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Skin cancer is cancer that begins in the skin. It’s the most common type of cancer in the United States. There are many types of skin cancer, the most serious of which is melanoma.

One potential risk factor for developing skin cancer is having a lighter or white skin tone. However, it’s important to know that skin cancer can happen in skin of all colors, including black skin.

Continue reading to learn more about skin cancer on black skin, how to spot it, as well as prevention strategies you can use in your daily life.

Yes, Black people can develop skin cancer. This is because they can be exposed to the same environmental risk factors, such as ultraviolet (UV) rays, as people of other races or ethnicities.

Overall, skin cancer is less common in Black people. Data from the Centers for Disease Control and Prevention (CDC) found that in 2018 (the most recent data we have available), 1 case of melanoma occurred per 100,000 Black people, compared with 25 cases per 100,000 white people.

Why is skin cancer less common in Black people?

To understand why skin cancer is less common in Black people, it’s important to understand a little skin biology.

Normally, all skin contains a pigment called melanin. However, compared with white skin, black skin has a higher amount of melanin.

Higher amounts of melanin absorb or reflect more UV rays from the sun, helping to better protect skin cells from harm. This level of protection isn’t present in white skin, making it more vulnerable to damage from UV rays.

What are the risks associated with skin cancer in Black people?

Due to the fact that skin cancer is less common in Black people, some may perceive their risk of skin cancer as low. They may not seek care for potentially cancerous skin changes.

A 2018 study used focus groups to evaluate Black and Latino people’s knowledge and attitudes about skin cancer. Researchers found that:

  • Many study participants perceived themselves to have a low risk of skin cancer due to having a darker skin tone or a lack of family history of skin cancer.
  • Black participants reported skin cancer symptoms more inconsistently than Latino participants.
  • Few study participants reported regular use of sun protection behaviors.

Many times, skin cancer isn’t diagnosed in Black people until its later stages. In fact, according to the American Academy of Dermatology, 25 percent of melanomas in Black people are diagnosed after the cancer has already spread to surrounding lymph nodes.

Receiving a diagnosis at a later stage can make skin cancer much harder to treat. It can also negatively impact outlook.

It’s possible for other People of Color to develop skin cancer as well. It’s associated with the same types of risks as in Black people.

Compared with white people, the rate of skin cancer in other People of Color is lower. However, it’s higher than in Black people. For example, according to data from the CDC, in 2018 there were:

  • 5 melanoma cases per 100,000 Native American or Alaska Native people
  • 4 melanoma cases per 100,000 Latino people
  • 1 melanoma cases per 100,000 Asian and Pacific Islander people

There are several types of skin cancer. It’s possible that some types may be more common in certain People of Color than in others.

For example, basal cell carcinoma is more common in Hispanic and Asian American people than in Black people. Meanwhile, squamous cell carcinoma is more common in Black people than in other People of Color.

The main symptom of skin cancer is a change in an area of skin. This sounds very general, so let’s dive deeper into some general qualities to look for.

Not all skin cancers appear the same. It’s possible that a cancerous area could have one, a few, or all the characteristics listed below.

What’s important is that you make an appointment with a dermatologist if you have concerns about a certain area. They can evaluate the area to help determine whether it may be skin cancer.

Location

Generally speaking, skin cancer often appears on areas of the body that are frequently exposed to sunlight. Some examples of such areas include the:

  • face
  • ears
  • scalp
  • neck and shoulders
  • chest
  • arms and hands

Additionally, skin cancer on black skin tends to show up more often in specific areas of the body. These include the:

  • bottom of the foot
  • lower legs
  • palms
  • under a fingernail or toenail
  • groin

Remember that skin cancer can show up anywhere on your body. If you notice an area that’s concerning, regardless of where it’s located, be sure to see a dermatologist.

Color

A cancerous area can have a different color from the surrounding area of skin. It’s typically darker. On black skin, this may appear as:

  • dark brown
  • purple
  • ashen gray
  • black

Another thing to look out for with spots or moles is color distribution. A cancerous mole or spot may not have even color throughout. For example, some areas may be darker or lighter than others.

Shape

Spots or moles that may be cancerous are often different in shape than other spots and moles on your body. Look for spots or moles that have an irregular or asymmetrical shape, or a jagged border.

Size

For some types of skin cancer, such as melanoma, a spot or mole may be quite large. A good metric to use would be to look for suspicious areas that are larger than the size of a pea.

Bleeding

It’s possible that an area affected by skin cancer may bleed or form into a sore.

Texture

Some types of skin cancer, such as basal and squamous cell carcinoma, may appear as an area that feels dry, scaly, or rough compared with the surrounding skin.

Evolution

Skin cancer often evolves or changes over time. For example, you may notice that an area of concern becomes larger or forms a sore that either doesn’t heal or comes back.

Skin cancer is often diagnosed by a dermatologist. This is a type of doctor who specializes in conditions affecting the skin. The first steps include getting your medical history and performing a physical exam.

The physical exam will include a skin exam, during which your dermatologist checks your skin for spots or bumps that appear abnormal. If they find an area that has a concerning color, size, or shape, they’ll perform a skin biopsy.

