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What to Know About Skin Cancer if You Have Dark Skin

It’s a common misconception that people who have darker skin don’t need sun protection and don’t get  skin cancer. The truth is the connection between skin color and skin cancer is more complex than that. 

We connected with Jordan Abbott, MD, a dermatologist with Banner MD Anderson Cancer Center, to find out more about what you should know about skin cancer if you have dark skin.

“Skin cancer can occur in people of all skin types. Even if you never get sunburned, you can still develop skin cancer. Skin cancer is less common in people with dark skin; however, it is still important to protect and check your skin because there is still a risk for developing skin cancer,” she said.

Even though most skin cancers are caused by cell damage from the sun’s ultraviolet (UV) radiation, not all skin cancers are the same. The most common types are:

  • Basal cell carcinoma: This is the most common type of skin cancer and it usually grows slowly. It’s unlikely to spread to other parts of the body.
  • Squamous cell carcinoma: This is the second most common type of skin cancer. Rarely, it can spread to other parts of the body if it’s not treated.
  • Melanoma: Melanoma develops in the cells that produce melanin, which is the pigment that gives your skin its color. It can spread to other parts of the body if it’s not detected early.

What’s different about skin cancer when your skin is dark?

If you have darker skin, your skin has higher levels of melanin. Melanin does provide some natural protection against UV rays from the sun. So people with darker skin have a lower risk of skin cancer than people with lighter skin. 

But you can still develop skin cancer if you have darker skin. Your higher melanin levels don’t give you complete protection. Many times, people with darker skin don’t have their skin checked. In addition, skin cancer is often misdiagnosed or diagnosed at a later stage because it is less common in people of color. This delay in diagnosis can lead to worse survival rates.

Melanoma, the deadliest form of skin cancer, tends to occur in parts of the body that don’t get a lot of sun exposure, such as the palms of your hands, soles of your feet and mucous membranes (the moist tissue lining of your mouth, nose, sinuses and pelvic organs). Thus, frequently checking every part of your skin and reporting changes to your health care provider is important. 

Signs and symptoms to watch for

Whatever your skin color, there are five key signs of skin cancer to look for when you’re examining your moles. You can remember them by thinking of ABCDE:

  • Asymmetrical or irregularly shaped moles
  • Borders that are uneven
  • Color variation within the same lesion
  • Diameter more than the size of a pencil eraser
  • Evolving or changing moles

In darker skin:

  • Moles may match your skin color and be harder to notice.
  • Skin cancer may appear as bumps that are pink or translucent.
  • Skin cancer may appear in places that aren’t exposed to the sun, making them easier to overlook.

“Since people with darker skin are more likely to develop skin cancer in non-sun exposed areas such as the palms and soles, under the nails and in the groin, you should examine these areas regularly and use a handheld mirror for difficult-to-see locations,” Dr. Abbott said. “It is especially important to look between the toes and at the bottoms of the feet. It is normal to have moles in these areas, but if they are larger than a pencil eraser, have them checked by a dermatologist.”

You should check your skin monthly for any changes or concerns. Contact a health care provider if you notice anything that doesn’t seem right to you, including sores that are not healing properly, a lump that may bleed or develop a crust or flat spots that are rough, dry or scaly. 

It’s especially important to get medical care if you have a history of sun exposure, a family history of skin cancer, a weakened immune system or other risk factors such as genetic conditions. 

Spotting skin cancer early means treatment is usually less invasive and more successful. “Skin cancer in those with darker skin is, on average, diagnosed at a later stage. This means the skin cancer is more advanced at the time of diagnosis due to delay in presentation or detection,” Dr. Abbott said. “It is important to recognize this and raise awareness that skin cancer can affect individuals of all skin colors because skin cancer is highly treatable when found early.”

How to protect your skin from the sun

Even if you have darker skin, you still need protection to lower your risk of skin cancer and reduce signs of aging. “Dark skin can get sunburned and anyone can develop skin cancer,” Dr. Abbott said. Here’s what can help:

  • Wear sunscreen: Apply a broad-spectrum sunscreen with an SPF of 30 or higher to your exposed skin. Reapply sunscreen every two hours, or after swimming or sweating. “People with more pigment in their skin may find that tinted sunscreen products are easier to blend in the skin,” Dr. Abbott said.
  • Cover up: Wear long-sleeved shirts, pants, wide-brimmed hats and sunglasses with UV protection. 
  • Seek shade: Limit your time in the sun between 10 a.m. and 4 p.m. When you’re outdoors, seek shade under umbrellas or trees. 

The bottom line

Even if you have darker skin, you’re still at risk for skin cancer. People with darker skin are often diagnosed when skin cancer is at more advanced stages and treatment may be more invasive and less likely to succeed.

To stay safe, protect yourself from the sun and check your skin regularly for any changes. If you notice anything that concerns you, reach out to your health care provider or connect with an expert at Banner Health.

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