People of all colors, including those with brown and black skin, get skin cancer. While there are not enough studies to know the true statistical incidence due to underreporting, we are 100% certain that melanoma and non-melanoma skin cancers are increasing in darker skin populations. Unfortunately, there is no indication this trend will stop.
Importance of Annual Skin Exams
The reality is, nonmelanoma skin cancer, including basal cell carcinoma and squamous cell carcinoma, affects more than 3 million Americans a year. Melanoma, the deadliest form of skin cancer, continues to rise each year. Studies show people of color, receive a late stage diagnosis of Stage III and Stage IV melanoma with greater frequency than fair-skinned patients. This may be in part due to the lack of education and awareness of skin cancer occurring in darker skinned individuals in both the public arena and the medical community. As a result skin exams are not suggested or insisted upon by pediatricians and internists. Unfortunately, some dermatologists do not insist on skin cancer checks on these patients thinking that there isn’t really a great concern. All of these possibilities can result in lesions being under recognized or misdiagnosed. Often, the appearance of skin cancer in darker skin tones can appear differently than in fair skin tones - as well as sometimes in “hidden” locations such as oral mucosa, nail beds, palms and soles. An annual skin exam (in the nude) performed by a board certified dermatologist using a dermatoscope to look pigment patterns in the skin is paramount for everyone, as early detection and treatment are key to survival. Be your own best advocate.
UV Exposure is Cumulative
Sun protection is for everyone. It must start at a young age for a long-term difference. I would like to see parents, physicians and schools take a more active role when it comes to educating young children about the importance of sun safety behaviors. Using sunscreen, reapplying sunscreen, wearing UPF treated clothing and hats, being aware of the time of day and the length of time spent outdoors - just to name a few. In fact, this past year I have been telling all of my patients that they must wear a physical sunscreen inside the house. Blue light, fluorescent light, halogen light and visible light from computers and cell phones are damaging our retinas and skin. Whether you are in the sun or not, you are still exposed to UV radiation and the results are cumulative.
Sunscreen vs Sunblock
Sunscreens are chemical agents that penetrate the skin and absorb the UV rays before they reach and damage the dermal layers. Sunblock are physical compounds that deflect light and defend against ultraviolet (UV) rays. They sit on top of the skin and acts as a barrier. Typically, a sunblock includes zinc oxide or titanium oxide or a combination of the two.
Sunblocks are best for people with sensitive skin. Until recently, sunblocks were opaque, creating a chalky appearance on skin due to the titanium oxide ingredient. However, if you are a person of color or someone who prefers not to have that chalky appearance, I recommended that you look for a sunblock with micronized zinc oxide which is much less noticeable, blends beautifully, and comes in a variety of tints.
Regardless of what the sky outside looks like, wearing sunscreen or sunblock daily is a must. Appearances may be misleading when it comes to the UV index, which directly correlates to your skin exposure and sunburn risk. No matter where you are, I highly recommend checking your UV index for your risk of exposure.