A cross sectional examination of sunburn incidence in the context of race/ethnicity and skin type

ABSTRACT

Sun exposure is physiologically necessary, yet excessive amounts can be detrimental to skin, causing photoaging, sunburn, and skin cancer. Sunburn, presenting as delayed onset erythema, has been partially characterized for Caucasians, however the impact of excessive sun exposure has been less studied across race/ethnicity and skin tones. Herein, we present findings from a survey conducted across the United States, where sunburns were examined in a racially and ethnically diverse sample of 3597 participants spanning the Fitzpatrick skin phototype (FSP) scale. Individuals reporting sunburn were probed on the signs, severity, pain level, and anatomical location of their most recent sunburn and on the associated type of activity. Over the 8-month evaluation period (January-August 2020), sunburns were self-reported at rates generally consistent with those reported annually pre-COVID, with 39% Caucasian, 20% Asian, 12% African American and 32% Latino respondents reporting at least one sunburn. While average sunburn incidence among African American is low, a closer look reveals that African Americans with lighter skin tones (FSPs I-II) report higher sunburn rates (25.5%, n = 12), thus highlighting that sunburn risk does not depend on race/ethnicity alone. Furthermore, African Americans and Hispanics self-reported a significantly higher percentage of severe sunburns compared with Caucasians (27%, 20% and 11%, respectively) and African Americans, unlike Caucasians, indicated “peeling” as the top sign of their sunburn. This work provides a better understanding of the sunburn experience across race/ethnicity and skin tones and is a step toward enabling more personalized sun safety awareness and education.