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2, 3, 7, 22, 24, 25, 32, 39, 40, 46, 47ĭaily application of tinted sunscreens reduced the appearance of cutaneous hyperchromias after 60 days. 59 Tinted sunscreens reduce VL transmission by 93–98%.

24 Yellow Fe 2O 3 protects melanocompetent subjects from VL-induced pigmentation. 24, 58 Depending on the oxidation state, Fe 2O 3 may appear yellow, red, or black. 48, 58 Tinted sunscreens consist of a blend of iron oxides (Fe 2O 3) and TiO 2 pigments that function as VL and UV blockers. Since neither organic nor inorganic UV filters used in sunscreens protect against VL, tinted (colored) sunscreens are available to protect against VL. 15, 17, 24, 31– 33 For proper photoprotection, sunscreens should be combined with measures outlined above. 2, 17, 22, 23, 30 Nanosized inorganic filters (i.e., ZnO, TiO 2) do not have VL photoprotective properties, but non-nanosized inorganic filters do. 2, 17, 22, 23, 30 It is a misconception that mineral filters are “physical blockers” as they absorb UV photons, especially in nanosized form. 2, 17, 22, 23, 30 All UV filters, including mineral filters are “chemicals”. 2, 17, 22, 23, 30 While these terms are used interchangeably, organic and inorganic filters are the terms recommended by the US Food and Drug Administration (FDA). 26, 29 UV filters used in sunscreens may be either organic (i.e., chemical) or inorganic (i.e., mineral) ( Table 1). Photoprotective measures include avoiding the sun, seeking shade, using photoprotective clothing, wearing wide-brimmed hats and sunglasses, and applying broad-spectrum sunscreens.

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Photoprotection is critical to maintain skin health, minimize post-inflammatory hyperpigmentation, and prevent photoaging and photocarcinogenesis. 25– 28 However, the cumulative dose of blue light emitted by these low-intensity sources is not relevant for VL biologic effects as it does not reach the dose demonstrated to induce hyperpigmentation. 3, 11– 19, 17, 20– 24 Environmental exposure to VL is primarily from the sun, but also from electronic devices such as smartphones, tablets, and computer screens. 3, 9– 11 However, VL compromises 50% of EMR that reaches the earth’s surface (versus UV, which is responsible for only 5%) and has been shown to induce pigment darkening and erythema as discussed in Part I. 2– 8 Cutaneous photobiology studies have focused primarily on the ultraviolet (UV) portion of the solar spectrum, as the erythema peak is around 295nm. 2– 7 The majority of EMR that reaches the earth’s surface is composed of UVB (290–320 nm), UVA2 (320–340 nm), UVA1 (340–400 nm), VL (400–700 nm), and infrared (IR) (700 nm-1 mm) radiation. 1 The sun emits broad-spectrum electromagnetic radiation (EMR) with a peak in the visible light (VL) (400–700 nm) range. The adverse effects of sun exposure on the skin are well-established. Further development should focus on better protection in the range of UVA1 (340–400nm) and VL while enhancing the cosmesis of the final products. These novel methods include topical, oral, and subcutaneous agents. Alternative measures to confer VL photoprotection are being explored. There are no established guidelines regarding VL photoprotection. In the US, these filters are regulated by the FDA as an over-the-counter drug and are subjected to more stringent regulations than in Europe, Asia, and Australia. Organic and inorganic UV filters used in sunscreens do not protect against VL only tinted sunscreens do. Photoprotection against VL includes sun avoidance, seeking shade, and the use of photoprotective clothing. However, VL comprises 50% of EMR that reaches the earth’s surface, and, as discussed in Part I of this CME, VL has cutaneous biologic effects such as pigment darkening and erythema. Cutaneous photobiology studies have focused primarily on the UV portion of the solar spectrum.

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