Photoprotection of the Skin from Visible Light‒Induced Pigmentation: Current Testing Methods and Proposed Harmonization

Blue light protection factor: a method to assess the protective efficacy of cosmetics against blue light-induced skin damage in the Chinese population

BACKGROUND

Previous studies have shown that visible light (VL), especially blue light (BL), could cause significant skin damage. With the emergence of VL protection products, a harmonization of light protection methods has been proposed, but it has not been widely applied in the Chinese population.

OBJECTIVE

Based on this framework, we propose an accurate and simplified method to evaluate the efficacy of BL photoprotection for the Chinese population.

METHODS

All subjects (n = 30) were irradiated daily using a blue LED light for four consecutive days. Each irradiation dose was 3/4 MPPD (minimum persistent pigmentation darkening). The skin pigmentation parameters, including L*, M, and ITA°, were recorded. We proposed the blue light protection factor (BPF) metric based on the skin pigmentation parameters to evaluate the anti-blue light efficacies of different products.

RESULTS

We found that the level of pigmentation rose progressively and linearly as blue light exposure increased. We proposed a metric, BPF, to reflect the anti-blue light efficacy of products based on the linear changes in skin pigment characteristics following daily BL exposure. Moreover, we discovered that the BPF metric could clearly distinguish the anti-blue light efficacies between two products and the control group, suggesting that BPF is an efficient and simple-to-use metric for anti-blue light evaluation.

CONCLUSION

Our study proposed an accurate and simplified method with an easy-to-use metric, BPF, to accurately characterize the anti-blue light efficacies of cosmetic products, providing support for further development of anti-blue light cosmetics.

Evaluation of the protection of sunscreen products against long wavelength ultraviolet A1 and visible light-induced biological effects

BACKGROUND

Long wavelength ultraviolet-A1 in combination with visible light induces hyperpigmentation, particularly in dark-skin phototypes. This study evaluated the efficacy of four sunscreen formulations in protecting against VL + UVA1 (370-700 nm).

METHODS

The test products (A-D) were applied to the back of 12 volunteers, then irradiated with 320 J/cm2 VL + UVA1 (3.5% UVA1 [370-400 nm]). Immediately after irradiation, and at Days 1, 7, and 14, erythema and pigmentation were assessed by investigator global assessment (IGA), colorimetry (Δa* and ΔITA) and diffuse reflectance spectroscopy (DRS)-measured relative dyschromia (area under the curve AUC). Control areas were irradiated without sunscreen.

RESULTS

Product D, containing titanium dioxide 11%, iron oxides 1%, and antioxidants, provided the highest and most consistent protection. Compared with unprotected irradiated control, it had statistically significantly less erythema on IGA, DRS (Δoxyhemoglobin), and colorimetry (Δa*) at Day 0; less pigmentation on IGA at all time points, on DRS (relative dyschromia) at Days 7 and 14, and on colorimetry (ΔITA) at Day 0. Product B, containing zinc oxide 12% plus organic UV filters, iron oxides 4%, and antioxidants, also showed some efficacy.

CONCLUSION

Of the sunscreens tested, the tinted products provided better protection against VL + UVA1 than the non-tinted products. Since the product with 1% iron oxides was superior to the product with 4% iron oxides, further studies are needed to evaluate whether iron oxide content correlates with better protection.

Awareness of sun exposure risks and photoprotection for preventing pigmentary disorders in Asian populations: Survey results from three Asian countries and expert panel recommendations

BACKGROUND

In this article, we review and discuss the photoprotection behavior of Asians based on the literature, along with a subanalysis of an original online survey, and make recommendations to optimize photoprotection for Asian populations to prevent photoaging and pigmentary disorders.

METHODS

An international panel of eight dermatologists from Asia (China, Korea, Japan, Singapore, Indonesia, and Vietnam) met to discuss sunscreen photoprotection for Asian patients. Additionally, a subanalysis of an online survey by 3000 respondents from three Asian countries (China, Indonesia, and Japan) investigated general public awareness and attitudes to sun exposure.

