Skin of Color Savvy: UV Safety in Skin of Color, with Rebecca Vasquez, MD and Adewole Adamson, MD, MPP

Welcome to Skin of Color Savvy: The Art and Science of Treating Patients of Color!

In this clinical episode of Skin of Color Savvy: The Art and Science of Treating Patients of Color, this week's host Rebecca Vasquez, MD, associate professor of dermatology at UT Southwestern, is joined by long-time colleague Adewole (Ade) Adamson, MD, MPP, assistant professor at Dell Medical School and expert in skin cancer epidemiology, to discuss UV safety and photo protection in patients with skin of color.

The conversation begins by addressing a pervasive myth: that melanin-rich skin is immune to ultraviolet (UV) damage. Adamson clarifies that UV radiation can harm all skin types, though the outcomes and risk levels vary by pigmentation and genetic ancestry. While darker skin types are less susceptible to sunburn and UV-induced skin cancers, they remain at risk for pigmentary disorders, photoaging, and photosensitive conditions—underscoring the need for nuanced, individualized counseling.

Both dermatologists highlight the importance of educating patients about risk factors beyond skin tone, such as family history, immune status, and occupational sun exposure. Vasquez and Adamson emphasize the need to move beyond the oversimplified “sunscreen-first” messaging and instead promote a broader approach that includes shade-seeking, UV-protective clothing, and behavioral modifications. Critically, they caution against fear-based messaging and advocate for compassion and empowerment in photo protection counseling.

Vasquez encourages tinted sunscreens containing iron oxide to address visible light-induced hyperpigmentation, while both physicians acknowledge ongoing challenges in color-matching for melanin-rich skin. They agree that product accessibility, aesthetic acceptability, and cost are key to adherence and recommend patient-driven choices guided by basic SPF and UVA criteria.

The conversation shifts to research gaps. Adamson shares findings from his team’s systematic review of melanoma and UV exposure, revealing no consistent link between UV exposure and melanoma in patients of color. Instead, melanoma tends to appear on non–sun-exposed sites like palms and soles. Similarly, he notes a lack of high-quality data on nonmelanoma skin cancers (e.g., basal cell carcinoma) in patients of color, largely due to poor representation in registries and trials.

The episode closes with practical pearls, including Adamson’s tip to store sunscreen in coolers—protecting its efficacy and enhancing comfort during reapplication. Both guests stress culturally competent counseling and authentic, evidence-based conversations that build trust with patients of color.

To learn more about the Skin of Color Society's (SOCS) mentorship programs and initiatives, visit Skin of Color Society.

Editor’s note: This podcast summary was edited with the help of artificial intelligence tools.