Summer is right around the corner and you know what that means: sunburn season.
But aren’t sunburns just one of those ubiquitous summer experiences?
It doesn’t have to be.
Sunburn has increasingly garnered attention by doctors and dermatologists as one of the most preventable causes of skin cancer.
According to a study earlier this year from the Journal of the American Osteopathic Association, sunburns can be a tricky issue, particularly for people of color.
The researchers concluded that people with darker skin are still likely to get a sunburn if they are out in the sun too long.
And, the researchers said, if people with darker complexions do get skin cancer, they are more likely to die from it.
That danger prompted a warning this month during Melonoma/Skin Cancer Detection and Prevention Month from Rush University Medical Center.
Experts there say skin color is no shield from skin cancer and that people with darker skin have a higher melanoma mortality rate.
Sunburns and darker skin
A pool of more than 400 participants from Florida self-reported on a variety of questions relating to sunburn and skin care.
From this data, researchers listed the major predictors of sunburn.
The study reinforced certain already well-established predictors of sunburn.
Those included age. Younger people (ages 18-29) are statistically most likely to get a burn.
However, researchers also concluded that people identifying as “non-white” are also likely to get sunburned.
The conclusion may seem counterintuitive. Anecdotal evidence might suggest that people with darker skin don’t get sunburns, but researchers said that simply isn’t true.
Melanin, the component in our skin that determines pigment, plays a large role in natural skin protection from the sun’s UV rays.
The darker one’s skin, the more melanin is present and therefore the greater the UV protection.
Dr. Brooke A. Jackson, a board-certified dermatologist based in North Carolina told Healthline, “darker skin does have a level of ‘built-in’ sun protection, which can range from SPF 4-13,” but that doesn’t mean sunburns don’t happen.
“It will require a longer sun exposure for a dark-skinned individual to get severe and painful sunburn, but the consequences of severe sunburn are the same,” Sergey Arutyunyan, an osteopathic medical student, study author, and lead researcher, told Healthline.
It’s all about attitude
So, if people with darker skin are naturally more protected from the sun, why did this research determine they were still likely to report having a sunburn?
The answer seems be “attitudinal” — meaning how the individual personally feels about their risk of sunburn, skin cancer, and sun protection.
“It could be that non-white participants may think that their darker skin protects them from sunburn and as a result do not practice sun-protective behaviors,” the researchers write.
That, in turn, opens up another, larger question about how the myth got started that people with darker skin don’t sunburn.
Jackson offers this hypothesis: In clinical research, there was (and potentially still is) a lack of representation of people with darker skin.
“We have all seen pictures of fair skinned people with sunburn — we know what that looks like,” she said. “But, how many pictures have you seen of a medium-toned or darkly complected person with a sunburn? Patients may not recognize they have a sunburn because their skin doesn't necessarily look the way clinical pictures tell us it should look.”
A serious matter
No matter the pigment of your skin, sunburn is a serious issue.
When you get a bad burn skin starts peeling off. That’s literally your skin dying — or what doctors refer to as apoptosis.
The body is “killing the skin cells whose DNA has been damaged by UV radiation from the sun,” said Arutyunyan.
Data supplied in the report states that between 2002 and 2011 the rate of skin cancer in the United States has increased, making it the most common type of cancer in the country.
Also rising is the rate of melanoma, the most dangerous and deadly form of skin cancer.
“The risk of melanoma nearly doubles for people with a history of sunburn, and 86 percent of melanomas can be attributed to exposure to UVR from the sun,” says the study.
In addition, people with dark skin are more likely to die if they get skin cancer than people with light skin.
“When skin cancer is diagnosed in darker individuals, it is usually more advanced. As a result, five-year survival rate for melanoma, for example, is 93 percent for white race and only 69 for black race,” says Arutyunyan.
Jackson also points out that certain hereditary conditions such as high blood pressure and diabetes, which have a higher incidence among African-Americans, may also be a sunburn factor because the medicines used to treat those ailments can increase sensitivity to the sun.
“Add that to the belief that protection is not necessary and you have the perfect storm for a sunburn,” she said.
Arutyunyan hopes that this new research will help change people’s perceptions and attitudes toward sunburn prevention, in the same way that other forms of prevention have become commonplace — such as Pap smears and colonoscopies to screen for cervical and colorectal cancers.
Jackson emphasizes seeing a board-certified dermatologist for a skin cancer screening because, in her words, “A delayed diagnosis means a poor prognosis.”
Editor's note: This story was originally published on March 10, 2017 and was updated on May 26, 2017.