RESULTS

A pre-meeting survey of the eight experts from Asia showed key concerns of Asian patients consulting dermatologists are pigmentary disorders, especially actinic/senile lentigo, post-inflammatory hyperpigmentation, melasma, vitiligo, and Hori's nevus. The survey subanalysis of participants from China, Indonesia, and Japan with predominantly Fitzpatrick skin types (FST) II to IV revealed that they are particularly concerned about sun exposure causing photoaging and pigmentary disorders. Most of the respondents indicated they have limited knowledge on sunlight radiation and appropriate sunscreen protection factors. Only 22%, 13%, and 3% for China, Indonesia, and Japan, respectively, systematically use multiple protective measures (using sunscreen, avoiding midday sun, staying in the shade, wearing a hat, protective clothing, and sunglasses) when exposed to the sun.

CONCLUSIONS

Further education is needed for Asian populations on the importance of comprehensive daily photoprotection, including broad-spectrum sunscreen, with high UVA and visible light protection, to reduce and prevent photoaging and pigmentary disorders.

Photoaging's portrait: The road map towards its photoprotection

OBJECTIVE

To summarize key research published by the author's group, dealing with skin photoaging and its photoprotection.

MATERIALS AND METHODS

Two methodologies (standard photographs and selfies imaging) resulting from referential skin ageing atlases were applied on 2487 subjects of different ancestries, ages and gender. These aimed at first to best assess and grade the variable severities of some facial signs (texture/wrinkles, pigmentary spots, sagging and vascular disorders) that occur progressively during the photoaging process. Second, such methodologies were used to record the benefits brought by a photoprotective regimen (671 women and men).

RESULTS

In all studied ancestries, each facial sign show an increase severity along decades, at its own pace, some showing a linear like progression, whereas some plateau at early ages. These changes differed according to skin innate colour (phototype) and with individual behaviours vis-à-vis sun exposures, more so among European women than North-East Asian women. An effect of gender (less severe alterations) was observed on Chinese men, as compared to Chinese women. Pigmentary disorders were found hallmarks of photo-aged North-East Asian women. Globally, photoaging impact the apparent age of the different subjects. The counteracting effects of strong topical Photoprotective regimens were evidenced along a 6-month seasonality in Chinese and French women or 1-year period in Brazilian women with phototypes II to VI. Photoprotection led to a more even skin complexion among Indian subjects with pigment irregularities.

CONCLUSION

Two factors clearly hamper a better assessment of the efficiency of photoprotection of the sun-induced cutaneous ageing: short durations (months) of the studies with regard to the global fate of photoaging by decades and the number of studied subjects, limited to hundreds for practical reasons. The methodology based on the automatic analysis of facial signs through selfies images could theoretically bypass both factors, allowing thousands of subjects to be studied along years.

Broad-spectrum sunscreens containing the TriAsorB™ filter: In vitro photoprotection and clinical evaluation of blue light-induced skin pigmentation

BACKGROUND

Blue light (BL), particularly high-energy visible (HEV) light (400-450 nm), can cause skin damage and pigmentation. Therefore, effective sunscreens should offer photoprotection beyond ultraviolet (UV) radiation to also prevent or limit BL-induced cutaneous effects.

OBJECTIVES

To evaluate the in vitro BL photostability and photoprotection properties of nine sunscreens containing the broad-spectrum UV/BL phenylene bis-diphenyltriazine (PBDT or TriAsorB™) filter, together with three other organic UV filters, and to assess the in vivo photoprotection level provided by two of these products against BL-induced skin pigmentation.

METHODS

In vitro BL photostability and photoprotection factors, comprising the percentage of BL radiation stopped by the product (%BL) and the critical wavelength extended to BL (BL-CW), were determined by spectrophotometry. The in vivo photoprotection provided by two representative sunscreens (i.e. similar formulations, one non-tinted and one tinted) was assessed in two open randomized studies (20 and 16 women, respectively) after exposure of two test areas (with and without sunscreen) on the back of each subject to a 412-nm irradiation dose at 50 J/cm2 , using instrumental and clinical measurements of skin pigmentation. The percentage sunscreen photoprotective effectiveness (%PPE) was calculated by comparing intrasubject post-exposure pigmentation changes between the with and without sunscreen test areas.

RESULTS

In vitro, the nine PBDT-containing products were highly photostable and had a BL-CW ≥385 nm and a %BL ≥30% (range: 30%-50%), thus allowing effective BL photoprotection. In vivo, both representative sunscreens prevented BL-induced immediate skin pigmentation (1 and 24 h post-exposure) with %PPE values ranging from 50.7% to 75.5% for colorimetric assessments (p < 0.001) and from 31.2% to 72.7% for visual scores (p ≤ 0.001).

