A comparison of tinted sunscreen availability in urban versus suburban settings in the Detroit area

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Grant, Ciara J. Grayson, Pranita V. Rambhatla, Tasneem F. Mohammad This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4504894/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Tinted sunscreens are important for the management of pigmentary disorders and can offer better aesthetics compared to their non-tinted counterparts. However, high prices and limited access pose barriers to access for many skin of color patients. This study assesses tinted sunscreen availability and cost in Detroit, MI versus wealthier surrounding suburbs. Tinted sunscreen products in CVS, Walgreens, and Rite Aid stores in Detroit, Troy, and the Bloomfield area were catalogued and analyzed. Detroit has a much lower per capita income and a higher non-Caucasian population compared to Troy and the Bloomfield area. Our findings show that Detroit has significantly fewer tinted sunscreen products per store (mean 3.6 for all stores, 5.2 for CVS) compared to the Bloomfield area (mean 6.2 for all stores, 9.6 for CVS). Bloomfield's mean price per ounce ( $ 21.67) was significantly higher than Detroit ( $ 16.99) and Troy ( $ 17.24), however, no differences emerged after excluding unique products. Significant differences were also seen in the mean SPF between all areas. These findings suggest that lower-income and higher skin of color areas have limited tinted sunscreen accessibility, which may contribute to reduced sunscreen usage and increased disease burden for these communities. Tinted sunscreen photoprotection skin of color pigmentary disorders barriers to access Figures Figure 1 Introduction Skin of color (SOC) individuals are less likely to utilize sunscreen, with 2020 estimated sunscreen usage rates of 43.5% in non-Hispanic whites, 31.4% in Hispanic adults, and 12% in non-Hispanic Black adults [ 1 ]. Mineral based sunscreens often leave a visible residue on darker skin tones, potentially deterring their use in these populations [ 2 ]. Sunscreen marketed for SOC individuals also tends to cost three times more than products marketed for lighter skin [ 3 , 4 ]. This price gap may significantly impact those with limited financial resources. Broad-spectrum photoprotection, including visible light coverage, is important in skin of color populations for management of photoaging, photodermatoses and pigmentary disorders, which disproportionately affect this population. While skin cancers related to chronic sun exposure are much lower in skin of color populations, inaccurate perceptions about sunscreen use and skin cancer among non-white individuals may result in heightened UV exposure and delayed diagnoses of skin cancer [ 5 ]. Detroit, Michigan, and its surrounding suburbs exhibit significant racial and socioeconomic diversity, which creates an ideal landscape to evaluate tinted sunscreen availability among populations with differing skin tones and financial resources. This manuscript investigates the availability of tinted sunscreen in select retail stores across Detroit and its surrounding suburbs. Insights gained from this research could help better understand how socioeconomic disparities affect tinted sunscreen accessibility and pave the way for increased efforts to make tinted sunscreen more accessible. Methods The availability of tinted sunscreen products at CVS, Walgreens, and Rite Aid retail stores within the city boundaries of Detroit, Troy, Bloomfield Township, West Bloomfield Township, and Birmingham, Michigan were analyzed. The locations were chosen based off their median income, spatial distribution, and racial demographics. Bloomfield Township, West Bloomfield Township, and Birmingham were combined into one region (Bloomfield area) during analysis given their similar racial, socioeconomical, and spatial demographics. A total of 52 stores were physically visited and 229 products were cataloged. Factors analyzed included mean number of products and brands, availability in different tints versus universal shade, price, and SPF. For products available in various shades, each shade was considered a unique sunscreen product. A two-sample student’s t-test was used to determine significance between the means of 2 groups. Results Detroit exhibits the lowest income per capita ( $ 22,861), at less than half of Troy's ( $ 54,762) and nearly three and a half times lower than the Bloomfield area ( $ 78,428) [ 6 ]. Additionally, Detroit has a notably higher percentage of non-Caucasian residents (87.8%), followed by Troy (35.4%) and then the Bloomfield area (23.4%) [ 6 ]. These statistics highlight substantial