From fairest pale to luscious brown, all skin types need to take care in the sun. Skin cancer can strike anyone, regardless of color, and can occur even with skin types rich in melanin. If you have lighter skin that burns easily, you have a higher risk of developing skin cancers, but contrary to popular belief, deep pigmentation does not make you immune.
With all skin tones, the key to prevention is protection, which means avoiding sun exposure during peak hours, wearing protective clothing and, of course, using broad spectrum sunscreens and sunblocks.
“Skin cancer prevention is the same for all skin types – sun protection, sun protection, sun protection,” said Washington, D.C. Dermatologist Cheryl Burgess, MD, FAAD. “Naturally, those with richly pigmented skin have an innate sun protective factor provided by their melanocytes. For example, a brown skin person with Fitzpatrick Skin Type V has an innate SPF of about 13, whereas, a Fitzpatrick Skin Type II or III has a SPF of only around 3.”
Because many people of color think they are not susceptible to the damage of the sun, skin cancers are often diagnosed later, making them much harder to treat and even harder to cure. This was the case with the legendary reggae musician Bob Marley. He developed a lesion under his toenail, which was dismissed as a soccer accident, but turned out to be an aggressive and deadly form of melanoma. Bronze skin types, including African Americans, Asians, Hispanics and American Indians, are all susceptible to basal cell carcinoma, squamous cell carcinoma and melanoma, the most common types of cancer affecting the skin.
“One to two percent of all cancers in Blacks are skin cancers. Of those skin cancers, between one and eight percent are melanoma,” said Dr. Burgess. “The risk of basal cell and squamous cell carcinomas in Blacks is low due to less deliberate sunbathing; however, melanoma has many more factors of risk than just sun exposure. This is evident because melanomas can occur internally and non-sunexposed areas.”
Non-Caucasians may feel that skin protection isn’t necessary, mainly because dark brown skin tones rarely burn. “The truth is quite the contrary. Avoidance of sun exposure during peak hours (10AM-4PM summer months and 10AM-2PM winter months), reapplication of sun protection every two hrs and protective clothing recommendations are usually discussed with all my patients,” Dr. Burgess said.
According to Connecticut-based Dermatologists Mona Gohara, M.D. and Maritza Perez, M.D, on the Skin Cancer Foundation website, there is a correlation between UV light exposure and basal cell carcinoma in darker skin types. “This explains the relatively higher incidence of this malignancy among darker-skinned populations living in sunnier climates, such as Hispanics residing in New Mexico and Arizona.” Because of delayed diagnoses, the 5-year mortality rates of non-Caucasians with melanoma are higher – in some cases, significantly higher – than Caucasians stricken with the disease.
“Using adequate sunscreen is vital daily for all skin types to guard against skin diseases and the aging effects of UV exposure,” said New York Facial Plastic Surgeon Sam Rizk, MD, FACS. “Everyone is susceptible to sunburn, even darker skin types that are naturally pigment protected. I also encourage my patients to use SPF30 year round and to avoid sun exposure of any kind for at least three weeks post surgery.” Yet, as Dr. Rizk says, often with darker skinned individuals, it is harder to get this point across because they tend not to burn as quickly or as visibly. “Particularly with patients who live in the Middle East, Southern Europe and Latin America where sun exposure is part of their daily lifestyle, it is more challenging to get them to use sufficient sun protection.”
“Depending upon the amount of melanin in their skin, pigment protected skin types have an enhanced resistance to damaging UV rays; however they can develop a sunburn that can seriously increase the risk of developing skin cancer. My advice to all my patients is to protect your skin with sunblock judiciously, no matter the color of your skin,” said Beverly Hills Dermatologist Zein Obagi, MD. “Other conditions we see frequently in darker skin types are hyperpigmentation and melasma, which is more common in women than in men. People of Latin or Hispanic, North African, African-American, Asian, Indian, Middle Eastern, and Mediterranean descent are more likely to develop melasma. It is also more difficult to treat in these skin types due to the greater risk of scarring and hypopigmentation or skin lightening.”
Skin cancer can look very different from person to person, which can make it hard to self-diagnose. The only way to tell if you have skin cancer is to see your dermatologist.