Do we need sunscreens at all?

Let me qualify that a little further: As Indians, with melanin rich skin, do we need sunscreens at all?

The short answer is Yes (but of course!).

The long answer follows, and includes where and when sunscreen is best used, but read on.

There are a few reasons why we as Indians/ Asians do need sunscreen. But before we get there, let us look at what we do not need sunscreens for.

We do not need sunscreens for preventing skin cancer in a way similar to how sunscreens are recommended for Caucasians with cancer. I say this with caveats, mainly because until now, we have not seen a very big reduction in skin cancer occurrence with sunscreens, compared to say, avoiding the sun or staying in the shade. And in India, skin cancer is rare, and mostly seen in places in India where arsenic exposure, prolonged contact of heat with the skin, or some similar, non solar environmental factor is implicated. Interestingly, certain types of skin cancer which are unique to our ethnicity, occur in non sun exposed regions – such as the palms and soles!  So because sun induced skin cancers have a very low incidence in India, at least this far, we are not going to be using sunscreens for skin cancer, at least for now. The graph below shows an indicative comparison of melanoma and non melanoma skin cancers between India and the West. As a very rough estimate, non melanoma skin cancer rates in the West range between 20 to 30 times that in India, while melanoma cancers are > 30X common in the West.

The second reason we are not going to be using sunscreens, is for becoming fairer, to a shade different than our own natural complexion. However, because most of us are tanned from sun exposure, sunscreens will still give a skin brightening result, more about it in the days to come.

So what do we need sunscreens for?

We Indians, and generally Asians, are at the highest risk of pigmentary conditions – be it annoying, trivial pigmentation after just a mosquito bite, or disfiguring pigmentary conditions such as a hair dye induced pigmentation, which severely impacts the quality of life.

If you see the graph below for melasma, you will see that it is quite different from the skin cancer graph above. South East Asia and India are in lead positions here.

In certain special groups, such as pregnant women, the occurrence of pigmentary conditions like melasma can be very high, affecting up to 1 in 2 women. And sunscreens have been proven to help improve melasma, even when used solo!

The number of people who are experiencing facial pigmentation as a side effect of hair dye use, is on the rise, and such pigmentation may also occur due to the use of fragrances, cosmetic products, personal care products, coatings  and colors, resins, paints, plants – most of these causes are unavoidable in everyday life. And since sun exposure is an important part of the development of these conditions, using sunscreen can be protective to a large extent.

Outside of this, straight forward sunlight allergy occurring as itchy patches on the forearms and neck, is very common in our population. All of this highlight that some form of protection from sunlight is necessary.

And then comes the aspect of photoaging. In a culture, which places a premium on looking good, looking young – to signal vitality and productivity, the rise of anti aging treatments and procedures, nationally and internationally should come as no surprise. That said, there is a crucial difference between photoaging in the West and photoaging in Skin of Color (SOC), which includes Indian skin types. Compared to Western skin types, which age with wrinkles, fine lines and dehydration, we age with increased pigmentation, open pores and sagging. This is true all the way across the globe for this latitude, and near abouts.

This is related to the backstory of our migration, out of Africa. But yes, to be able to survive the sun in this part of the world, we need our melanin. Which is great, as this is the single main reason for low cancer rates in this tropical region, despite high UV exposure. However, with this high protection, comes high chances of pigmentation, as we accumulate solar induced skin damage in the process of ageing. And sunscreens seem to be the best way to protect ourselves.

Which leaves us with question of  ‘do we HAVE to use sunscreens’? Yes, if you want to protect your skin from aging and pigmentation over time. We don’t HAVE to use sunscreens to prevent skin cancer. In other words, sunscreens are best used for antiaging and pigmentation prevention, when it comes to Indian skin types.

So, if you have crossed over to the sun(screen) side, you may like to explore the anatomy of a sunscreen, coming soon.