differences in both income and racial demographics among the three areas, providing an ideal setting to explore variations in tinted sunscreen availability. CVS was the most prevalent store and contained 86% of all available tinted sunscreen products catalogued. Detroit exhibited the highest likelihood of stores lacking any tinted sunscreens at 32% of stores, followed by Troy at 25%, and the Bloomfield area at 15%. Detroit also has less than one-fourth the number of stores per non-Caucasian capita compared to Troy, and less than one-seventh in comparison to the Bloomfield area [ 6 ]. This data suggests that areas with lower income levels are more prone to experiencing a scarcity of stores offering tinted sunscreens. This is particularly consequential, given Detroit's higher population of individuals with skin of color, highlighting a discrepancy in tinted sunscreen accessibility linked to socioeconomic disparities. Table 1 shows the different products catalogued in each area. When comparing products in all three retail chains, Detroit averaged 3.6 products per store, Troy had 4.1, and the Bloomfield area had 6.2. This difference was more pronounced when focusing solely on CVS outlets, where Detroit averaged 5.2 products per store, Troy had 6.5, and the Bloomfield area had 9.6 (Fig. 1 A-B). Similar trends were observed in the mean number of available brands. The increased number of products found in the Bloomfield area primarily stemmed from a higher availability of products featuring a universal tint, rather than products available in various shades (Fig. 1 C-D). Table 1 Tinted sunscreen products found in each area. 10 products were not found across all three areas. 8 products were found in all 3 areas. Product Availability Detroit Troy Bloomfield, West Bloomfield, & Birmingham Unique products not available in all 3 areas Protekt SPF30 Tinted Mineral Sunscreen La Roche-Posay Anthelios Mineral Tinted Sunscreen for Face Sun Bum Mineral SPF 30 Tinted Sunscreen Face Lotion Hawaiian TropicMineral Skin Nourishing Tinted Milk for Face Sun Bum Mineral SPF 30 Tinted Sunscreen Face Lotion La Roche-Posay Anthelios Mineral Tinted Sunscreen for Face MDSolarSciences Mineral Tinted Crème MDSolarSciences Tinted Solar Stick Vichy Capital Soleil Tinted Face Mineral Sunscreen Avene Solaire UV Mineral Multi-Defense Tinted Fluid Sunscreen Avene Mineral Tinted Compact (Beige) Avene Mineral Tinted Compact (Honey) Products available in all 3 areas CeraVe Hydrating Mineral Sunscreen Face Sheer Tint Eucerin Sensitive Mineral Face Sunscreen Everyday by Unsun Mineral Tinted Face Sunscreen Lotion (Light/Medium) Everyday by Unsun Mineral Tinted Face Sunscreen Lotion (Medium/Deep) Neutrogena Mineral UV Tint (Light) Neutrogena Mineral UV Tint (Medium) Neutrogena Mineral UV Tint (Medium/Deep) Neutrogena Mineral UV Tint (Deep) The mean price per ounce across all stores was $ 16.99 in Detroit, $ 17.24 in Troy, and $ 21.67 in the Bloomfield area. Similarly, the price per product across all stores was $ 21.24 in Detroit, $ 21.78 in Troy, and $ 25.07 in the Bloomfield area. This difference in price per product was significantly different in the Bloomfield area compared to Detroit and Troy. However, upon excluding unique products not found in all three areas, no significant differences in price emerged. There was also a significant difference in the mean SPF values among Detroit, Troy, and the Bloomfield area (mean of 30.2, 31.2, and 36). This discrepancy might be attributed to the presence of more unique brands offering higher SPF products in Troy and the Bloomfield area. Conclusions Concerns about sunscreen's appearance on the skin deter about a third of individuals from its use, however tinted sunscreen has the potential to increase sunscreen use in SOC populations due to better cosmetic appearance [ 7 ]. Little research has been done on the availability and barriers to tinted sunscreen use in economically disadvantaged areas. Our analysis showed that stores in Detroit have fewer tinted sunscreen products, which underscores a potential accessibility gap for individuals in lower-income and higher SOC areas. Weig et al. (2020) found that 16.4% of individuals identify cost as a barrier to the use of sunscreen products [ 7 ]. Studies have shown that sunscreen marketed towards those with darker skin, such as tinted sunscreen, is more expensive than products targeting fair-skinned individuals, and the high cost of tinted sunscreen likely impedes its use by many individuals, particularly those in lower income areas [ 3 , 4 , 8 ]. Retail outlets other than those included in this study may carry a wider variety of tinted sunscreens; however, there are no Walmart, Target, or Kroger retail stores in the city of Detroit, while these stores are present in the surrounding suburbs. Additionally, the percentage of individuals purchasing sunscreen online versus in retail stores in Detroit remains unknown. 