Review
Photoprotection beyond ultraviolet radiation: A review of tinted sunscreens

https://doi.org/10.1016/j.jaad.2020.04.079Get rights and content

Ultraviolet radiation and visible light both have biologic effects on the skin. Visible light can induce erythema in light-skinned individuals and pigmentation in dark-skinned individuals. Broad-spectrum sunscreens protect against ultraviolet radiation but do not adequately protect against visible light. For a sunscreen to protect against visible light, it must be visible on the skin. Inorganic filters (also known as mineral filters), namely, zinc oxide and titanium dioxide, are used in the form of nanoparticles in sunscreens to minimize the chalky and white appearance on the skin; as such, they do not protect against visible light. Tinted sunscreens use different formulations and concentrations of iron oxides and pigmentary titanium dioxide to provide protection against visible light. Many shades of tinted sunscreens are available by combining different amounts of iron oxides and pigmentary titanium dioxide to cater to all skin phototypes. Therefore, tinted sunscreens are beneficial for patients with visible light–induced photodermatoses and those with hyperpigmentation disorders such as melasma and postinflammatory hyperpigmentation.

Section snippets

Cutaneous effects of sunlight

Sunlight is a well-established cause of photodamage, photoaging, and skin cancer. It consists of ultraviolet (UV) (290-400 nm), visible (400-700 nm), and infrared (>700 nm) radiation. UV radiation comprises 5% of solar radiation reaching the surface of the earth, and visible light, defined as the part of the electromagnetic spectrum that is visible to the human eye, comprises 44%.1 Visible light penetrates the skin to a depth range of 90 to 750 μm, compared with 1.5 to 90 μm for UV radiation.2

Visible light photoprotection

The emerging knowledge of photobiologic effects of visible light has stimulated discussion on photoprotection against visible light. Currently available UV filters used in sunscreen products consist of 2 categories: organic (also commonly known as chemical) and inorganic (also known as mineral). These filters are designed to absorb, scatter, and reflect UV photons with wavelengths up to 380 nm but are not designed to reduce visible light–induced effects.7

Inorganic filters are used as nanosized

Definition of tinted sunscreens

Tinted sunscreens are products that combine a colored base coverage with UV filters. The tint is achieved by incorporating into the final product a blend of iron oxides and pigmentary titanium dioxide, which are pigments that function as visible light filters but not as UV filters (Table II). Iron oxides are pigments produced from ferrous sulfate. Depending on the oxidation state, they may appear yellow, red, or black. Yellow or red pigment appears as yellow or red because of reflection of the

Tinted sunscreens and constitutive skin color

To accommodate the variety of skin colors of patients, tinted products of different shades are available (Fig 1). The shade is obtained by mixing the 3 iron oxides—yellow, red, and black—with pigmentary titanium dioxide, which helps provide coverage and opacity. Tinted sunscreen products of different shades have been developed for individuals of all Fitzpatrick skin phototypes (from I to VI). For a same sunscreen base, the light and dark tints are obtained using a combination of different

In vitro studies

Kaye et al11 demonstrated that tinted sunscreens that contain iron oxides and the inorganic filters titanium dioxide or zinc oxide reduced transmittance of visible light more effectively than untinted sunscreens containing titanium dioxide or zinc oxide alone or products containing organic filters. The decreased visible light transmittance in the former is due to synergistic effects of the visible light scattering properties of the titanium dioxide and the visible light absorption properties of

Conclusion

Given the ever-increasing understanding of the effects of visible light on the skin, it is important to practice photoprotection against this waveband, particularly in patients with dermatoses that are aggravated or induced by visible light. The use of tinted sunscreen is a viable option for this patient population. A better knowledge of the physical properties and interactions of iron oxides, pigmentary titanium dioxide, and UV filters, and their impact on the attenuation of transmittance of

References (21)

There are more references available in the full text version of this article.

Cited by (0)

Funding sources: None.

Conflicts of interest: Dr Lyons is a subinvestigator for Incyte, Beiersdorf, Unigen Inc, General Electric, Lenicura, Estée Lauder, Miragen, Biofrontera, Pfizer, and L'Oréal. Author Trullas is an employee of ISDIN. Dr Kohli is a subinvestigator for Beiersdorf, Estée Lauder, Unigen Inc, L'Oréal, Ferndale Laboratories, Allergan, and Johnson & Johnson, and has served as a consultant for Pfizer, Johnson & Johnson, and Beiersdorf. Dr Hamzavi is an investigator for the Patient-Centered Outcomes Research Institute, Incyte, L'Oréal, Beiersdorf, Estée Lauder, Unigen Inc, Ferndale Healthcare Inc, Pfizer, Allergan, and Johnson & Johnson, and has served as a consultant for Pfizer, Johnson & Johnson, and Beiersdorf. Dr Lim is an investigator for Incyte, Beiersdorf, L'Oréal, Pfizer, and the Patient-Centered Outcomes Research Institute, has served as a consultant for Pierre Fabre, ISDIN, Ferndale Healthcare Inc, and Galderma, and has participated as a speaker in general educational sessions for Pierre Fabre, Eli Lilly, Johnson & Johnson, and Ra Medical Systems.

IRB approval status: Exempt.

Reprints not available from the authors.

View full text
© 2020 by the American Academy of Dermatology, Inc.