PubMedCureus2026-08-30
Beyond Melanin: A Literature Review of Photoprotection Mechanisms and Gaps in Skin of Color.
Leybengrub Pamella P, Eyob Wintana W, Petrossian Lina L, Shetty Saumya S et al.
There is a critical need for tailored photoprotection in skin of color (SOC) populations. SOC has higher eumelanin-to-phenomelanin ratios, more mature melanosomes, and enhanced DNA repair capacity compared with lighter skin. The quantity and distribution of melanin in darker skin provide natural photoprotection. This leads to a misconception that SOC populations are inherently protected from all photodamage and serves as a barrier to proper photoprotection for these populations. Although the skin cancer incidence is lower in dark skin, mortality is higher, perhaps as a result of late diagnosis or misdiagnosis. These populations are still susceptible to skin damage from ultraviolet (UV) radiation, resulting in exacerbation of various dermatologic conditions, including pigmentation disorders, photodermatoses, and skin cancer. This review aims to comprehensively examine the photoprotection needs for SOC populations, addressing gaps between physiological characteristics and clinical outcomes, evaluating current photoprotection practices, examining educational implications, and considering future directions for photoprotection for SOC. A literature search was performed using PubMed and Google Scholar. The search was conducted from database inception through July 15, 2026. Articles were included if they addressed photoprotection, photodamage, photoaging, pigmentary disorders, photodermatoses, or skin cancer in SOC populations. Visible light (VL) and long-wave UVA1 are significant contributors to pigmentary alteration in SOC. The major drivers of pigmentation in SOC and photodamage can manifest as pigmentary disorders, particularly melasma and post-inflammatory hyperpigmentation (PIH), photoaging, photodermatoses, and skin cancer risk. Comprehensive photoprotection strategies for individuals with SOC include behavioral sun avoidance measures, sun-protective clothing, avoiding harmful behaviors, and community-based education programs. Sunscreen formulations for SOC should be tailored to skin phototype (SPT), with an SPF of 30 and broad protection that covers UVA, VL, and infrared A to limit hyperpigmentation and photoaging. Iron oxide-containing sunscreens provide VL protection and reduce white cast. Niacinamide-containing sunscreens are helpful for reducing PIH. Since UV and VL generate reactive oxygen species (ROS) that promote inflammation and persistent PIH, antioxidants in sunscreen are important in SOC to neutralize this damage and support DNA repair. Comprehensive photoprotection is essential for SOC populations. SOC individuals face unique manifestations of photodamage. Effective photoprotection in SOC requires extension beyond traditional UVB protection to meet the specific needs of SOC. Additionally, targeted education, community engagement, and barriers to care need to be addressed to improve outcomes. It is important for the dermatology community to commit to inclusivity and advocate for equitable access to photoprotection resources for all.