Tinted Sunscreens: Consumer Preferences Based on Light, Medium

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IN COLLABORATION WITH THE SKIN OF COLOR SOCIETY

Visible light (VL) has been shown to increase tyrosinase activity and

induce immediate erythema in light-skinned individuals and long-

lasting pigmentation in dark-skinned individuals. Tinted sunscreens

(TSs) formulated with iron oxides (IOs) and/or pigmentary titanium

dioxide (PTD) provide functional and cosmetic benefits and are a

safe, effective, and convenient way to protect against both UV and

high-energy VL. We conducted an analysis of over-the-counter

TSs with the objective of investigating the factors that influence

consumer preference when choosing TS depending on underlying

skin tone. Descriptive data for each product were collected from an

online supplier that provides reviewer information. The top 10 most

helpful reviews were analyzed and coded by a consensus qualitative

coding scheme, which included positive and negative descriptors in

5 major categories. Most products provided only one color shade,

and tone incompatibility was the most commonly cited negative

feature, with the vast majority of these comments being from

consumers of dark skin tones. Top recommended products

corresponded with increased shade options, indicating the dearth

of shade diversity in products to be a potential area of improvement

in tinted sunscreen options.

Cutis. 2022;109:198-202, 223.

unscreen formulations typically protect from

UV radiation (290–400 nm), as this is a well-

established cause of photodamage, photoaging,

and skin cancer.

However, sunlight also consists of

visible (400–700 nm) and infrared (>700 nm) radia-

tion.

In fact, UV radiation only comprises 5% to 7% of

the solar radiation that reaches the surface of the earth,

while visible and infrared lights comprise 44% and 53%,

respectively.

Visible light (VL) is the only portion of the

solar spectrum visible to the human eye; it penetrates the

skin to a depth range of 90 to 750 µm compared to 1.5 to

90 µm for UV radiation.

Visible light also may come from

artificial sources such as light bulbs and digital screens.

The rapidly increasing use ofsmartphones, tablets, lap-

tops, and other digital screens that emit high levels of

short-wavelength VL has increased concerns about the

safety of these devices.Although blue light exposure from

screens is small compared with the amount of exposure

from the sun, there is concern about the long-term effects

of excessive screen time. Recent studies have demon-

strated that exposure to light emitted from electronic

devices, even for as little as 1 hour, may cause reactive

oxygen species generation, apoptosis, collagen degrada-

tion, and necrosis of skin cells.

Visible light increases

tyrosinase activity and induces immediate erythema in

light-skinned individuals and long-lasting pigmentation

in dark-skinned individuals.

4,6

Tinted Sunscreens: Consumer

Preferences Based on Light, Medium,

and Dark Skin Tones

Henriette De La Garza, MD; Poom Visutjindaporn, MD; Mayra B.C. Maymone, MD; Neelam A. Vashi, MD

Drs. De La Garza, Visutjindaporn, and Vashi are from the Department of Dermatology, Boston University School of Medicine, Massachusetts.

Dr. Maymone is from the Department of Dermatology, Brown University, Providence, Rhode Island. Dr. Vashi also is from the VA Boston Healthcare

System, Massachusetts.

The authors report no conflict of interest.

Correspondence: Neelam A. Vashi, MD, Department of Dermatology, Boston University School of Medicine, 609 Albany St J502, Boston, MA 02118

([email protected]).

doi:10.12788/cutis.0504

PRACTICE POINTS

• Visible light has been shown to increase tyrosinase

activity and induce immediate erythema in light-

skinned individuals and long-lasting pigmentation in

dark-skinned individuals.

• The formulation of sunscreens with iron oxides and

pigmentary titanium dioxide are a safe and effective

way to protect against high-energy visible light,

especially when combined with zinc oxide.

• Physicians should be aware of sunscreen character-

istics that patients like and dislike to tailor recommen-

dations that are appropriate for each individual

to enhance adherence.

• Cosmetic elegance and tone compatibility are

the most important criteria for individuals seeking

tinted sunscreens.

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Sunscreens consist of chemical and mineral active

ingredients that contain UV filters designed to absorb,

scatter, and reflect UV photons with wavelengths up to

380 nm. Historically, traditional options do not protect

against the effects induced by VL, as these sunscreens use

nanosized particles that help to reduce the white appear-

ance and result in transparency of the product.

