or mole that is growing, bleeding, itching or changing in any way
• A color change on the skin, scalp, mouth, lips or genital area, especially skin darkening
• A sore that does not heal, or heals and comes back
• Nail changes, including a dark line or streak in a nail, or a spot under or around the nail that does not heal
• A scaly or rough patch that does not go away

See a dermatologist promptly if you notice any of these. The AAD says skin cancer, including melanoma, is highly treatable when found early.

Shade and clothing come first

The AAD says everyone should protect their skin from the sun, and for darker skin it lists three steps in this order:

1. Seek shade.
2. Wear sun-protective clothing like long sleeves, pants or a long dress.
3. Apply a tinted sunscreen that offers broad-spectrum protection, SPF 30 or higher, and water resistance.

The AAD's general sunscreen advice adds a wide-brimmed hat and sunglasses with UV protection, and says the sun's rays are strongest between 10 a.m. and 2 p.m.

How to check your own skin

The AAD recommends a regular skin self-exam for people of every skin tone. You need a full-length mirror, a handheld mirror and a private space. Look at every area, including the places listed above that get little sun, and check your nails and the soles of your feet with care. The AAD says to pay close attention to an existing growth, an area that was injured or treated with radiation, or a scar, because skin cancer is more likely to develop there.

If you find a spot that could be skin cancer, the AAD says to make an appointment with a board-certified dermatologist and to say when you book that you found a possible sign of skin cancer.

Acne marks and darker skin

People with darker skin often notice that pimples leave dark marks that last for months. The AAD's page on fading dark spots says a spot a few shades darker than your natural color usually fades within 6 to 12 months, and that sunscreen is essential: it "can prevent new dark spots and patches. It can also help to clear existing ones." Our guide on dark marks after pimples covers the treatment side.

If you are treating acne, choose a tinted sunscreen that is also non-comedogenic, as the AAD suggests for oily skin. Our guide to sunscreen for acne-prone skin covers the label words to look for.

Vitamin D

The NHS says people with brown or black skin may need more time in sunlight to make the same amount of vitamin D as people with lighter skin. The AAD says people with darker skin tones may be at higher risk of low vitamin D, and recommends getting it from food and fortified drinks. Our guide on whether sunscreen blocks vitamin D covers the research and the NHS supplement advice.

A simple routine for darker skin

1. Each morning, apply a tinted, broad-spectrum, SPF 30 or higher sunscreen to your face and neck, using at least a teaspoon for the face, as the AAD suggests.
2. Reapply every two hours when outdoors, and after swimming or sweating.
3. Add shade, a wide-brimmed hat and sun-protective clothing on long days outside.
4. Check your whole skin, including palms, soles and nails, for the warning signs above.

Skinli's sample plan shows where sunscreen fits in a full morning routine.