Skin Cancer Risks in Darker Skin

Know your skin cancer risks based on skin tone

People with darker complexions aren’t at risk for skin cancer, right? Not so fast. People of all skin tones can and do get skin cancer.

It’s true if you have darker skin, you have more melanin or natural pigment than people with lighter skin and, therefore, a lower risk of skin cancer. The more melanin, the more protection against the sun’s harmful UV rays, but this defense isn’t foolproof.

“And, unfortunately, due to this misperception, when skin cancer does occur in people with darker skin, the outlook is often worse,” says Nil Celebi Cherukuri, MD, a dermatologist at Geisinger. “That’s why sun protection and regular skin examinations — both at home and in the doctor’s office — are essential for everyone, regardless of skin tone. When found and diagnosed early, most skin cancers can be cured.”

Skin cancer risks in people with darker skin tones

While people with dark skin tones have a lower skin cancer risk, spending time in the sun still damages all skin types and colors — even if you don’t burn. Plus, UV radiation can lead to premature aging, wrinkles, dark spots and changes in skin texture in people of all complexions.

Because skin cancer in deeper skin tones is harder to detect, it may go overlooked and is often diagnosed at later stages when it’s harder to treat.

“The types of melanoma that we typically see in darker skin tones like African Americans are rarer and occur in more unusual places like the soles of feet, buttocks and under or around the nails,” says Dr. Celebi Cherukuri. “Because of this, spots are more likely to be overlooked.”

Signs of skin cancer on dark skin

Most skin cancers show up on parts of the body that get a lot of sun. But for people with darker skin tones, skin cancer often occurs on areas that get little sun exposure and can look different.

The telltale sign of skin cancer is a new growth or a change in an existing mole or dark spot. When watching for symptoms, follow the ABCDE rule:

Asymmetrical in shape
Border that’s irregular or blurred
Color changes
Diameter that’s larger than one-quarter inch, or the size of a pencil eraser
Evolving, meaning the mole or spot changes in size, shape, color or texture

Other common signs of skin cancer include:

A sore that won’t heal, or one that heals and comes back again
Patch of skin that feels rough or dry, or bleeds
A dark line underneath or around a fingernail or toenail

“Skin cancer typically doesn’t have any symptoms in the early stages,” says Dr. Celebi Cherukuri. “So, any new growth or rapidly changing spots or wounds that don’t heal after 2 months or more should be evaluated by your primary care provider.”

Preventing skin cancer

Sunshine — in hot or cool weather — is an important reminder for everyone to protect their skin.

First and foremost, use sunscreen every time you go outdoors, even on cloudy days. While melanin offers some natural protection for darker skin tones, it can’t absorb all UV rays.

About 30 minutes before heading outside, generously apply a broad-spectrum sunscreen with at least SPF 30 to all exposed skin, including the tops of feet, ears and neck. Also, be sure to reapply sunscreen every 2 hours or after sweating or swimming.

“I recommend a mineral-based sunscreen for optimal protection,” says Dr. Celebi Cherukuri. “Today’s more advanced options are less likely to leave behind a white residue and come in different tints to more closely match skin colors.”

Other tips for preventing skin cancer:

Wear sun-protective clothing like lightweight long-sleeved shirts and pants, a wide-brimmed hat and sunglasses.
Apply lip balm with sunscreen.
Seek shade whenever possible, especially during peak sun hours, usually between 10 a.m. and 4 p.m.
Avoid tanning beds or sunlamps that emit harmful artificial UV rays.

Importance of regular skin checks

Early detection and action lead to better outcomes, regardless of your skin tone.

Schedule regular skin cancer screenings with your primary care provider and be sure to discuss any changes in your skin.

In between appointments, perform monthly skin self-exams to look for any new moles or old ones that have changed in size, color, shape or texture.

For a thorough skin check, find a well-lit area and use a mirror to inspect your entire body, paying close attention to areas often missed, such as your scalp, soles of the feet and between the toes. Record and talk to your doctor about any concerning findings.

“It’s a fact that skin cancer affects people of all colors,” says Dr. Celebi Cherukuri. “Fortunately, you can take steps to reduce your risk. Be proactive about monitoring your skin health and take precautions while enjoying fun in the sun all year long.”