To block

VL, the topical agent must be visible. Tinted sunscreens

(TSs) are products that combine UV and VL filters. They

give a colored base coverage that is achieved by incorpo-

rating a blend of black, red, and yellow iron oxides (IOs)

and/or pigmentary titanium dioxide (PTD)(ie, titanium

dioxide [TD] that is not nanosized). Because TSs offer

an instant glow and protect the skin from both sun and

artificial light, they have become increasingly popular

and have been incorporated into makeup and skin care

products to facilitate daily convenient use.

The purpose of this analysis was to study current

available options and product factors that may influence

consumer preference when choosing a TS based on the

reviewer characteristics.

Methods

The keyword sunscreen was searched in the broader

category of skin care products on an online supplier

of sunscreens (www.sephora.com). This supplier was

chosen because, unlike other sources, specific reviewer

characteristics regarding underlying skin tone also were

available. The search produced 161 results. For the pur-

pose of this analysis, only facial TSs containing IO and/

or PTD were included. Each sunscreen was checked by

the authors, and 58 sunscreens that met the inclusion

criteria were identified and further reviewed. Descriptive

data, including formulation, sun protection factor (SPF),

ingredient type (chemical or physical), pigments used,

shades available, additional benefits, price range, rating,

and user reviews, were gathered. The authors extracted

these data from the product information on the website,

manufacturer claims, ratings, and reviewer comments on

each of the listed sunscreens.

For each product, the content of the top 10 most helpful

positive and negative reviews as voted by consumers (1160

total reviews, consisting of 1 or more comments) was ana-

lyzed. Two authors (H.D.L.G. and P.V.) coded consumer-

reported comments for positive and negative descriptors

into the categories of cosmetic elegance, performance,

skin compatibility and tolerance, tone compatibility, and

affordability. Cosmetic elegance was defined as any feature

associated with skin sensation (eg, greasy), color (eg, white

cast), scent, ability to blend, and overall appearance of the

product on the skin. Product performance included SPF,

effectiveness in preventing sunburn, coverage, and finish

claims (ie, matte, glow, invisible). Skin compatibility and

tolerance were represented in the reviewers’ comments

and reflected how the product performed in association

with underlying dermatologic conditions, skin type, and

if there were any side effects such as irritation or allergic

reactions. Tone compatibility referred to TS color similar-

ity with users’ skin and shades available for individual

products. Affordability reflected consumers’ perceptions of

the product price. Comments may be included in multiple

categories (eg, a product was noted to blend well on the

skin but did not provide enough coverage). Of entries, 10%

(116/1160 reviews) were coded by first author (H.D.L.G.)

to ensure internal validity. Reviewer characteristics were

consistently available and were used to determine the top

5 recommended products for light-, medium-, and dark-

skinned individuals based on the number of 5-star ratings

in each group. Porcelain, fair, and light were considered

light skin tones. Medium, tan, and olive were considered

medium skin tones. Deep, dark, and ebony were consid-

ered dark skin tones.

Results

Sunscreen Characteristics—Among the 161 screened prod-

ucts, 58 met the inclusion criteria. Four types of formula-

tions were included: lotion, cream, liquid, and powder.

Twenty-nine (50%) were creams, followed by lotions

(19%), liquids (28%), and powders (3%). More than 79%

(46/58) of products had a reported SPF of 30 or higher.

Sunscreens with an active physical ingredient—the min-

erals TD and/or zinc oxide (ZO)—were most common

(33/58 [57%]), followed by the chemical sunscreens avo-

benzone, octinoxate, oxybenzone, homosalate, octisalate,

and/or octocrylene active ingredients (14/58 [24%]), and

a combination of chemical and physical sunscreens

(11/58 [19%]). Nearly all products (55/58 [95%]) con-

tained pigmentary IO (red, CI 77491; yellow, CI 77492;

black, CI 77499). Notably, only 38% (22/58) of products

had more than 1 shade. All products had additional

claims associated with being hydrating, having antiaging

effects, smoothing texture, minimizing the appearance of

pores, softening lines, and/or promoting even skin tone.