94.2–95.6% of households in the Troy, Bloomfield, West Bloomfield, and Birmingham have a broadband internet subscription, compared to only 79.4% of households in Detroit [ 6 ]. This suggests a broader disparity in tinted sunscreen availability, and limited internet access, along with the costs of online products and delivery fees, may further prohibit access. In summary, these findings underscore stark differences in tinted sunscreen availability across areas with varying racial and income demographics. Addressing these disparities is essential to ensure equitable access to tinted sunscreen products, and further research is needed to determine if these disparities exist across broader geographic regions. Declarations TFM has served as an investigator for Ferndale Laboratories, Estée Lauder, Unigen, Clinuvel, Incyte, Allergan and Pfizer; a consultant for Beiersdorf, and has served on the advisory board for Incyte and Ferndale Laboratories. GJG, CJG, and PVR have no conflicts of interest to disclose. Patient consent: Not applicable. Authorship: All authors contributed to the design, data collection, analysis, and drafting of the manuscript. Acknowledgments: None References NCI. Sun-Protective Behavior. Accessed 1/10/24. https://progressreport.cancer.gov/prevention/sun_protection#field_most_recent_estimates Xu S, Kwa M, Agarwal A, Rademaker A, Kundu RV. Sunscreen Product Performance and Other Determinants of Consumer Preferences. JAMA Dermatol. Aug 1 2016;152(8):920-7. doi:10.1001/jamadermatol.2016.2344 Zhou C, Lee C, Salas J, Luke J. Guide to tinted sunscreens in skin of color. Int J Dermatol. Dec 10 2023;doi:10.1111/ijd.16954 Song H, Beckles A, Salian P, Porter ML. Sunscreen recommendations for patients with skin of color in the popular press and in the dermatology clinic. Int J Womens Dermatol. Mar 2021;7(2):165-170. doi:10.1016/j.ijwd.2020.10.008 Higgins S, Nazemi A, Chow M, Wysong A. Review of Nonmelanoma Skin Cancer in African Americans, Hispanics, and Asians. Dermatol Surg. Jul 2018;44(7):903-910. doi:10.1097/dss.0000000000001547 Bureau UC. Quick Facts. 2020 data. https://www.census.gov/quickfacts/fact/table/troycitymichigan,birminghamcitymichigan,westbloomfieldcharter townshipoaklandcountymichigan,bloomfieldchartertownshipoaklandcountymichigan,detroitcitymichigan/PST045222 Weig EA, Tull R, Chung J, Brown-Joel ZO, Majee R, Ferguson NN. Assessing factors affecting sunscreen use and barriers to compliance: a cross-sectional survey-based study. J Dermatolog Treat. Jun 2020;31(4):403-405. doi:10.1080/09546634.2019.1587147 Hill MJ, Turney KC, Driscoll MS. Tinted sunscreens: Are these products affordable? Int J Dermatol. Nov 2022;61(11):e438-e439. doi:10.1111/ijd.15926 Additional Declarations Competing interest reported. TFM has served as an investigator for Ferndale Laboratories, Estée Lauder, Unigen, Clinuvel, Incyte, Allergan and Pfizer; a consultant for Beiersdorf, and has served on the advisory board for Incyte and Ferndale Laboratories. GJG, CJG, and PVR have no conflicts of interest to disclose. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 08 Jun, 2024 Submission checks completed at journal 31 May, 2024 Editor assigned by journal 31 May, 2024 First submitted to journal 30 May, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4504894","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":312167800,"identity":"3b1fc333-7c96-4838-b1f8-18d74537d8b8","order_by":0,"name":"Garett J. Grant","email":"","orcid":"","institution":"Henry Ford Hospital","correspondingAuthor":false,"prefix":"","firstName":"Garett","middleName":"J.","lastName":"Grant","suffix":""},{"id":312167801,"identity":"59b78783-18ee-4ec7-a106-b47d7e32d870","order_by":1,"name":"Ciara J. Grayson","email":"","orcid":"","institution":"Henry Ford Health System","correspondingAuthor":false,"prefix":"","firstName":"Ciara","middleName":"J.","lastName":"Grayson","suffix":""},{"id":312167802,"identity":"a308a160-2f3e-411d-861f-ce0e38902bf1","order_by":2,"name":"Pranita V. Rambhatla","email":"","orcid":"","institution":"Henry Ford Health System","correspondingAuthor":false,"prefix":"","firstName":"Pranita","middleName":"V.","lastName":"Rambhatla","suffix":""},{"id":312167804,"identity":"73edb667-b528-4acc-9f5f-cd9daf61ecf6","order_by":3,"name":"Tasneem