852 Racial differences in adolescent perceptions of skin color and tone: A questionnaire and colorimetric-based cross-sectional study

Abstract

Adolescents receive pressure from peers and social media to conform to perceived acceptable standards regarding skin tone. These pressures put them at an increased risk of engaging in unhealthy behaviors to achieve these standards. Thus, we aimed to better understand adolescent attitudes on skin tone in comparison to objective colorimetric data. Fifty patients were recruited from the Johns Hopkins Pediatric Dermatology clinic between the ages of 12-19. Adolescents were asked to fill out a survey on their sunscreen, tanning bed, and skin lightening cream use. They were then given the Pantone Skin Color Guide, consisting of 110 skin color palettes and reported their perceived and desired skin tones. The surveyor then used the standardized Pantone Capsure device, which includes all 110 skin colors for image capture to record the subject’s objective skin tone from the left dorsal hand and also included an internal control. Descriptive statistics, Fisher’s Exact Tests, and ANOVA subgroup analysis were performed. A total of 28.3% of individuals self-reported as black, 17.4% east asian, 39.1% white, and 15.2% of other races with a median Fitzpatrick skin phototype IV. Overall, 20% of adolescents felt pressure to have tan skin, and reported this pressure began at an average age of 12. The overwhelming majority of adolescents (nearly 96%) did not report wearing sunscreen on a daily basis. Only one adolescent reported using skin lightening creams but three patients reported use by family members. Black and asian participants were significantly more likely to desire a lighter skin tone than their perceived tone, while white participants were more likely to desire a darker skin tone (p<0.011). These findings suggest both sun exposure and skin bleaching safety initiatives should target pre-pubertal patients before they engage in risky behaviors aimed at achieving their desired skin tone.