Traditional physical sunscreens (those containing TD and/

or ZO) were more expensive than chemical sunscreens,

with a median price of $30. The median review rating was

4.5 of 5 stars, with a median of 2300 customer reviews per

product. Findings are summarized in Table 1.

Positive Features of Sunscreens—Based on an analysis of

total reviews (N=1160), cosmetic elegance was the most

cited positive feature associated with TS products (31%),

followed by product performance (10%). Skin compat-

ibility and tolerance (7%), tone compatibility (7%), and

affordability (7%) were cited less commonly as positive

features. When negative features were cited, consumers

mostly noted tone incompatibility (16%) and cosmetic

elegance concerns (14%). Product performance (13%)

was comparatively cited as a negative feature (Table 1).

Exemplary positive comments categorized in cosmetic

elegance included the subthemes of rubs in well and

natural glow. Exemplary negative comments in cosmetic

elegance and tone compatibility categories included the

subthemes patchy/dry finish and color mismatch. Table 1

illustrates these findings.

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Sunscreen characteristics No. (%)

Formulation (N=58)

Lotion 11 (19)

Cream 29 (50)

Liquid 16 (28)

Powder 2 (3)

SPF (N=58)

<30

12 (21)

30 21 (36)

>30

25 (43)

Active ingredient type

(N=58)

Chemical 14 (24)

Physical 33 (57)

Mixed 11 (19)

Pigments used (N=58)

Iron oxides

(CI 77491, CI 77492, CI 77499)

29 (50)

Pigmentary titanium dioxide

(CI 77891)

3 (5)

Mixed 26 (45)

Different shades available (N=58)

Yes 22 (38)

No 36 (62)

Additional benets (N=58)

Yes 58 (100)

No 0 (0)

TABLE 1. Tinted Sunscreen Characteristics and Descriptors of the Top 10 Most

Helpful Positive and Negative Comments as Voted by Consumers

Abbreviation: SPF, sun protection factor.

Main active ingredients in chemical sunscreens included avobenzone, octinoxate, oxybenzone, homosalate, octisalate, and octocrylene.

Main active ingredients in physical sunscreens included the minerals titanium dioxide and zinc oxide.

Consumers rated products from 1 to 5 on an online sunscreen supplier’s website (www.sephora.com), which automatically produces a

mean rating for each product.

Total number of comments within designated category.

Sunscreen characteristics No. (%)

Price, US $

<20

2 (3)

21–40 30 (52)

41–60 13 (22)

61–80 7 (12)

>100

6 (10)

Rating

(N=58)

5 1 (1)

4 35 (60)

3 21 (36)

2 1 (1)

1 0 (0)

Cosmetic elegance (n=522)

Positive comments 356 (69)

Negative comments 166 (31)

Performance (n=260)

Positive comments 112 (43)

Negative comments 148 (57)

Skin compatibility and tolerance

(n=148)

Positive comments 80 (54)

Negative comments 68 (46)

Tone compatibility (n=265)

Positive comments 76 (29)

Negative comments 189 (71)

Affordability (n=117)

Positive comments 52 (44)

Negative comments 65 (56)

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Product Recommendations—The top 5 recommenda-

tions of the best TS for each skin tone are listed in

Table 2. The mean price of the recommended products

was $42 for 1 to 1.9 oz. Laura Mercier Tinted Moisturizer

Oil Free Natural Skin Perfector broad spectrum SPF 20

(Laura Mercier) was the top product for all 3 groups.

Similarly, of 58 products available, the same 5 products—

Laura Mercier Tinted Moisturizer Oil Free Natural Skin

Perfector broad spectrum SPF 20, IT Cosmetics CC+

Cream with SPF 50 (IT Cosmetics, LLC), Tarte Amazonian

Clay BB Tinted Moisturizer Broad Spectrum SPF 20 (Tarte

Cosmetics), NARS Pure Radiant Tinted Moisturizer Broad

Spectrum SPF 30 (NARS Cosmetics), and Laura Mercier

Tinted Moisturizer Natural Skin Perfector broad spectrum

SPF 30—were considered the best among consumers of

all skin tones, with the addition of 2 different products

(bareMinerals Original Liquid Mineral Foundation Broad

Spectrum SPF 20 [bareMinerals] and ILIA Super Serum

Skin Tint SPF 40 Foundation [ILIA Beauty]) in the dark

skin group. Notably, these products were the only ones on

Sephora’s website that offered up to 30 (22 on average)

different shades.

