There is more to treating skin of color than meets the eye. Cultural influences can be important factors in patients' maladies as well as issues of noncompliance and treatment choices. Learning about the culture is as important as learning about the physiology.
The rising sun is a beautiful spectacle to view from the window of a 747 jumbo jet at 31,000 feet. The colors of light bouncing off the ocean below are simply more breathtaking than any faceted jewel.
However, the increased UVA radiation striking my face through the window glass at an elevation of 31,000 feet will not have pleasant consequences. I can just feel my collagen and elastin fibers fragmenting and yielding to the forces of gravity. Yes, the sun is beautiful, life-giving - and a silent robber of my youth. I wonder how many of the 400 people sitting on this plane with me are thinking the same thoughts. Probably not too many. Am I a freak, or have my years of dermatology training and experience changed my photobehavior awareness? Is it possible to change photobehavior awareness in others?
Lessons from Down Under
Australia has probably done one of the finest jobs of any country trying to educate people on proper photobehavior. The Australian "slip on a shirt, slop on sunscreen, slap on a hat" educational program was successfully reducing the incidence of sun exposure and sunburn when fully funded, but as the funding dried up for the advertising announcements, so too did the improvements in photobehavior awareness. This means that the behavior alterations were not successful, since people went back to old habits when the message was not shouted frequently and loudly.
This leads me back to my original question: Is it possible to change photobehavior awareness? After much thought, I think the answer is "not at the present time." Perhaps this view is too pessimistic.
Sextet for photo awareness
What would have to change if we were to make the whole world photo-aware?
I think if these six changes could be implemented, photobehavior could be modified permanently.
Is it practical to expect that these changes could be implemented? Probably not. Should we stop trying? No. Dermatologists cannot let the sun set on important photobehavior issues. The true consequences of the rising sun must be understood.
Zoe Diana Draelos, M.D. Clinical associate professor of dermatology, Wake Forest University School of Medicine, Winston-Salem, N.C.