F. Mohammad","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyElEQVRIiWNgGAWjYHACNhAhxy/B+Iw49TxQLcaSM5jNSNOSuOEGsVrsxQ4fe/AzZxvj5tvNbA9/MNjkyzsQskU6Ld2wd9ttZrM7h9mNeRjSLDceIKglx0yCd9ttNrMb+cekGRgOGxg2EKFF8u+22zzGM5LZJH8Qq0UaaIuEgUQymwQPUIs8AR0MPLfT0qRlt902kLiRzCbNY5BmYEBIC/vs5GOSb7fdru8HO6zCxkCekMPQANAKgwOkaQECUm0ZBaNgFIyC4Q8A60s5LnDbT7kAAAAASUVORK5CYII=","orcid":"","institution":"Henry Ford Health System","correspondingAuthor":true,"prefix":"","firstName":"Tasneem","middleName":"F.","lastName":"Mohammad","suffix":""}],"badges":[],"createdAt":"2024-05-30 19:44:04","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4504894/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4504894/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":58309386,"identity":"2eed8f67-1d07-40d6-a7da-140d93f9d2a9","added_by":"auto","created_at":"2024-06-13 18:53:56","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":220024,"visible":true,"origin":"","legend":"\u003cp\u003e(A-B) Mean number of tinted sunscreen products and brands per retail store in each area of interest. (C-D) Mean number of tinted sunscreen products per store in each area that was a universal shade or multi-shade product. Light gray bars include products from all 3 stores (CVS, Walgreens, and Rite Aid). Black bars only include products from CVS. Error bars represent the standard deviation. * represents a significant difference with a p-value ≤ 0.05.\u003c/p\u003e","description":"","filename":"Fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-4504894/v1/b5915ae64c37a4191d4b8cfb.png"},{"id":58309387,"identity":"3344082e-b46e-4a22-b77b-828930de1e80","added_by":"auto","created_at":"2024-06-13 18:54:01","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":458451,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4504894/v1/cecd8b35-abf1-42da-a7bd-b5090a991bc6.pdf"}],"financialInterests":"Competing interest reported. TFM has served as an investigator for Ferndale Laboratories, Estée Lauder, Unigen, Clinuvel, Incyte, Allergan and Pfizer; a consultant for Beiersdorf, and has served on the advisory board for Incyte and Ferndale Laboratories.\n\nGJG, CJG, and PVR have no conflicts of interest to disclose.","formattedTitle":"A comparison of tinted sunscreen availability in urban versus suburban settings in the Detroit area","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSkin of color (SOC) individuals are less likely to utilize sunscreen, with 2020 estimated sunscreen usage rates of 43.5% in non-Hispanic whites, 31.4% in Hispanic adults, and 12% in non-Hispanic Black adults [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Mineral based sunscreens often leave a visible residue on darker skin tones, potentially deterring their use in these populations [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Sunscreen marketed for SOC individuals also tends to cost three times more than products marketed for lighter skin [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. This price gap may significantly impact those with limited financial resources. Broad-spectrum photoprotection, including visible light coverage, is important in skin of color populations for management of photoaging, photodermatoses and pigmentary disorders, which disproportionately affect this population. While skin cancers related to chronic sun exposure are much lower in skin of color populations, inaccurate perceptions about sunscreen use and skin cancer among non-white individuals may result in heightened UV exposure and delayed diagnoses of skin cancer [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDetroit, Michigan, and its surrounding suburbs exhibit significant racial and socioeconomic diversity, which creates an ideal landscape to evaluate tinted sunscreen availability among populations with differing skin tones and financial resources. This manuscript investigates the availability of tinted sunscreen in select retail stores across Detroit and its surrounding suburbs. Insights gained from this research could help better understand how socioeconomic disparities affect tinted sunscreen accessibility and pave the way for increased efforts to make tinted sunscreen more accessible.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThe availability of tinted sunscreen products at CVS, Walgreens, and Rite Aid retail stores within the city boundaries of Detroit, Troy, Bloomfield Township, West Bloomfield Township, and Birmingham, Michigan were analyzed. The locations were chosen based off their median income, spatial distribution, and racial demographics. Bloomfield Township, West Bloomfield Township, and Birmingham were combined into one region (Bloomfield area) during analysis given their similar racial, socioeconomical, and spatial demographics. A total of 52 stores were physically visited and 229 products were cataloged. Factors analyzed included mean number of products and brands, availability in different tints versus universal shade, price, and SPF. For products available in various shades, each shade was considered a unique sunscreen product. A two-sample student\u0026rsquo;s t-test was used to determine significance between the means of 2 groups.