What People of Color Need to Know About Sun Protection and Skin Cancer

You might have heard a common misconception that people of color don’t need sunscreen and don’t get skin cancer. The truth is that anyone can get skin cancer. While people with darker skin may have a lower skin cancer risk, the sun’s harmful rays can cause damage to all skin types and colors. People of color still need to protect their skin from the sun and watch for signs of skin cancer.

Why should people of color use sunscreen?

Melanin is the substance in the body that gives your skin, hair, and eyes their color. Melanin is made by cells in the skin called melanocytes. Melanin helps protect against skin damage by absorbing the sun’s ultraviolet (UV) rays. People who have darker skin have more melanin. This is why they are less likely to get a sunburn than people with lighter skin.

But melanin cannot absorb all UV rays, and even people with higher amounts of melanin can get skin damage. Skin damage can cause sunburn, skin cancer, and premature aging. Staying in the shade as much as possible, using sunscreen and following other sun protection recommendations can help protect skin from damage from UV rays.

To avoid the frustrating white cast that some sunscreens leave on darker skin, consider using a sunscreen containing zinc oxide instead of titanium oxide.

How common is skin cancer in people of color?

There are several types of skin cancer. Melanoma is a type of skin cancer that is more likely to grow and spread compared to other types, such as basal cell or squamous cell skin cancers. “People of color may be less likely to develop skin cancer, including melanoma, but it can happen. And if you and your doctors aren’t looking for it, you probably won’t see it,” said American Society of Clinical Oncology (ASCO) expert Dr. Katy Tsai, MD, a medical oncologist at the Helen Diller Family Comprehensive Cancer Center.

“The types of melanoma that we see on darker skin are rarer and can occur in more unusual places, such as the palms of the hands, the soles of the feet (acral melanoma), and even on mucosal surfaces such as the genitalia (mucosal melanoma). It is important to have access to doctors who recognize the importance of thorough skin exams on all different colors of skin, and who are aware of all the different types of melanoma that can occur.”

What signs of skin cancer should people of color watch for?

Skin cancer is often painless and may only cause slight changes to the skin. While the American Cancer Society (ACS) does not have guidelines for skin cancer screening, many doctors and experts recommend that everyone check their own skin regularly. A monthly skin self-exam is a recommended way to watch your skin for changes. Reporting any skin changes to a doctor is important.

Here are signs and symptoms to look for:

• A changing spot or growth on the skin that is brown, black, or multiple colors.
• Moles and birthmarks that meet the ABCDEs of melanoma.
• A spot, mole, or birthmark that looks different from others on your skin. This is called an “ugly duckling.”
• An area or sore that is itchy, painful, crusty, scabbing, or bleeding and that does not get better, does not go away, or keeps coming back.
• A dark line underneath or around your nail.
• Skin changes on parts of your body that do not often get sun, such as the bottom of your feet, palms, groin, and buttocks.

When should I see a doctor for signs of skin cancer?

The earlier skin cancer is found, the easier it can be to treat. In addition to doing regular skin self-exams at home, seeing a family doctor or dermatologist regularly for a skin check is important. A skin check by a doctor involves looking over your entire body for any spots on your skin that could be cancer.

Visit the ACS skin cancer image gallery to see pictures of skin conditions, including skin cancers and non-cancerous skin conditions in people with different skin colors and tones.

Dr. Tsai is an Associate Editor on ASCO’s Patient Information Editorial Board.