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Skin cancer signs among people of color

Paoli Hospital June 4, 2018 Cancer

As a person of color, sunburn might not be among your top health considerations or concerns. More information about sunburn or sun exposure and damage is directed to the fair-skinned among us. But sunburn and sun damage can be harmful to everyone, and it can be particularly threatening for non-white people, who are more likely to be diagnosed with skin cancer in its later stages.

The most recent data available from the American Cancer Society shows that the five-year survival rate from melanoma is 93 percent among people with white skin, but only 69 percent for people with black skin.

“Skin cancer can happen to anyone, regardless of their gender, race, ethnicity of skin type. But among people with darker complexions and darker skin, often the cancer isn’t detected and diagnosed until it has progressed,” explains Sandra Urtishak, MD, hematologist and oncologist at the Cancer Center of Paoli Hospital, part of Main Line Health.

Melanin protects skin—up to a point

One of the myths surrounding sunburn and skin cancer is that people of color are protected from sun damage because of melanin. Melanin is a brown pigmentation that helps determine the color of a person’s skin. The more melanin a person has in their body, the darker the color of their skin.

Melanin can also act as a type of natural sunscreen by absorbing and deflecting ultraviolet (UV) rays—to a point. “Dark skin is not immune to sunburn or sun damage, which is why everyone should lather up with sunscreen and UV-protective gear when spending time in the sun, regardless of complexion,” says Dr. Urtishak.

Skin cancer can appear in surprising places

You might expect to see moles or spots that occur because of sun damage on areas of your body that have been exposed to the sun, like your back, legs, arms and shoulders. But, among people of color, skin cancer can present in surprising places.

“Areas that aren’t typically exposed to sunlight are where most cases of cancer present among non-white patients,” says Dr. Urtishak. The palms of your hands, bottom of your feet, below your toenails, and areas like your lower leg, groin and buttocks are popular spots for new moles or spots—the beginnings of skin cancer—to appear. These locations also make it more difficult to detect. For this reason, it’s important to spend extra time examining these areas for skin changes. Be thorough in checking your head, neck, hands and feet, too.

Skin cancer signs to look for

The best way to detect skin cancer is to be diligent in examining your skin for changes, like a new mole or spot on your body or one that has recently changed shape, color or texture. We call these the ABCDEs of melanoma:

  • A for asymmetrical (one side looks different than the other)
  • B for border (irregular shape vs. smooth and even)
  • C for color (more than one color, variegated brown or shades of brown)
  • D for diameter (generally more than six millimeters)
  • E for evolution (a mole that goes through changes)

People of color should also look out for a dark line underneath the fingernail or sores or color changes inside your mouth, skin changes that can easily be overlooked. Any time you have a mole or a spot that changes size, shape or color, or itches or bleeds, you should see a dermatologist for a comprehensive, full-body checkup.

Skin cancer prevention and screening

The recommendations for skin cancer prevention are simple: Use sunscreen, wear a hat or other protective clothing when in direct sun, seek shade, if possible, and avoid intentional tanning. The American Academy of Dermatology recommends sunscreen with SPF 30 or higher.

Unfortunately, we can’t always rely on an all-day approach to sunscreen. In warm weather months we perspire and swim, and the sunscreen product wears off sooner than anticipated. Therefore, you should reapply the lotion every two to four hours or sooner, especially when swimming or being active outdoors.

Although it is not always practical to seek shade, keep in mind that the peak time for the sun’s rays to do their damage is between 10:00 am and 4:00 pm. Therefore, during those hours you need to be more vigilant about exposure and application of sunscreen.

Main Line Health serves patients at hospitals and health centers throughout the western suburbs of Philadelphia. To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (225.5654) or use our secure online appointment request form.