The proportion of individuals with skin of color (SoC) who use sunscreen was found to have doubled when National Health and Nutrition Examination Survey (NHANES) data from 2021-2023 were compared with those from 2003-2004.

Although the proportion of Black participants reporting sunscreen use was lower than that of other non-White groups and far below that of White participants, public health initiatives appear to be having an effect, according to the lead author of the study, Christine Olagun-Samuel, medical student at New York University (NYU) Grossman School of Medicine, New York City.

The NHANES skin protection data were presented at the Skin of Color Society (SOCS) Annual Scientific Symposium 2026, held the day before the American Academy of Dermatology (AAD) 2026 Annual Meeting.

Sunscreen Use Doubled Over Past 20 Years

Although numerous sun protection behaviors were examined in the NHANES data, the change in sunscreen use was the most striking among Black participants. The good news is that it doubled. The more sobering news is that it involved a climb from an almost negligible rate of 4.4% in 2003-2004 to 11.4% in 2021-2023, the most recent period evaluated.

In other words, despite apparent progress, “there remains significant opportunity for increased advocacy to address apparent disparities” by race and ethnicity, reported Olagun-Samuel, who performed this work under her mentor, Prince Adotama, MD, assistant professor in the Department of Dermatology at NYU Grossman School of Medicine and co-founder of NYU’s Skin of Color Program.

Yet, the data itself might speak to one of these opportunities. Although the variables that potentially affect sunscreen use were not evaluated in this study, Adotama speculates that the growing array of tinted sunscreens that block sun rays in the visible light spectrum (300 nm-750 nm) might account for at least some increase in the use observed among individuals with SoC.

“Tinted sunscreens that block visible light are a relatively new thing,” Adotama told Medscape Medical News. He believes this is important to SoC individuals for two reasons. 

One is that it provides protection against many complications of sun exposure caused by visible light that are most common in patients with darker skin, such as postinflammatory pigmentation and melasma. The other is that tinted sunscreens are far more palatable for darker skin types.

“Black individuals who have tried the traditional sunscreens are often unhappy with the pasty complexion these produce,” Adotama explained. “With the tinted sunscreens, it is easier to match your skin tone to avoid this problem.”

These products are not so new that they are hard to find, but individuals not accustomed to using sunscreen might be unaware that they are available. Moreover, Adotama suggested that clinicians who see a limited number of patients with darker skin might not know that they should be recommending these types of products specifically for SoC.

In this study, NHANES data were pooled in 2-year cycles, starting with 2003-2004 and ending with 2021-2023 (two cycles were missed). Three sun-protective behaviors — sunscreen use, sun avoidance, and sun-protective clothing — were stratified by race. Each behavior was confirmed in those participating in the NHANES survey if they responded, “always” or “most of the time.” The behavior was not confirmed if survey participants responded with any other answer.

In this evaluation, Black participants served as the reference group and were compared with White, Hispanic, Asian, or multiracial respondents, although the data presented by Olagun-Samuel grouped all races other than Black and White into a single category of “other races and ethnicities.”

By percentage, there was increased use of sunscreen in 2021-2023 vs 2003-2004 among White participants (36.4% vs 28.7%) and the pool of other racial categories (29.1% vs 17.2%).

Shade Protection Preferred by Black Individuals

Shade protection was employed more often by Black participants in 2003-2004 (46.2%) than by White participants (26.5%) and other racial groups (37.8%), but this declined over the subsequent 20 years by about 8% in Black participants while increasing by about 6% in White participants, with little change in other racial groups.

Use of protective clothing (long sleeves) in 2003-2004 was highest among the other-race group (13.1%) relative to Black (6.4%) or White participants (5.5%). Over time, it increased by about 5% in other races, 3% in White participants, and 2% in Black participants.

When expressed in odds ratios (ORs), sunscreen use was 8.01 times higher among White participants relative to Black participants (95% CI, 5.15-12.47) at the most recent timepoint. Among White individuals, shade protection was employed about 1.75 times more frequently (95% CI, 1.30-2.36) than by Black individuals, and their use of long-sleeve sun protection was lower (OR, 0.76), but the difference was not significant (95% CI, 0.55-1.05).

In his own practice, Adotama routinely recommends sun protection, including regular use of sunscreens, in his SoC patients for their multiple health benefits. This is particularly relevant to those at high risk for dyschromias, such as those with acne or other inflammatory skin diseases that trigger postinflammatory hyperpigmentation. He suggested that the cosmetic benefits of sun protection can be highly motivating even for those who consider their skin cancer risk to be low.

To elicit adherence, he tries to judge their interest and attention to this advice. “Many patients consider the need for sun protection to be new information and are open to the value of protecting themselves,” he said. “But I ask about specific concerns if I detect hesitation.”

These concerns have included doubts about the safety of sunscreen and the risk for vitamin D deficiency.

“There is a lot of disinformation circulating about sunscreens, and I think it is worth explaining that these products are safe and the importance of sun protection specific to SoC,” he said. 

An expert who has written extensively on sun protection in skin of color, Susan C. Taylor, MD, professor of dermatology at the University of Pennsylvania, Philadelphia, suggested that the small but growing percentage of patients with darker skin tones who routinely use sun protection has been made easier by the increased number of products developed for skin of color.

“It is encouraging to see more patients of African ancestry using sunscreen to protect their skin from the harmful effects of ultraviolet and visible light,” said Taylor, who just completed her term as president of the American Academy of Dermatology. She indicated that clinicians can play a role in further increasing sun protection practices by educating patients.

“For these patients, guidance on selecting appropriate options like tinted sunscreens in tone-matching shades that provide protection from both UV [ultraviolet] and visible light can be particularly helpful,” she told Medscape Medical News.

Olagun-Samuel and Adotama reported having no potential conflicts of interest. Taylor reported having financial relationships with AbbVie, Arcutis, Armis Scientific, Avita, Beiersdorf, Biorez, Bristol Myers Squibb, Cara Therapeutics, Dior, Eli Lilly, EPI Health, Evolus, Galderma, GloGetter, Hugel America, Incyte, Johnson & Johnson, L’Oréal USA, MJH Life Sciences, Pfizer, Piction Health, Sanofi, Scientis US, UCB, and Vichy Laboratories.