Sunscreen and Acne: What’s the Connection?
If you are just starting an acne treatment program, one of the first things you need to do is to choose the right sunscreen for your acne-prone skin. Protecting your skin from the sun is essential to the long-term success of your acne treatment program, especially if you have Asian, brown, or black skin.
- Everybody needs a little sun so the skin can make vitamin D. Otherwise, you need to take a vitamin D supplement or cod liver oil.
- Sun protection is especially important when you are using products to disinfect the skin.
- The darker your skin, the more important it is to use sun protection when you are treating acne, because you have greater potential for long-term discoloration1 of the skin.
- Even if you have black skin, you need sunscreen when you are using acne medications such as benzoyl peroxide, Retin-A, or Accutane.
- Different skin types2 need different kinds of sunscreen.
- Cosmetics that contain sun protection may be enough for people who have dark skin, but they are never enough for people who have fair skin.
Sunlight Is Both Good and Bad for Your Skin
The way most of us relate to the sun for our skin care is that the sun is either totally good or totally bad. If you love to lie out in the sun, you might argue that tanning your skin makes imperfections harder to see—and the fact is, it does. A great tan can shift attention from blemished skin to a manly torso or shapely legs. But unnaturally golden skin can become freckled and spotted skin, and the brown (or even black) imperfections in the skin will be worst where skin has not been treated.
At the opposite extreme, some people always cover every inch of skin with sunscreen before they step outdoors. When the national health service of Australia started encouraging people to slather themselves with sunscreen in the early 1990’s, they were surprised that melanoma rates actually went up, instead of down. It turns out that vitamin D protects against skin cancer, and the skin needs about 20 minutes of exposure to ultraviolet light, without sunscreen to block ultraviolet light, every day in the summer and even more during the winter if you live in a temperate or northerly climate.
Unprotected skin out in the sun for hours each day is not healthy. Overprotected skin that never makes vitamin D is not healthy3, either. Everyone, whether they have acne or not, needs at least a little sun, but also a little sunscreen to keep skin vibrant, unblemished, and, it is to be hoped, cancer-free.
Everyone Who Has Acne Needs Sunscreen
Generally speaking, fair skin usually burns, while black skin never burns. Dermatologists classify skin color into Fitzpatrick skin types4. Skin type I is fair skin that burns easily when exposed to sun. People who have this skin type often have blond or red hair and blue eyes. Sunburned skin freckles in childhood, and forms age spots in adulthood. People who have skin type I never tan.
Skin type II is slightly more pigmented. It burns easily but can tan. Skin types III and IV are the Mediterranean or Middle Eastern “olive” skin types. Type III skin may burn, but tans easily. Type IV skin seldom burns, and tans very quickly.
Fitzpatrick skin type V is dark brown skin that rarely burns. And Fitzpatrick skin type VI is black skin that never burns, that is, unless it is being treated for acne.
There is one thing that everyone who has ever been told about their skin type needs to remember about skin types and acne5: Acne medication can make every skin type behave as if it were Fitzpatrick type I. Even if you have deep, dark black skin, if you use benzoyl peroxide, or if your doctor has prescribed Retin-A or Accutane, going out into the sun can cause irritation, inflammation, and burning.
And if you have Asian, brown, or black skin, that irritation can leave permanent discoloration on your skin. Even if you have dark brown or black skin, you may need a sunscreen when you are treating acne-prone skin, although just SPF 15 may be enough. Especially fair skin in tropical sun may need SPF 70.
How to Choose the Right Sunscreen
Many people who have acne hate the feel of sunscreen even though they know they need it. The problem usually is that they are not using the right type of sunscreen for their type of skin. Here are some basic guidelines.
- If you have oily skin and you do not use makeup, use sunscreen that contains zinc oxide and/or titanium dioxide6. These chemicals serve as a physical barrier to sunlight and don’t feel greasy on your skin. Since the whiteness of zinc oxide and titanium dioxide can leave black skin looking purple, use tinted sunblock made with these ingredients if you have black, oily skin.
- If you have oily skin and you use makeup, choose a foundation that contains sunscreen. At least SPF 15 is needed, but you can’t have too much sun protection. If you have oily skin and your makeup tends to streak, use tinted sunscreen instead of foundation and finish with an oil-absorbent powder.
- If your skin is very shiny, you can mix a shine control product with your sunscreen to keep your face from showing glare. Use equal parts of sunscreen and shine control.
- If you have dry skin and you do not use makeup, sunscreens that also contain zinc oxide and/or titanium dioxide7 (grape seed extract), cucumber, or saxifrage (strawberry begonia) extract can prevent freckling of your skin.
- If you have dry skin and you do use makeup, any product that contains jojoba oil offers additional protection for your skin.
- If you tend to break out due to “whatever,” that is, you have sensitive skin, avoid products that contain avobenzones, benzophenones, oxybenzones8 methoxycinnamate (most commonly found in waterproof sunscreens), and para-aminobenzoic acid (also known as PABA). These ingredients can cause pimples.
- Loose powder with sunscreen ingredients may provide sun protection of SPF 8 to 20. This is enough for African skin types, but people with people with other skin types who use makeup need a sunscreen in addition to powder.
- If you have Asian skin, it is critical to use non-irritant skin protection when you are using whitening agents.
- Never use any product that foams or leaves your skin feeling tingly.
- Always avoid products that contain butyl stearate9, cocoa butter, cinnamon oil, Cocos nucifera (coconut oil), decyl oleate, isopropyl isostearate, isopropyl myristate, isopropyl neopentanoate, isopropyl palmitate, myristyl myristate, myristyl propionate, octyl palmitate, octyl stearate, peppermint oil, or propylene glycol-2 (PPG-2). Check the label. These ingredients can cause pimples to break out on acne-prone skin.
- Davis E.C., Callender V.D. Postinflammatory Hyperpigmentation. The Journal of Clinical and Aesthetic Dermatology. 2010;3(7):20–31.
- Diffey B.L., Grice J. The influence of sunscreen type on photoprotection. The British Journal of Dermatology. 1997;137(1):103-5.
- Matsuoka L.Y., Wortsman J., Hanifan N., Holick M.F. Chronic sunscreen use decreases circulating concentrations of 25-hydroxyvitamin D. A preliminary study. Archives of Dermatology (Journal). 1988;124(12):1802-4.
- “Table 3: Fitzpatrick Skin Type,” The Surgeon General’s Call to Action to Prevent Skin Cancer. US Department of Health and Human Services: Office of the Surgeon General (US). 2014.
- Spann C.T. Ten tips for treating acne vulgaris in Fitzpatrick skin types IV-VI. Journal of Drugs in Dermatology. 2011 Jun;10(6):654-7.
- Latha M.S., Martis J., Shobha V., Shinde R.S., Bangera S., Krishnankutty B., Bellary S., Varughese S., Rao P., Kumar B.R.N. Sunscreening Agents: A Review. The Journal of Clinical and Aesthetic Dermatology. 2013;6(1):16–26.
- Sime S., Reeve V.E. Protection from inflammation, immunosuppression and carcinogenesis induced by UV radiation in mice by topical Pycnogenol. Photochemistry and Photobiology. 2004;79(2):193-8.
- Collins P., Ferguson J. Photoallergic contact dermatitis to oxybenzone. The British Journal of Dermatology. 1994;131(1):124-9.
- Fulton J.E. Jr., Pay S.R., Fulton J.E. III. Comedogenicity of current therapeutic products, cosmetics, and ingredients in the rabbit ear. Journal of the American Academy of Dermatology. 1984;10(1):96-105.
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