Comment

Tone Compatibility—Tinted sunscreens were created to

extend the range of photoprotection into the VL spec-

trum. The goal of TSs is to incorporate pigments that

blend in with the natural skin tone, produce a glow, and

have an aesthetically pleasing appearance. To accom-

modate a variety of skin colors, different shades can

be obtained by mixing different amounts of yellow,

red, and black IO with or without PTD. The pigments

and reflective compounds provide color, opacity, and

a natural coverage. Our qualitative analysis provides

information on the lack of diversity among shades

available for TS, especially for darker skin tones. Of the

58 products evaluated, 62% (32/58) only had 1 shade. In

our cohort, tone compatibility was the most commonly

cited negative feature. Of note, 89% of these comments

were from consumers with dark skin tones, and there was

a disproportional number of reviews by darker-skinned

individuals compared to users with light and medium

skin tones. This is of particular importance, as TSs have

been shown to protect against dermatoses that dispro-

portionally affect individuals with skin of color. When

comparing sunscreen formulations containing IO with

regular mineral sunscreens, Dumbuya et al

found that

IO-containing formulations significantly protected against

VL-induced pigmentation compared with untreated skin

or mineral sunscreen with SPF 50 or higher in individuals

with Fitzpatrick skin type IV (P<.001). Similarly,

Bernstein et al

found that exposing patients with

Fitzpatrick skin types III and IV to blue-violet light

resulted in marked hyperpigmentation that lasted up to

3 months. Visible light elicits immediate and persistent

pigment darkening in individuals with Fitzpatrick skin

phototype III and above via the photo-oxidation of pre-

existing melanin and de novo melanogenesis.

Tinted

sunscreens formulated with IO have been shown to aid

in the treatment of melasma and prevent hyperpigmenta-

tion in individuals with Fitzpatrick skin types IV to VI.

Patients with darker skin tones with dermatoses aggra-

vated or induced by VL, such as melasma and postinflam-

matory hyperpigmentation, may seek photoprotection

provided by TS but find the lack of matching shades

unappealing. The dearth of shade diversity that matches

all skin tones can lead to inequities and disproportionally

affect those with darker skin.

TABLE 2. Top 5 Products as Rated by Reviewers With Light, Medium, and Dark Skin Tones

Rank Light skin tone Medium skin tone Dark skin tone

1 Laura Mercier Tinted Moisturizer Oil

Free Natural Skin Perfector broad

spectrum SPF 20 (Laura Mercier)

Laura Mercier Tinted Moisturizer Oil

Free Natural Skin Perfector broad

spectrum SPF 20

Laura Mercier Tinted Moisturizer Oil

Free Natural Skin Perfector broad

spectrum SPF 20

2 IT Cosmetics CC+ Cream with

SPF 50+ (IT Cosmetics, LLC)

Laura Mercier Tinted Moisturizer

Natural Skin Perfector broad

spectrum SPF 30

NARS Pure Radiant Tinted

Moisturizer Broad Spectrum

SPF 30 (NARS Cosmetics)

3 Tarte Amazonian Clay BB Tinted

Moisturizer Broad Spectrum

SPF 20 Sunscreen (Tarte Inc)

IT Cosmetics CC+ Cream

with SPF 50+

Laura Mercier Tinted Moisturizer

Natural Skin Perfector broad

spectrum SPF 30

4 NARS Pure Radiant Tinted

Moisturizer Broad Spectrum

SPF 30

NARS Pure Radiant Tinted

Moisturizer Broad Spectrum

SPF 30

bareMinerals Original Liquid

Mineral Foundation Broad

Spectrum SPF 20 (bareMinerals)

5 Laura Mercier Tinted Moisturizer

Natural Skin Perfector broad

spectrum SPF 30

Tarte Amazonian Clay BB Tinted

Moisturizer Broad Spectrum

SPF 20 Sunscreen

ILIA Super Serum Skin Tint

SPF 40 Foundation (ILIA Beauty)

Abbreviation: SPF, sun protection factor.