CONCLUSIONS

All PBDT-containing sunscreens were considered effective at absorbing BL radiation in vitro. The two representative broad-spectrum sunscreens tested in subjects significantly reduced BL-induced immediate skin pigmentation following single exposure to monochromatic BL radiation.

Induced skin aging by blue-light irradiation in human skin fibroblasts via TGF-β, JNK and EGFR pathways

BACKGROUND

Studies indicate that blue light (BL) irradiation can damage human skins, but the impact of BL irradiation on skin aging is unknown.

OBJECTIVES

This study aimed to give an insight to phenotypic characteristics and molecular mechanism of blue light-induced skin aging, and thus provide a theoretical basis for the precise protection of photodermatosis.

METHODS

The effect of BL on skin photoaging in mice was evaluated by non-invasive measurement equipment and histopathology analysis. The effect of BL irradiation on the proliferation of HFF-1 cells was detected by the Real-Time Cell Analyzer. The expression and protein levels of genes associated with skin aging were examined.

RESULTS

Our studies indicated photoaging caused by BL irradiation, including collagen disorder and increased MMP1. BL irradiation also inhibited cell proliferation and collagen expression in human skin fibroblasts by inhibiting TGF-β signaling pathway, based on in vitro experiments. Importantly, BL irradiation promoted the degradation of collagen by increasing MMP1 activated by the JNK/c-Jun and EGFR pathways. Moreover, ROS levels were significantly increased after BL irradiation in human skin fibroblasts. Yet, the transcriptional change in human skin fibroblasts caused by BL irradiation was unable to be completely restored by ROS scavenger.

CONCLUSION

BL irradiation down-regulated expression of type I collagen genes and up-regulated MMP1 expression to inhibit the proliferation of human skin fibroblasts. Multiple key pathways including TGF-β, JNK, and EGFR signaling were involved in BL-induced skin aging. Our results provide theoretical bases for the protection of photoaging caused by BL irradiation.

Clinical and molecular change induced by repeated low-dose visible light exposure in both light-skinned and dark-skinned individuals

BACKGROUND

Visible light (VL) is known to induce pigmentation in dark-skinned individuals and immediate erythema in light-skinned individuals. However, the effects of accumulated low-dose VL exposure across skin types are not well established.

METHODS

Thirty-one healthy subjects with light (Fitzpatrick skin types [FST] I-II, n = 13) and dark (FST V-VI, n = 18) skin types were enrolled. Subjects' buttocks were exposed daily to VL, wavelength 400-700 nm, with a dose of 120 J/cm2 at 50 mW/cm2 , for four consecutive days. Microarray using Affymetrix GeneChip (49,395 genes) was performed followed by qRT-PCR on skin samples.

RESULTS

Repeated low-dose VL irradiation induced immediate pigment darkening and delayed tanning in dark-skinned individuals while no discernable pigmentation and erythema were observed in light-skinned individuals. Top ten upregulated genes by repeated VL exposure in microarray included melanogenic genes such as tyrosinase (TYR), tyrosinase-related protein-1 (TYRP1), dopachrome tautomerase (DCT), premelanosome protein (PMEL), melan-A (MLANA), and solute carrier family 24, member 5 (SLC24A5) and genes involved in inflammation/matrix remodeling/cell signaling including chemokine (C-C motif) ligand 18 (CCL18), BCL2-related protein A1 (BCL2A1), and cartilage oligomeric matrix protein (COMP). In qRT-PCR CCL18 was upregulated in light skin with a greater extent (mean fold change ± SD; 4.03 ± 3.28, p = .04) than in dark-skinned individuals (1.91 ± 1.32, p = .07) while TYR was not significantly upregulated in both skin types.

CONCLUSION

This study highlights the genes upregulated by cumulative VL exposure involved in pigmentation, immune response, oxidation/reduction, and matrix remodeling across skin types providing relevant information on daily solar exposure.

Photoprotection in skin of color

As populations in many parts of the world are projected to become more racially diverse over the coming decades, we must better understand the unique characteristics of the skin of populations with skin of color (SOC). This review aims to highlight important physiologic and clinical considerations of photoprotection in SOC. Ultraviolet radiation and visible light affect dark and light skin differently. SOC populations have historically not been informed on photoprotection to the same degree as their light skinned counterparts. This has exacerbated dermatologic conditions in which SOC populations are disproportionately affected, such as hyperpigmentary disorders. Patients should be encouraged to utilize multiple methods of photoprotection, ranging from avoidance of sunlight during peak intensity hours, seeking shade, wearing sun-protective clothing and wide-brimmed hat, and applying sunscreen. Ideal sunscreens for SOC populations include those with UVA-PF/SPF ratios ≥ 2/3 and tinted sunscreens to protect against VL. Although there have been increased efforts recently, more research into photoprotection for SOC and targeted public education are required to disseminate photoprotection resources that are patient-centered and evidence-based.

