Black don't crack.
We've all heard the saying, especially in the past when the presence of melanin was believed to give natural protection against the sun’s harmful UV rays. For this reason many people of colour still assume they're innately protected against premature photoaging or skin cancers.
But now there's more research to show that patients with darker skin tones are not more immune to skin cancers and photoaging. In fact, leading dermatologist Dr S'lindile Ndwalane tells Drum, they are uniquely predisposed to pigmentary disorders that are worsened by ultraviolet exposure, such as melasma, and tend to get worse post-inflammatory pigmentation following inflammatory conditions such as acne.
Dr S'lindile says anyone with skin should be using sunscreen, even infants. "Most sunscreens are safe enough to use from the age of six months," she explains.
"You may have noticed that dark-skinned children get darker when playing outdoors. Lighter-skinned children get red. That is a sign that the sun is causing some damage to the skin even at that age. Most of the sun damage and skin cancers we get later on in life are as a result of the accumulation of UV exposure over the years," explains Dr S'lindile.
Although the incidence of skin cancers is lower in this phototype group, the mortality rates are substantially higher when compared with their Caucasian counterparts.
"This is a result of delayed detection/treatment and a false perception that dark skin offers complete protection against skin cancer. Ethnicity does not really inform skin type. People of colour do experience sunburn, and from a biological point of view, all skin types appear to be sensitive to UV-induced DNA damage," she explains.
Sun protection is the mainstay of treatment for pigmentary disorders, which have been repeatedly shown to be among the most common conditions seen by dermatologists among black people. Not only pigmentary conditions occur with inadequate sun protection, but some autoimmune conditions such as lupus, which are aggravated by sun exposure.
Although there is no complete 100% sun protection, the dermatologist says that "the higher the SPF, the better the cover".
"Any SPF is better than none. The recommended SPF is at least 30. That blocks about 97% of UVB (type B ultraviolet). There is no complete 100% blockage. Sunscreen needs to be reapplied every two or three hours as the efficacy or protection is not guaranteed after two hours," explains Dr S'lindile.
We might be approaching colder days with less exposure to the sun, but Dr S'lindile says sunscreen should not only be used in summer. "As long as the sun rises, there is ultraviolet radiation (UVR)," she says.
"UVR are present throughout the year. Some UVR also penetrates through windows, glass, water, and some clothing. Most available studies were previously focused on the UV radiation part of the light spectrum. The effects of visible light and infrared radiation had not been, until recently, clearly established.
"These lights can also be emitted from household light bulbs, TV or computer screens. This is why we always stress the importance of using a broad-spectrum sunscreen, in all seasons and whether one is indoors or outdoors."
Dr S'lindile recommends a broad-spectrum sunscreen that covers for UVA, UVB and visible light.
"UVR and visible light both have biological effects on the skin. Visible light can induce erythema in light-skinned individuals and pigmentation in dark-skinned individuals."
There are two types of sunscreens, physical (mineral) and chemical sunscreen.
The physical sunscreens contain physical reflectors such as zinc oxide or titanium which tend to give off that white/grey glare. This is more visible on darker skin, though the physical sunscreen are the preferred type for sensitive skin.
Sunscreens also come in different formulations, for example creams, lotions and powder. The lighter the formulation, the better the glare.
Some sunscreens are tinted and untinted. Most tinted sunscreens are produced in one medium colour shade.
• Opt for chemical sunscreens (though these tend to cause reactions on sensitive skin)
• Choose lighter formulation and foundation-based sunscreen if you wear makeup
• Apply sunscreen at least 15-30 minutes before going outdoors
• Applying foundation over a physical sunscreen is an effective way to decrease the white residue left on the skin