Skin cancer affects more people than you might think. In fact, one in five Americans will develop skin cancer by the age of 70, according to the Skin Cancer Foundation. Although lightly complected individuals are more likely to get skin cancer, it's often more fatal in those with brown and Black skin. No one is immune to skin cancer, so prevention and early detection are key. However, that's not always easy on Black skin, given that skin cancers often present as darker spots.

Here's a Dermatologist's guide on how to detect skin cancer in Black skin, stay safe, and enjoy the sunshine, too.

How Does Skin Cancer Affect Black Skin?

It's a common misconception that people of color are immune to skin cancer. That's simply not true. According to the Skin Cancer Foundation, skin cancer represents 1 to 2 percent of all cancers in Black people. Although that's a lower number than the rate of skin cancer in white people, their survival rates are unfortunately lower. The estimated five-year survival rate for Black patients with melanoma—an aggressive form of skin cancer—is just 71 percent, versus 93 percent for white patients, as stated by the Skin Cancer Foundation.

The difference in mortality rates largely has to do with a delay in diagnosis, given that sometimes skin cancer is less pronounced on dark skin and can be located on easily overlooked spots. It often appears on skin that gets little sun exposure, like your palms, soles of your feet, and nailbeds. This highlights the importance of yearly skin examinations with a board-certified Dermatologist, monthly self-skin exams, and daily sun protection.

How to Detect Skin Cancer in Black Skin

The three most common skin cancers in people of color are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Knowing what these skin cancers look like is important for early detection. Take the time to research what skin cancer looks like on dark skin, so you can know what to look for, and find a Dermatologist you can trust who has experience with Black patients.

  • BCC is caused by unprotected sun exposure and is most likely to appear on sun-exposed areas like your head and neck. BCC on dark skin appears as non-healing sores, skin-colored bumps, lesions that are reddish and scaly, or pearly and pigmented. According to DermNet NZ, more than 50 percent of BCC in Black skin is brown or black, making it difficult to detect. Any lesion that is new or changes—particularly those in a sun-exposed area—should be evaluated by a doctor.
  • SCC often occurs on Black skin as a result of trauma, like thermal/radiation burns, long-term scars, or inflammatory skin conditions like Lupus. This is in juxtaposition to the SCC that usually occurs in light skin due to UV exposure. Lesions that are thick, crusted, painful, or new, especially in locations of previous trauma should be examined. According to Medical News Today, SCC can be easily treated when caught early.
  • Melanoma is an aggressive form of cancer, so catching it early is crucial. Melanoma results on Black skin from unprotected sun exposure and sunburns, as well as on areas that don't see too much sunlight, including the palms, soles of the feet, fingernails, toenails, and oral and genital mucosa. Brown or black spots on your skin or under your nails that are asymmetrical, irregular in border, shape, color, or changing in any way do require attention from your Dermatologist.

Sun Protection Tips for People of Color

If you have high levels of melanin in your skin, you have some protection from UV radiation. That said, your sun safety needs don't end there. A broad-spectrum sunscreen of SPF 30 or higher—like the EltaMD UV Glow Tinted Broad-Spectrum SPF 36—should be a part of your everyday routine no matter if it's raining, snowing, sunny, or if you're spending time outdoors or indoors. Yes, even the light bulbs in your home or office, the light from your cell phone and computer screens, and other forms of blue light can create hyperpigmentation. This is particularly important for people of color who are at higher risk of hyperpigmentation.

Along with a daily sunscreen habit, you should get serious about monthly self-skin exams, yearly Dermatologist visits, and extra sun protection, like wearing a wide-brimmed hat, sunglasses, sun-protective clothing, and seeking shade when possible.

Spreading Awareness for Black Skin Care

Black people are more likely to die from skin cancer, but it doesn't have to be this way. Delay in diagnosis is a big contributing factor to worse outcomes when it comes to skin cancer in Black and brown skin; misinformation and lack of awareness are largely to blame. Representation in Black skin care matters—and it may just save lives.

Author

  • Dr. Mona Gohara is a Connecticut-based Dermatologist and associate professor of Dermatology at Yale School of Medicine. She has a particular interest in skin cancer prevention and treatment for skin of color. Dr. Gohara spends a lot of time outdoors with her husband, son, and two dogs, Coco and Cleo. They all wear sunscreen.