During a skin biopsy, all or a portion of the abnormal-looking area is carefully removed using a sterile instrument. Local anesthesia is used to numb the area, so you won’t feel pain during the procedure.

The biopsy sample is sent to a lab where it’s checked under a microscope for signs of cancer. When the analysis is complete, your dermatologist will receive a report of the results, which they’ll then communicate to you.

Overall, the treatment that’s recommended for skin cancer depends on factors like the type of cancer, its stage, and where it’s located on your body.

Surgery is often used as a treatment for many types of skin cancer, particularly if cancer hasn’t spread to other areas. There are several types of procedures that may be used:

  • Excision. Excision uses a small blade to cut away the affected area.
  • Curettage and electrodesiccation. In curettage and electrodesiccation, a sharp tool called a curette is used to remove the cancerous area. Then, a tool that generates an electric current is used to burn and kill remaining cancer cells and stop bleeding.
  • Cryosurgery. Cryosurgery uses a special instrument to freeze and kill cancerous cells in the affected area.
  • Mohs surgery. Mohs surgery aims to remove as little tissue as possible. It’s often used for areas like the face, genitals, and fingers. Small layers of tissue are removed. Each layer is checked under a microscope for cancer cells until no cancer cells are observed.

There are also other treatments that may be used in addition to or instead of surgery, particularly if cancer has spread (metastasized) to other parts of the body. Some examples include:

  • Radiation. Radiation therapy uses high-energy radiation to kill cancer cells or stop them from growing.
  • Chemotherapy. Chemotherapy involves the use of strong drugs that can kill cancer cells or slow their growth.
  • Immunotherapy. This type of cancer treatment works to help your immune system identify and destroy cancer cells.
  • Targeted therapy. This therapy is directed at specific molecules that are present in cancer cells. Due to this, it may cause less damage to healthy tissue than radiation therapy or chemotherapy.

In general, skin cancer is caused by genetic changes that occur in the DNA of our cells. Sometimes, these changes can be harmful, causing cells to begin to grow and divide out of control.

UV radiation from the sun can cause damage to DNA. Because of this, frequent exposure to UV rays in the form of sunlight or UV lamps is associated with an increased risk of skin cancer.

However, not all types of skin cancer may be linked to sun exposure. Indeed, some skin cancers in Black people occur in areas that aren’t exposed to much sunlight, such as the soles of the feet, palms of the hands, and nails.

This type of skin cancer is called acral lentiginous melanoma (ALM). Some dermatologists have reported that ALM makes up 30 to 70 percent of melanomas seen in People of Color visiting their practice.

Doctors don’t yet know what causes ALM. However, it’s believed that genetic factors may play a role.

You can take the following steps in your day-to-day life to help prevent skin cancer:

  • Choose shade. Exposure to UV rays causes many types of skin cancer. Because of this, try to stay out of direct sunlight if you’re outside.
  • Steer clear of certain times. Try to avoid being outside when the sun is strongest, from 10 a.m. to 4 p.m. Instead, aim to be outside either earlier or later in the day.
  • Wear sunscreen. If you’re going to be out in the sun, make sure to wear sunscreen. Some tips for this include:
    • Select a water-resistant sunscreen with an SPF of 30 or higher.
    • Apply your sunscreen about 15 to 30 minutes before sun exposure. This allows it to better soak into your skin.
    • Don’t forget to put sunscreen on areas like the tops of the feet, ears, and back of the neck.
    • Reapply your sunscreen every 2 hours or after sweating or swimming.
  • Consider clothing. Take steps to cover areas that may be exposed to sunlight. Examples of items to consider include wide-brimmed hats, sunglasses, and long sleeves or pants.
  • Check your skin. Once a month, perform a thorough check of your skin. Look for spots or bumps that have an abnormal color, size, or shape. If you notice anything concerning, contact your dermatologist.

Skin cancer is often diagnosed in its later stages in Black people. Because of this, the outlook can sometimes be poorer.

For example, a 2019 study from a group at the CDC looked at melanoma in Black Americans. It found that the 5-year survival rate for melanoma was 66.2 percent for Black Americans, compared with 90.1 percent for white Americans.

Later diagnosis may be due to a variety of different factors, such as:

  • lower awareness of the signs and symptoms of skin cancer
  • less frequent use of sun protection
  • unequal access to healthcare

As is the case with many cancers, outlook is better when skin cancer is detected and treated early. Most skin cancers, including melanoma, can be cured when they’re found early.

As such, it’s vital to take steps to prevent skin cancer, regardless of the color of your skin. These can include doing regular skin checks and protecting yourself from UV rays. If you ever notice anything concerning, see a dermatologist.

Although it’s less common, Black people can get skin cancer. In fact, skin cancer is often diagnosed later in Black people, making it harder to treat and potentially leading to a poorer outlook.

Skin cancer is associated with changes in the skin that can include areas that have an abnormal color, shape, or size. In Black people, skin cancer can often be found in areas like the soles of the feet, lower legs, and palms.

When detected early, most skin cancers can be cured. Make sure to visit a dermatologist if you notice an area of skin that’s concerning. They can help determine whether skin cancer may be present.