The myth about melanoma and skin cancer in people of color

Summer is around the corner and with the heat and sunshine comes an important reminder to protect your skin. May is Skin Cancer Awareness Month and a good time to learn about safeguarding the largest organ of the body.

Skin cancer is by far the most common type of cancer. In fact, one in five Americans will develop skin cancer in their lifetime. The deadliest type of skin cancer is melanoma. According to the American Cancer Society, more than 100,000 new cases of melanoma will be diagnosed in the U.S. this year and more than 8,000 Americans will die from the disease.

There is a myth that people with dark skin tones can’t get skin cancer. We wanted to set the record straight, so we spoke with UC Davis Health dermatologist Oma Agbai, director of multicultural dermatology and hair disorders, to learn more about skin cancer, including risks, prevention and treatment — for all.

How can people prevent skin cancer?

Sunscreen is important — even for people who are Black or African American! Even though people with darker skin tones have more natural protection from melanin, it's still crucial for them to use sunscreen when they're going to be exposed to the sun for extended periods. Sunscreen helps provide an extra layer of protection against harmful UV radiation.

When using sunscreen, be sure to apply it correctly. It is important to apply sunscreen generously and evenly to all exposed areas, including the ears, neck, and tops of feet. Sunscreen should be reapplied every two hours or more frequently if swimming or sweating heavily. In general, dermatologists recommend an SPF of at least 30, which blocks 97% of UVB rays. Here are some other prevention tips:

• Whenever possible, try to stay in the shade during peak sun hours, typically between 10 a.m. and 4 p.m. Wearing protective clothing, such as lightweight long-sleeved shirts, wide-brimmed hats, and sunglasses, can also help minimize sun exposure.
• UV radiation can reflect off surfaces like water, sand, snow, and concrete, increasing exposure and possible skin damage. People should be mindful of these surfaces and take extra precautions, such as wearing sunglasses and applying sunscreen more frequently.
• Regular self-examinations of the skin can help detect any changes or abnormalities early on. If there are any concerning moles, spots, or changes in the skin, let your doctor know right away.

How common is skin cancer in people of color?

Although rare, skin cancer can occur in people of color and I have seen this in my patients. People of African descent, in particular, can have an unusual presentation of melanoma: It tends to occur on the hands or feet. Bob Marley, the legendary African American reggae singer, tragically died of a melanoma that was diagnosed on his foot.

It's vital for people with darker skin tones to pay attention to changes in their skin and to consult a dermatologist if they notice any concerning signs or symptoms. Early detection and treatment of melanoma can improve outcomes, regardless of skin color.

What other factors impact skin cancer in people of color?

Some people of color may face barriers to accessing quality health care, including lack of insurance, limited access to dermatologists, and cultural or language barriers. These can all impact the timely diagnosis and treatment of melanoma.

Addressing disparities requires raising awareness about melanoma risk among people of color. It also means improving cultural competency among health care providers and working toward equitable access to health care for early detection and treatment.

What are warning signs of skin cancer and, especially melanoma?

Here are the commonly seen warning signs, but please talk to your doctor about any new or changing growths, because I often seen melanomas that do not follow these rules:

Asymmetry: Melanomas often have irregular shapes. One half might not match the other half.

Borders: The borders of melanomas may be uneven, rather than smooth.

Color: Melanomas may contain different colors or shades within the same lesion, such as brown, black, blue, red, or white.

Diameter: While melanomas can be small, they often grow larger than the size of a pencil eraser (about 6mm) in diameter.

Evolution: Any changes in size, shape, color, or elevation of a mole or skin lesion should be monitored closely. This includes changes in texture, itching, bleeding, or crusting.

Location: Melanomas can develop anywhere on the body, including areas that receive little sun exposure. In people with darker skin tones, melanomas are more likely to occur on areas like the palms, soles of the feet, mucous membranes and under the nails.

New Lesions: Keep an eye out for new moles or pigmented areas that develop on the skin, especially if they show any of the warning signs mentioned above.

If you are diagnosed with skin cancer, what treatments are available?

Fortunately, we use advanced treatments for melanoma that are dramatically changing outcomes for this lethal type of skin cancer. Treatment options include:

• Surgery
• Immunotherapy
• Targeted therapy
• Chemotherapy
• Radiation

For other types of skin cancer, such as basal and squamous carcinoma, we perform less invasive surgery such as Mohs surgery, electrosurgery and cryosurgery as well as use topical creams.

Contact the UC Davis Health Department of Dermatology, if you have questions or would like to schedule an appointment. You can also call 800-770-9282.