Black Don’t Crack If You Protect It

With summer upon us, we need to be safe while showing skin and having fun in the sun. Here are a few facts and helpful steps to keep you protected.

Many think darker skin offers more protection from the sun, but it’s not absolutely true. If you’re Black or Hispanic, be sure to wear a sunscreen with a sun protection factor (SPF) of at least 15 and to reapply it every two hours. Because Black people often develop melanoma on non-exposed skin, pay special attention to moles or pigment changes beneath fingernails, around the base of the nail, between fingers and toes, and on the palms and soles. If you spot anything suspicious, see your doctor.

Black and Hispanic people are less likely than White people to contract melanoma–the most dangerous type of skin cancer–but they also tend to be diagnosed with it later, at more advanced stages.

The use of sunscreen is important in certain medical conditions sometimes encountered in the Blacks such as lupus erythematosus, porphyria cutanea tarda, polymorphous light eruption, and phototoxic/photoallergic dermatoses. Oftentimes, Blacks have a false perception that their darker skin is protection enough. However, as previously mentioned, there is only minimal inherent protection, and variation exists within this inherent protection, as there are a wide variety of skin tones amongst Blacks. Therefore, without the use of sunscreens, these medical conditions tend to progress and worsen over time.

Choose the right SPF

SPF (Sun Protection Factor) is a common indicator of UVB absorption provided by manufacturers, which you will find on the labels of these products. This rating goes from as low as 2, up to 30 and above. The minimum SPF you should choose, no matter what your skin color/type, and no matter the time of year, is SPF15. Bear in mind that parts of the body that are especially sensitive (i.e. lips) or rarely exposed to sunlight  (i.e. backs) may need a higher factor or a sun block.

A higher SPF does not give you higher protection; it gives you longer protection from the effects of the sun. So, if your skin would redden after 30 minutes if you didn’t use any sunscreen, an SPF 2 would allow you to stay in the sun for 60 minutes before you redden/darken.

This is only true in theory however, as a sunscreen’s effectiveness depends:

* on how thickly and frequently you apply it

* what activities you do. If you swim or sweat a lot, the sunscreen won’t last as long.

Remember, your skin can still redden/darken up to 24 hours after exposure to the sun, so burning may not be immediately obvious.

*Skin type Reaction to sun

* Very fair /sensitive Always burns, rarely tans Fair/sensitive Burns easily, but will tan

* Fair Tans gradually, likely to burn first

* Medium Tans well, unlikely to burn first

* Dark Tans easily, rarely or never burns

NOTE: I would avoid a sunscreen that contains zinc or titanium dioxide, as both of these chemicals will leave a white cast on the skin. That’s a huge problem against dark skin, such as myself. Find a sunscreen that contains avobenzone. If you have dry, ashy skin, then you’ll want a sunscreen with lots of moisture in it.

Please note that the SPF given is just a guide. Always follow the manufacturer’s instructions for each sunscreen.

What’s the difference between sunscreen and sunblock? Sunscreens absorb UV rays, while sunblocks deflect them. A sunblock, properly applied, prevents all UV from reaching the skin. Sunblocks used to be easily recognizable as the bright white stripes that skiers and lifeguards once wore; they are now much more cosmetically acceptable. Common sense precautions Dr Patel recommend the following:

* choose a sunscreen with a minimum of SPF15, higher if you’re very fair skinned or have sensitive skin, have freckles or moles, or a history of skin cancer, or for use on children. Try a sunblock stick for lips cheeks and nose

* put your sunscreen on at least 20 minutes before you go out. Don’t skimp on quantity and make sure you cover all exposed areas especially the back of your neck, and areas which don’t see much daylight, such as your stomach and back

* re-apply the sunscreen frequently, especially after swimming or playing sport. A waterproof version may be best for you

* stay in the shade between 11am and 3pm, because the sun is at its strongest during this time

* don’t be fooled by clouds, fabric umbrella shades or even clothes. You can burn through all these things. Many clothes do not block out UV rays, so even making your children wear T-shirts may not be enough. Watch out for special clothes that do provide UV protection

* take extra care in, on and around water, as water reflects the sun’s rays, and will make you burn more easily

* wear a hat that covers your face and the back of your neck

* drink lots of water to help prevent dehydration

* if you do burn slightly, calamine lotion or yoghurt can help cool your skin, or take a cool bath or shower. If you have a more serious burn you should see your GP

In addition, sunscreen use is extremely important for pigmentary disorders, which are a growing concern among Blacks and other dark-colored persons. Whether it be hypo-/depigmentation disorders like vitiligo, or hyperpigmentation disorders like postinflammatory hyperpigmentation and melasma, sunscreen use as adjunctive therapy is effective and efficacious. It is often the case that Blacks treated with bleaching agents such as hydroquinone will have recurrence or recalcitrant disease if sunscreen is not utilized. However, when 4% hydroquinone and sunscreen are used in combination, melasma can be effectively treated.

Insist that your doctor check you for suspicious moles, and remember that self-examination is a powerful tool. Patients and their spouses are often the ones who discover melanoma first. Routinely examine your entire body for moles that look different from most others you have, change over time, or have abnormal symptoms, such as bleeding and itching.

And last but not least, have fun!