Let’s be clear right from the start. No matter what color your skin is, if you’re exposed to the sun, there’s a possibility that you can get skin cancer.
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“Darker skin tends to have more of a pigment called melanin to protect from the sun’s harmful rays,” says dermatologist Angela Kyei, MD. “That doesn’t mean people with dark skin can’t get skin cancer. They can and they do. Just not at as high rates as fair-skinned people.”
Why skin cancer often goes undetected in dark-skinned people
Despite the sun protection that the additional melanin offers, Dr. Kyei says African Americans tend to suffer more melanoma deaths than any other ethnic group.
“It’s not that skin cancer’s harder to detect in people with dark skin,” Dr. Kyei says. “The problem is that moles in dark-skinned people don’t get checked as often because of the misconception that dark-skinned people don’t get skin cancer.”
People with darker skin also tend to get skin cancer in different locations than people with fair skin. “For example, in African Americans and Asians, we see it more often on their nails, hands and feet,” says Dr. Kyei. “Caucasians tend to get it more in sun-exposed areas.”
How treatments for darker-skinned people can differ
For the most part, skin cancer is treated the same way in dark-skinned people as it is in those with lighter skin.
It begins with surgery to remove the cancer. However, taking additional precautions can reduce scarring in people with darker skin, as they tend to suffer from thick scars, known as keloids.
“If a patient comes to me with basal cell carcinoma, which is the most common type of skin cancer, I ask about any previous experience with scars,” Dr. Kyei says.
“The reason I ask that question is that I don’t want someone to end up with a thick scar somewhere noticeable like their face. If you’re someone who tends to get thick keloids and your cancer is very superficial and not high-risk, we might start with a chemotherapy cream as an initial treatment method instead of surgery.”
Despite the potential for scarring, surgery is the only treatment method for melanoma. “Melanoma is deadly,” says Dr. Kyei. “It has to be cut out no matter what.” Injected steroids can sometimes help minimize scarring.
Dr. Kyei says people with darker skin often ask her if they need sunscreen.
“That’s a controversial question,” she says. “It depends on who you ask. If you look at African Americans in general, they’re all different colors. If you’re on the lighter side of the spectrum, you’re more likely to need a sunscreen. My stance is that it’s never wrong to wear sunscreen. It can only help.”
The potential for Vitamin D deficiency is one of the reasons why some darker-skinned people hesitate to use sunscreen. “If your skin is dark, you tend to be low in Vitamin D because you block more of the sun,” Dr. Kyei says. “But you can always take a Vitamin D supplement.”