Sunscreen advice should factor in ethnicity and skin colour

The necessity of year-round sunscreen use has been brought into focus by Prof Tim Spector (Health expert Tim Spector criticised for remarks on year-round use of sunscreen, 13 May). In a diverse country like the UK, it is pivotal to provide nuanced public health messaging on sun protection that is inclusive of all citizens.

The 2021 census underscores the UK’s ethnic diversity, with London being the most ethnically diverse region in England. With a latitude of 51.5072, London has an average UV index of 0-2 between the months of October and March. Statistical data reveals lower skin cancer rates among the UK’s ethnic minorities, largely due to their melanin-rich skin, which confers some innate UV protection. Furthermore, melanoma skin cancers in this cohort typically occur in parts of the body that have not been exposed to the sun.

Scientific data also indicates that vitamin D deficiency is more prevalent among minority ethnic groups in the UK. Elevated melanin levels in the skin, a lower UV index and covering most of the skin with clothing when outdoors are identified as contributing factors.

Vitamin D is required for healthy bones and muscles, and a deficiency is associated with osteomalacia and rickets. A deficiency of this vitamin is also increasingly linked with cancers, autoimmune diseases and cardiovascular disease.

Maintaining optimal levels of vitamin D extends beyond its intake via diet or supplements. A growing body of evidence indicates that exposure to sunlight carries distinct health benefits, independent of vitamin D synthesis.

Current scientific evidence does not support the year-round use of sunscreen by the UK’s ethnic minority population in the absence of a medical indication. The low UV-index during winter months, prevalent vitamin D deficiency and lower rates of skin cancer in the ethnic minority population call for a reassessment of the generic approach to sun protection that fails to consider skin colour.
Dr Ophelia E Dadzie
Consultant dermatologist, Chalgrove, Oxfordshire

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