What may be of a surprise to you are the social issues that in fact surround sunscreen- namely, including medical disparities and the environmental concerns sunscreens pose. Although the discussion of these social issues are far from extensive, in this third and final installment of our series, we hope to provide you with some interesting food for thought.
To start, one dangerous myth that has been perpetuated is that those with darker skin tones don’t need to use sunscreen, since sunburns are rare or never occur at all. While darker skin tones have more melanin (the pigment in our skin), which offers a slightly higher degree of protection from UV rays, it should be stressed that the use of sunscreen is just equally important in all skin tones. In fact, studies show that despite the fact that people of colour (POC) are less likely to develop skin cancers, their rates of morbidity and mortality are much worse than those of white patients. This is because skin cancers in POC tend to be diagnosed at more advanced stages, which is partially attributed to by less awareness and socioeconomic barriers. Currently, both skin cancer screening and public health education campaigns primarily target fair-skin caucasians, nearly excluding the African American* demographic completely.
More specifically, one study found that African Americans* were 4 times more likely to present with advanced stage IV melanoma and 1.5 times more likely to die from melanoma than Caucasians, based on a population study of 262,394 cases of melanoma (with a proportion of 1106 African Americans). Again, remember that melanoma is the most severe form of skin cancer, and it is often caused by UV rays! One reason proposed for this poorer outcome is that melanomas in African Americans occur more often in sun-exposed skin (such as soles of the feet and palms where there is less melanin)- which differs from the typical case of melanoma in Caucasians.
In part, another contributing factor to this medical disparity may be the limited pictures of medical conditions in skin of POC featured in literature and medical schools. This gap of knowledge renders it less likely that signs of skin cancer are caught earlier on in POC, contributing to overall poorer outcomes.
Another social issue posed by sunscreen is whitecasting- which refers to when sunscreens leave a pasty-white sheen on the skin after application, posing an especially frustrating issue for those with darker complexions. Physical sunscreens are known to cause white cast more often, though the alternative, chemical sunscreen, also poses issues when it comes to the environment.
Sunscreens with a specific chemical known as oxybenzone have been linked to dangerous environmental consequences. Oxybenzone (also known as benzophenone-3) is a photo-toxicant; essentially, exposure to light makes this chemical toxic. Specifically, this chemical is known to damage coral reefs and other aquatic life. Oxybenzone causes DNA damage and disrupts endocrine functions. It leads to something known as coral bleaching, which is when stressed corals expel the beneficial algae that lives on them. This can lead to coral death, which is significant, because many animals and plants rely on the biodiverse ecosystem created by coral. Coral reefs are also directly beneficial to humans: they absorb 97% of the energy from ocean waves, meaning that they protect us from floods and storms! Losing coral means that more damage can be caused by extreme weather.
Oxybenzone is not the only chemical in sunscreen that is linked to environmental issues. Others include benzophenone-2, OD-PABA, 4-Methylbenzylidene camphor, 3-Benzylidene camphor, nano-Titanium dioxide, nano-Zinc oxide- the list goes on. These chemicals are harmful to aquatic life, though oxybenzone is currently one of the more studied chemicals.
Remember, this doesn’t mean that all sunscreens are bad! The benefits of sunscreen (protection from UV rays and skin disease, regardless of your skin colour) far outweigh the negatives. It’s all a matter of being conscious of which sunscreens you pick. And with this blog post, we are finishing our sunscreen series. We hope that these posts have given you a bit to chew on. So next time you head out into the sun, do yourself a favour and remember to put on a little sunscreen.
*Bite Sized Science would like to acknowledge the nuances in language when referring to African Americans and Black folx. While these two terms are frequently used interchangeably, African American specifies Black people born in the United States, while Black encompasses both African Americans and Black people from countries and continents outside of Africa. Unfortunately, the referenced study did not specify this distinction in terminology, thus we have chosen to mirror the study’s language in order to best represent its findings.
References
Byrd KM, Wilson DC, Hoyler SS, Peck GL. Advanced presentation of melanoma in African Americans. Journal of the American Academy of Dermatology. 2004;50(1):21–4.
Downs CA, Kramarsky-Winter E, Fauth JE, Segal R, Bronstein O, Jeger R, et al. Erratum to: Toxicological effects of the sunscreen UV filter, benzophenone-2, on planulae and in vitro cells of the coral, Stylophora pistillata. Ecotoxicology. 2014;23(3):472–3.
Downs CA, Kramarsky-Winter E, Segal R, Fauth J, Knutson S, Bronstein O, et al. Toxicopathological Effects of the Sunscreen UV Filter, Oxybenzone (Benzophenone-3), on Coral Planulae and Cultured Primary Cells and Its Environmental Contamination in Hawaii and the U.S. Virgin Islands. Archives of Environmental Contamination and Toxicology. 2015;70(2):265–88.
Gupta AK, Bharadwaj M, Mehrotra R. Skin cancer concerns in people of color: risk factors and prevention. Asian Pacific journal of cancer prevention: APJCP. 2016;17(12):5257.
Hancock L. Everything You Need to Know about Coral Bleaching-And How We Can Stop It [Internet]. WWF. World Wildlife Fund; [cited 2020Aug22]. Available from: https://www.worldwildlife.org/pages/everything-you-need-to-know-about-coral-bleaching-and-how-we-can-stop-it
Mahendraraj K, Sidhu K, Lau CS, Mcroy GJ, Chamberlain RS, Smith FO. Malignant Melanoma in African–Americans. Medicine. 2017;96(15).
Prichep D. Diagnostic Gaps: Skin Comes In Many Shades And So Do Rashes [Internet]. NPR. NPR; 2019 [cited 2020Aug22]. Available from: https://www.npr.org/sections/health-shots/2019/11/04/774910915/diagnostic-gaps-skin-comes-in-many-shades-and-so-do-rashes
US Department of Commerce NOAA. The Importance of Coral Reefs - Corals: NOAA's National Ocean Service Education [Internet]. Corals Tutorial. National Oceanic and Atmospheric Administration U.S.; 2013 [cited 2020Aug22]. Available from: https://oceanservice.noaa.gov/education/tutorial_corals/coral07_importance.html
US Department of Commerce NOAA. Sunscreen Chemicals and Coral Reefs [Internet]. Skincare Chemicals and Marine Life. National Oceanic and Atmospheric Administration U.S; 2018 [cited 2020Aug22]. Available from: https://oceanservice.noaa.gov/news/sunscreen-corals.html#:~:text=In a 2016 study, a,corals and other marine life.&text=The compound has been found,directly from swimmers wearing sunscreens.
UV Radiation [Internet]. Centers for Disease Control and Prevention. 2020 [cited 20 July 2020]. Available from: https://www.cdc.gov/nceh/features/uv-radiation-safety/index.html#:~:text=UV%20radiation%20is%20classified%20into,and%20ultraviolet%20C%20(UVC)
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