Commentary: Facial Aesthetic Dermatological Procedures and Photoprotection in Chinese Populations

The medical literature on aesthetic dermatology has primarily focused on a light-skinned patient population, yet patients of darker skin types have different needs and priorities. In Chinese individuals, key concerns include altered pigmentation, which is perceived to age the individual, and also relates to the Chinese cultural standard of beauty of fair skin; many seek aesthetic treatment for this. Non-invasive cosmetic procedures such as lasers and injections are also gaining in popularity in the Chinese market, but this population is prone to hyperpigmentation as an adverse effect of such procedures. Considered and tailored approaches, both to primary concerns of photoaging and the side effects of cosmetic treatments, are warranted.

Update on Melasma-Part II: Treatment

Melasma is a prevalent chronic relapsing pigmentary disorder that affects photoexposed areas, especially in women of childbearing age. Although there is currently no curative treatment available for melasma, this manuscript critically reviews the knowledge regarding photoprotection, topical and oral therapies, and procedures such as peelings, laser, and microneedling that represent the main strategies for control and prevention of this disease. As the pathogenesis of melasma is not entirely understood, there are prospects for the development of new therapeutic strategies that might act on the pathways that promote sustained pigmentation rather than merely decreasing melanin synthesis and removing melanin from the epidermis.

5G Electromagnetic Radiation Attenuates Skin Melanogenesis In Vitro by Suppressing ROS Generation

Recently, the impacts of 5G electromagnetic radiation (EMR) with 28 GHz on human health have been attracting public attention with the advent of 5G wireless communication. Here, we report that 5G (28 GHz) EMR can attenuate the skin pigmentation in murine melanoma cells (B16F10) and a 3D pigmented human epidermis model (Melanoderm™). B16 cells were exposed to 5G (28 GHz) with or without α-MSH for 4 h per day. Interestingly, 5G attenuated α-MSH-induced melanin synthesis. Fontana-Masson staining confirmed that the dendritic formation of α-MSH stimulated B16 cells was diminished by 5G exposure. To confirm the anti-melanogenic effect of 5G EMR, MelanoDerm™ was irradiated with 5G at a power intensity of 10 W/m² for 4 h a day for 16 days and melanin distribution was detected with Fontana-Masson staining, which supported the anti-melanogenic effect of 5G EMR. Consistently, 5G EMR suppressed α-MSH induced upregulation of melanogenic enzymes; tyrosinase, TRP-1, and TRP-2. Of note, 5G EMR attenuated ROS production stimulated by α-MSH and H₂O₂, suggesting that 5G EMR may dissipate ROS generation, which is pivotal for the melanin synthesis. Collectively, we demonstrated that 5G EMR can attenuate skin pigmentation by attenuating ROS generation.

The Damaging Effects of Long UVA (UVA1) Rays: A Major Challenge to Preserve Skin Health and Integrity

Within solar ultraviolet (UV) light, the longest UVA1 wavelengths, with significant and relatively constant levels all year round and large penetration properties, produce effects in all cutaneous layers. Their effects, mediated by numerous endogenous chromophores, primarily involve the generation of reactive oxygen species (ROS). The resulting oxidative stress is the major mode of action of UVA1, responsible for lipid peroxidation, protein carbonylation, DNA lesions and subsequent intracellular signaling cascades. These molecular changes lead to mutations, apoptosis, dermis remodeling, inflammatory reactions and abnormal immune responses. The altered biological functions contribute to clinical consequences such as hyperpigmentation, inflammation, photoimmunosuppression, sun allergies, photoaging and photocancers. Such harmful impacts have also been reported after the use of UVA1 phototherapy or tanning beds. Furthermore, other external aggressors, such as pollutants and visible light (Vis), were shown to induce independent, cumulative and synergistic effects with UVA1 rays. In this review, we synthetize the biological and clinical effects of UVA1 and the complementary effects of UVA1 with pollutants or Vis. The identified deleterious biological impact of UVA1 contributing to clinical consequences, combined with the predominance of UVA1 rays in solar UV radiation, constitute a solid rational for the need for a broad photoprotection, including UVA1 up to 400 nm.