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Performance—Tinted sunscreen formulations contain-

ing IO have been proven effective in protecting against

high-energy VL, especially when combined synergistically

with ZO.

Kaye et al

found that TSs containing IO and

the inorganic filters TD or ZO reduced transmittance of

VL more effectively than nontinted sunscreens contain-

ing TD or ZO alone or products containing organic filters.

The decreased VL transmittance in the former is due to

synergistic effects of the VL-scattering properties of the

TD and the VL absorption properties of the IO. Similarly,

Sayre et al

demonstrated that IO was superior to TD and

ZO in attenuating the transmission of VL. Bernstein et al

found that darker shades containing higher percentages

of IO increased the attenuation of VL to 98% compared

with lighter shades attenuating 93%. This correlates with

the results of prior studies highlighting the potential of

TSs in protecting individuals with skin of color.

In our

cohort, comments regarding product performance and

protection were mostly positive, claiming that consistent

use reduced hyperpigmentation on the skin surface, giv-

ing the appearance of a more even skin tone.

Tolerability—Iron oxides are minerals known to be

safe, gentle, and nontoxic on the surface of the skin.

Two case reports of contact dermatitis due to IO have

been reported.

16,17

Within our cohort, only a few of the

comments (6%) described negative product tolerance or

compatibility with their skin type. However, it is more

likely that these incompatibilities were due to other ingre-

dients in the product or the individuals’ underlying derma-

tologic conditions.

Cosmetic Elegance—Most of the sunscreens available

on the market today contain micronized forms of TD and

ZO particles because they have better cosmetic accept-

ability.

However, their reduced size compromises the

protection provided against VL whereby the addition

of IO is of vital importance. According to the RealSelf

Sun Safety Report, only 11% of Americans wear sun-

screen daily, and 46% never wear sunscreen.

The most

common reasons consumers reported for not wearing

sunscreen included not liking how it looks on the skin,

forgetting to apply it, and/or believing that applica-

tion is inconvenient and time-consuming. Currently, TSs

have been incorporated into daily-life products such as

makeup, moisturizers, and serums, making application

for users easy and convenient, decreasing the necessity of

using multiple products, and offering the opportunity to

choose from different presentations to make decisions for

convenience and/or diverse occasions. Products contain-

ing IO blend in with the natural skin tone and have an

aesthetically pleasing cosmetic appearance. In our cohort,

comments regarding cosmetic elegance were highly val-

ued and were present in multiple reviews (45%), with

69% being positive.

Affordability—In our cohort, product price was not pre-

dominantly mentioned in consumers’ reviews. However,

negative comments regarding affordability were slightly

higher than the positive (56% vs 44%). Notably, the mean

price of our top recommendations was $42. Higher price

was associated with products with a wider range of shades

available. Prior studies have found similar results demon-

strating that websites with recommendations on sunscreens

for patients with skin of color compared with sunscreens

for white or fair skin were more likely to recommend more

expensive products (median, $14/oz vs $11.3/oz) despite

the lower SPF level.

According to Schneider,

daily use

of the cheapest sunscreen on the head/neck region recom-

mended for white/pale skin ($2/oz) would lead to an annual

cost of $61 compared to $182 for darker skin ($6/oz). This

showcases the considerable variation in sunscreen prices

for both populations that could potentiate disparities and

vulnerability in the latter group.

Conclusion

Tinted sunscreens provide both functional and cosmetic

benefits and are a safe, effective, and convenient way to

protect against high-energy VL. This study suggests that

patients with skin of color encounter difficulties in find-

ing matching shades in TS products. These difficulties

may stem from the lack of knowledge regarding dark

complexions and undertones and the lack of representa-

tion of black and brown skin that has persisted in der-

matology research journals and textbooks for decades.

Our study provides important insights to help derma-

tologists improve their familiarity with the brands and

characteristics of TSs geared to patients with all skin tones,

including skin of color. Limitations include single-retailer

information and inclusion of both highly and poorly rated

comments with subjective data, limiting generalizability.

The limited selection of shades for darker skin poses a

roadblock to proper treatment and prevention. These data

represent an area for improvement within the beauty indus-

try and the dermatologic field to deliver culturally sensitive

care by being knowledgeable about darker skin tones and

TS formulations tailored to people with skin of color.

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