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eDetroit exhibits the lowest income per capita (\u003cspan\u003e$\u003c/span\u003e22,861), at less than half of Troy's (\u003cspan\u003e$\u003c/span\u003e54,762) and nearly three and a half times lower than the Bloomfield area (\u003cspan\u003e$\u003c/span\u003e78,428) [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Additionally, Detroit has a notably higher percentage of non-Caucasian residents (87.8%), followed by Troy (35.4%) and then the Bloomfield area (23.4%) [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. These statistics highlight substantial differences in both income and racial demographics among the three areas, providing an ideal setting to explore variations in tinted sunscreen availability. CVS was the most prevalent store and contained 86% of all available tinted sunscreen products catalogued. Detroit exhibited the highest likelihood of stores lacking any tinted sunscreens at 32% of stores, followed by Troy at 25%, and the Bloomfield area at 15%. Detroit also has less than one-fourth the number of stores per non-Caucasian capita compared to Troy, and less than one-seventh in comparison to the Bloomfield area [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. This data suggests that areas with lower income levels are more prone to experiencing a scarcity of stores offering tinted sunscreens. This is particularly consequential, given Detroit's higher population of individuals with skin of color, highlighting a discrepancy in tinted sunscreen accessibility linked to socioeconomic disparities.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the different products catalogued in each area. When comparing products in all three retail chains, Detroit averaged 3.6 products per store, Troy had 4.1, and the Bloomfield area had 6.2. This difference was more pronounced when focusing solely on CVS outlets, where Detroit averaged 5.2 products per store, Troy had 6.5, and the Bloomfield area had 9.6 (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA-B). Similar trends were observed in the mean number of available brands. The increased number of products found in the Bloomfield area primarily stemmed from a higher availability of products featuring a universal tint, rather than products available in various shades (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eC-D).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTinted sunscreen products found in each area. 10 products were not found across all three areas. 8 products were found in all 3 areas.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eProduct Availability\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDetroit\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTroy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBloomfield, West Bloomfield, \u0026amp; Birmingham\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUnique products not available in all 3 areas\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProtekt SPF30 Tinted Mineral Sunscreen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLa Roche-Posay Anthelios Mineral Tinted Sunscreen for Face\u003c/p\u003e \u003cp\u003eSun Bum Mineral SPF 30 Tinted Sunscreen Face Lotion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHawaiian TropicMineral Skin Nourishing Tinted Milk for Face\u003c/p\u003e \u003cp\u003eSun Bum Mineral SPF 30 Tinted Sunscreen Face Lotion\u003c/p\u003e \u003cp\u003eLa Roche-Posay Anthelios Mineral Tinted Sunscreen for Face\u003c/p\u003e \u003cp\u003eMDSolarSciences Mineral Tinted Cr\u0026egrave;me\u003c/p\u003e \u003cp\u003eMDSolarSciences Tinted Solar Stick\u003c/p\u003e \u003cp\u003eVichy Capital Soleil Tinted Face Mineral Sunscreen\u003c/p\u003e \u003cp\u003eAvene Solaire UV Mineral Multi-Defense Tinted Fluid Sunscreen\u003c/p\u003e \u003cp\u003eAvene Mineral Tinted Compact (Beige)\u003c/p\u003e \u003cp\u003eAvene Mineral Tinted Compact (Honey)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProducts available in all 3 areas\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eCeraVe Hydrating Mineral Sunscreen Face Sheer Tint\u003c/p\u003e \u003cp\u003eEucerin Sensitive Mineral Face Sunscreen\u003c/p\u003e \u003cp\u003eEveryday by Unsun Mineral Tinted Face Sunscreen Lotion (Light/Medium)\u003c/p\u003e \u003cp\u003eEveryday by Unsun Mineral Tinted Face Sunscreen Lotion (Medium/Deep)\u003c/p\u003e \u003cp\u003eNeutrogena Mineral UV Tint (Light)\u003c/p\u003e \u003cp\u003eNeutrogena Mineral UV Tint (Medium)\u003c/p\u003e \u003cp\u003eNeutrogena Mineral UV Tint (Medium/Deep)\u003c/p\u003e \u003cp\u003eNeutrogena Mineral UV Tint (Deep)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe mean price per ounce across all stores was \u003cspan\u003e$\u003c/span\u003e16.99 in Detroit, \u003cspan\u003e$\u003c/span\u003e17.24 in Troy, and \u003cspan\u003e$\u003c/span\u003e21.67 in the Bloomfield area. Similarly, the price per product across all stores was \u003cspan\u003e$\u003c/span\u003e21.24 in Detroit, \u003cspan\u003e$\u003c/span\u003e21.78 in Troy, and \u003cspan\u003e$\u003c/span\u003e25.07 in the Bloomfield area. This difference in price per product was significantly different in the Bloomfield area compared to Detroit and Troy. However, upon excluding unique products not found in all three areas, no significant differences in price emerged. There was also a significant difference in the mean SPF values among Detroit, Troy, and the Bloomfield area (mean of 30.2, 31.2, and 36). This discrepancy might be attributed to the presence of more unique brands offering higher SPF products in Troy and the Bloomfield area.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eConcerns about sunscreen's appearance on the skin deter about a third of individuals from its use, however tinted sunscreen has the potential to increase sunscreen use in SOC populations due to better cosmetic appearance [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Little research has been done on the availability and barriers to tinted sunscreen use in economically disadvantaged areas. Our analysis showed that stores in Detroit have fewer tinted sunscreen products, which underscores a potential accessibility gap for individuals in lower-income and higher SOC areas. Weig et al. (2020) found that 16.4% of individuals identify cost as a barrier to the use of sunscreen products [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Studies have shown that sunscreen marketed towards those with darker skin, such as tinted sunscreen, is more expensive than products targeting fair-skinned individuals, and the high cost of tinted sunscreen likely impedes its use by many individuals, particularly those in lower income areas [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRetail outlets other than those included in this study may carry a wider variety of tinted sunscreens; however, there are no Walmart, Target, or Kroger retail stores in the city of Detroit, while these stores are present in the surrounding suburbs. Additionally, the percentage of individuals purchasing sunscreen online versus in retail stores in Detroit remains unknown. 94.2\u0026ndash;95.6% of households in the Troy, Bloomfield, West Bloomfield, and Birmingham have a broadband internet subscription, compared to only 79.4% of households in Detroit [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. This suggests a broader disparity in tinted sunscreen availability, and limited internet access, along with the costs of online products and delivery fees, may further prohibit access.\u003c/p\u003e \u003cp\u003eIn summary, these findings underscore stark differences in tinted sunscreen availability across areas with varying racial and income demographics. Addressing these disparities is essential to ensure equitable access to tinted sunscreen products, and further research is needed to determine if these disparities exist across broader geographic regions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eTFM has served as an investigator for Ferndale Laboratories, Est\u0026eacute;e Lauder, Unigen, Clinuvel, Incyte, Allergan and Pfizer; a consultant for Beiersdorf, and has served on the advisory board for Incyte and Ferndale Laboratories.\u003c/p\u003e\n\u003cp\u003eGJG, CJG, and PVR have no conflicts of interest to disclose.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatient consent:\u003c/strong\u003e Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthorship:\u003c/strong\u003e All authors contributed to the design, data collection, analysis, and drafting of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e None\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNCI. Sun-Protective Behavior. Accessed 1/10/24. https://progressreport.cancer.gov/prevention/sun_protection#field_most_recent_estimates \u003c/li\u003e\n\u003cli\u003eXu S, Kwa M, Agarwal A, Rademaker A, Kundu RV. Sunscreen Product Performance and Other Determinants of Consumer Preferences. JAMA Dermatol. Aug 1 2016;152(8):920-7. doi:10.1001/jamadermatol.2016.2344 \u003c/li\u003e\n\u003cli\u003eZhou C, Lee C, Salas J, Luke J. Guide to tinted sunscreens in skin of color. Int J Dermatol. Dec 10 2023;doi:10.1111/ijd.16954 \u003c/li\u003e\n\u003cli\u003eSong H, Beckles A, Salian P, Porter ML. Sunscreen recommendations for patients with skin of color in the popular press and in the dermatology clinic. Int J Womens Dermatol. Mar 2021;7(2):165-170. doi:10.1016/j.ijwd.2020.10.008 \u003c/li\u003e\n\u003cli\u003eHiggins S, Nazemi A, Chow M, Wysong A. Review of Nonmelanoma Skin Cancer in African Americans, Hispanics, and Asians. Dermatol Surg. Jul 2018;44(7):903-910. doi:10.1097/dss.0000000000001547\u003c/li\u003e\n\u003cli\u003eBureau UC. Quick Facts. 