‘Next frontier in photoprotection’: Visible light protection education, awareness needed
Key takeaways:
- 91.68% of dermatologists counsel patients about visible light protection.
- 70.92% emphasize its role in exacerbating pigmentation in melanin-rich skin.
A study found that dermatologists could benefit from increased education, awareness and standardized guidelines on recommending visible light protection to patients.
“Visible light (VL) represents a significant, often underappreciated, contributor to skin pathology, particularly in individuals with melanin-rich skin,” Adam Friedman, MD, FAAD, professor and chair of dermatology at George Washington University School of Medicine & Health Sciences, a member of Healio Dermatology’s Peer Perspective Board and one of the study’s investigators, told Healio. “Unlike ultraviolet (UV) radiation, VL penetrates deeper into the dermis, triggering melanogenesis and inflammation that exacerbate conditions like melasma and post-inflammatory hyperpigmentation. With 40% of the U.S. population having melanin-rich skin, addressing VL protection is critical to advancing dermatologic care.”
Using data from an electronic survey completed by 974 dermatologists, Friedman and colleagues discussed the current counseling and prescribing practices, as well as the knowledge gaps, of VL protection.
The study found that almost all respondents (91.68%) counsel patients about VL protection and 70.92% emphasize its role in exacerbating pigmentation in melanin-rich skin. Of the dermatologists that reported they counsel patients about VL protection, 10.34% advised that patients with melanin-rich skin specifically use sunscreen with VL protective ingredients. Additionally, 48.89% emphasized that VL protective ingredients should be used for managing melasma and post-inflammatory hyperpigmentation.
“Patients with MR skin are uniquely susceptible to VL-induced hyperpigmentation, which tends to be more severe and longer-lasting than in those with lighter skin,” Friedman explained. “These differences are rooted in photobiology as VL more efficiently stimulates melanocytes in darker skin tones.”
To mitigate these effects, it is important that dermatologists recommend the proper ingredients. According to the study, the active ingredients in VL protection most recommended by dermatologists included iron oxides (90.92%), antioxidants (69.08%) and pigmentary titanium dioxide (58.85%).
“Iron oxides are uniquely capable of blocking VL by scattering and reflecting photons, reducing transmission by over 90%,” Friedman said. “They are particularly effective for patients with pigmentary disorders and melanin-rich skin.”
According to Friedman, iron oxides are also very cosmetically pleasing as they blend well into a wide range of skin tones. However, while iron oxides are a cornerstone of melasma and post-inflammatory hyperpigmentation care, other types of VL protection should be considered for different conditions.
For example, both tinted and antioxidant-enriched sunscreens are better for photosensitive dermatoses and erythema-prone skin as it may minimize inflammation. Additionally, pigmentary titanium dioxide may be used for melasma and pigmentary disorders.
With all of the benefits these ingredients have to offer, what is stopping the 8.32% of dermatologists who say they don’t counsel patients about VL protection? According to the survey, just over half (50.62%) of these dermatologists reported a lack of standardized guidelines as the main barrier.
“The lack of standardized guidelines for VL protection is the most pressing gap,” Friedman said. “Without these, practitioners rely on disparate and often incomplete knowledge to make recommendations.”
Secondary barriers to recommending VL protection included access to suitably tinted sunscreens (27.16%), limited availability of sunscreen choices (23.46%) and insufficient amount of supportive data (18.52%).
According to Friedman, these data signal a need for improved education and awareness among dermatologists about newer formulas, such as pigmentary titanium dioxide and antioxidants, that can best suit patients’ individualized needs.
“VL protection represents the next frontier in photoprotection, particularly for populations disproportionately affected by hyperpigmentation and other VL-mediated conditions,” he told Healio. “Expanding the availability and accessibility of VL-protective options can ensure that every patient receives the care they need to achieve optimal skin health.”