The protective effect of a novel sunscreen against blue light

BACKGROUND AND OBJECTIVE

Premature skin ageing, and skin hyperpigmentation are influenced by exogenous factors, such as ultraviolet radiation and blue light. In this study, we assess the protective effect of a sunscreen (TDF^® Blu Voile Sunscreen) in protecting the skin against the harmful effects of blue light irradiation in vivo and through the in situ quantitative and qualitative evaluation of protein carbonylation in human skin explants.

METHODOLOGY

The protective effect of the test product against blue light was first evaluated ex vivo on human skin explants. The treated and non-treated explants were exposed to 14 J/cm² of blue light 460 nm following which the protein carbonylation was evaluated by in situ epifluorescence imaging and separation by high-resolution gel electrophoresis. To determine whether the test product could also protect against the immediate and persistent pigmenting effect of blue light, two randomized in vivo studies were conducted, which included respectively 17 subjects with a skin phototype of IV and V (Fitzpatrick classification) and 22 subjects with a skin phototype of IV, V, and VI (Fitzpatrick classification). The duration of the study for each subject was 2 days (D1 and D2) for immediate observations and 5 days (D1-D5) for persistent observations. Specific zones on the subjects' back were either left non-treated or treated with the test product and were then exposed to a unique dose of blue light 415 nm. The onset of pigmentation between the treated and exposed zones was then assessed relative to the non-exposed treated zone through colorimetric measurements of the Individual Typology Angle (ITA^o ).

RESULTS

Human skin explants treated with test product showed significantly lower levels of accumulated carbonylated proteins, with a protection of 82%, following exposure to blue light 460 nm. Findings of the in vivo studies also indicated that the test product presented significantly better protective efficacy against immediate and persistent pigmentation induced by blue light 415 nm.

CONCLUSION

Hence, it can be concluded that the test product can protect against the oxidative stress as well as the immediate and persistent pigmentation induced by blue light.

A new in vitro method to predict in vivo photoprotection of skin hyperpigmentation induced by visible light

Background

Ultraviolet radiation is the main cause of skin pigmentation, but more recently visible light has been shown to be an important contributor especially in melano‐competent subjects. Photoprotection from visible light can improve several hyperpigmentation disorders. Recently, a visible light photoprotection assessment method has been proposed based on in vivo pigmentation; the visible light photoprotection factor (VL‐PF) is determined by assessment of the change in colorimetry parameter ITA over several days measured using a chromameter. Although in vivo methods remain the most representative of real life, in vitro methods are more suited to screening sunscreen formulations.

Objective

The aim of this study was to evaluate the correlation between in vivo and in vitro methods in assessing protection against visible light induced pigmentation.

Methods

We first analysed the in vitro protective properties of the 10 commercially available sunscreens using transmission measurements in the visible spectrum. Then, we performed a monocentric, double‐blind, randomized controlled study with intra‐individual comparisons in 20 healthy subjects and measure the VL‐PF in vivo of those sunscreens. The correlation between the VL‐PF and the percentage of blocked light was evaluated using the coefficient of determination R².

Results

A strong significant correlation was demonstrated between in vivo visible light protection factor and in vitro transmittance measurements, with the highest correlation factor at 420 nm and in the spectrum covering from 400 to 469 nm.

Conclusion

Transmittance measurements were found to be a good predictive tool to evaluate sunscreen visible light photoprotection efficacy and could be used to select formulations for final in vivo testing.

Sunscreens and Photoaging: A Review of Current Literature

Sunscreens have been on the market for many decades as a means of protection against ultraviolet-induced erythema. Over the years, evidence has also shown their efficacy in the prevention of photoaging, dyspigmentation, DNA damage, and photocarcinogenesis. In the USA, most broad-spectrum sunscreens provide protection against ultraviolet B (UVB) radiation and short-wavelength ultraviolet A (UVA) radiation. Evidence suggests that visible light and infrared light may play a role in photoaging and should be considered when choosing a sunscreen. Currently, there is a paucity of US FDA-approved filters that provide protection against long UVA (> 370 nm) and none against visible light. Additionally, various sunscreen additives such as antioxidants and photolyases have also been reported to protect against and possibly reverse signs of photoaging. This literature review evaluates the utility of sunscreen in protecting against photoaging and further explores the requirements for an ideal sunscreen.