2020 data. https://www.census.gov/quickfacts/fact/table/troycitymichigan,birminghamcitymichigan,westbloomfieldcharter\u003cbr\u003etownshipoaklandcountymichigan,bloomfieldchartertownshipoaklandcountymichigan,detroitcitymichigan/PST045222 \u003c/li\u003e\n\u003cli\u003eWeig EA, Tull R, Chung J, Brown-Joel ZO, Majee R, Ferguson NN. Assessing factors affecting sunscreen use and barriers to compliance: a cross-sectional survey-based study. J Dermatolog Treat. Jun 2020;31(4):403-405. doi:10.1080/09546634.2019.1587147\u003c/li\u003e\n\u003cli\u003eHill MJ, Turney KC, Driscoll MS. Tinted sunscreens: Are these products affordable? Int J Dermatol. Nov 2022;61(11):e438-e439. doi:10.1111/ijd.15926 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"archives-of-dermatological-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Archives of Dermatological Research](https://www.springer.com/journal/403)","snPcode":"403","submissionUrl":"https://submission.nature.com/new-submission/403/3","title":"Archives of Dermatological Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Tinted sunscreen, photoprotection, skin of color, pigmentary disorders, barriers to access","lastPublishedDoi":"10.21203/rs.3.rs-4504894/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4504894/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eTinted sunscreens are important for the management of pigmentary disorders and can offer better aesthetics compared to their non-tinted counterparts. However, high prices and limited access pose barriers to access for many skin of color patients. This study assesses tinted sunscreen availability and cost in Detroit, MI versus wealthier surrounding suburbs. Tinted sunscreen products in CVS, Walgreens, and Rite Aid stores in Detroit, Troy, and the Bloomfield area were catalogued and analyzed. Detroit has a much lower per capita income and a higher non-Caucasian population compared to Troy and the Bloomfield area. Our findings show that Detroit has significantly fewer tinted sunscreen products per store (mean 3.6 for all stores, 5.2 for CVS) compared to the Bloomfield area (mean 6.2 for all stores, 9.6 for CVS). Bloomfield's mean price per ounce (\u003cspan\u003e$\u003c/span\u003e21.67) was significantly higher than Detroit (\u003cspan\u003e$\u003c/span\u003e16.99) and Troy (\u003cspan\u003e$\u003c/span\u003e17.24), however, no differences emerged after excluding unique products. Significant differences were also seen in the mean SPF between all areas. These findings suggest that lower-income and higher skin of color areas have limited tinted sunscreen accessibility, which may contribute to reduced sunscreen usage and increased disease burden for these communities.\u003c/p\u003e","manuscriptTitle":"A comparison of tinted sunscreen availability in urban versus suburban settings in the Detroit area","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-13 18:53:51","doi":"10.21203/rs.3.rs-4504894/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-06-08T22:29:11+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-05-31T04:55:26+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-31T04:55:26+00:00","index":"","fulltext":""},{"type":"submitted","content":"Archives of Dermatological Research","date":"2024-05-30T19:42:04+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"archives-of-dermatological-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Archives of Dermatological Research](https://www.springer.com/journal/403)","snPcode":"403","submissionUrl":"https://submission.nature.com/new-submission/403/3","title":"Archives of Dermatological Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"09c177c4-0e81-49ee-9392-d46b227b0433","owner":[],"postedDate":"June 13th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-08-05T19:10:14+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-13 18:53:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4504894","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4504894","identity":"rs-4504894","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}