Australian Sunscreens: The Price of Protection for Skin of Colour With Pigmentary Disorders

Australia experiences some of the highest ultraviolet radiation (UVR) levels globally, known for causing sunburn, skin cancers, photoageing and immunosuppression. While effects of UVA and UVB are well-studied, visible light (VL; 400-700 nm) is the driving force behind pigmentary disorders, especially in skin of colour (SOC) patients. Nearly 50% of Australians are affected, with significant impacts on appearance and psychological well-being. Tinted sunscreens containing iron oxides and pigmentary-grade titanium dioxide are the only effective options for blocking VL. However, Australia's stringent Therapeutic Goods Administration (TGA) regulations limit the availability of colour-matched tinted sunscreens, significantly impacting SOC patients. SOC patients may also underestimate their need for photoprotection, believing their skin provides sufficient natural protection. In dermatological practice, tailored sunscreen recommendations for darker skin tones may sometimes be overlooked. This review explores the barriers to effective treatment and the cost implications for SOC individuals suffering from pigmentary disorders in Australia. The goal is to guide both patients and dermatologists in making informed decisions on VL protection and skin tone matching.