Skin cancer rates among Caucasians have been climbing steadily over the last decade, but so too are the number of incidences in ethnic skin. At the core of the problem is the (erroneous) belief that ethnic skin is immune from the sun’s carcinogenic rays. “People need to realize that skin of color burns too,” says YouBeauty Dermatology Expert Jeanine B. Downie, MD. “Radiation absorbed from the sun can have you seeing cancer down the road.”
However, while it’s hard to find data comparing skin cancer rates between white and non-caucasian skin types, we do know that melanoma mortality rates among darker-skin people are disproportionately higher. That’s because all these forms of cancer tend to be diagnosed at a later stage when they’re often advanced and potentially fatal, explains Dr. Mona Gohara, MD, assistant clinical professor at Yale University School of Medicine’s department of dermatology.
“Bob Marley died at age 36 from a melanoma that started under a toenail and spread to his brain,” says Maryland dermatologist, Dr. Noelle S. Sherber. “Lesions in these areas tend to grow horizontally and spread out on the skin’s surface, so early detection is key.”
Non-melanoma skin cancers are also on the rise. The milder, basal cell carcinoma is predominantly found among Caucasians, Hispanics and Asians, while the more aggressive squamous cell carcinoma most commonly strikes the African American and Asian-Indian communities and can metastasize to other organs quickly.
Research has found that basal cell carcinomas occur primarily on the parts of the body that receive the most UV exposure. Squamous cell carcinomas show up in exposed areas too, but also exhibit on legs and in the anogenital region on African American skin. Pay close attention to any lesion that bleeds, oozes, crusts, won’t heal or lasts longer than a month; in those cases, see a dermatologist immediately.
Experts point to a cultural lack of sun awareness and education among many ethnic groups as a factor. While Caucasians tend to be versed in the ABCDE warning signs of skin cancer (asymmetry, border irregularity, color, diameter and evolution) and are more likely to schedule regular skin cancer screenings with a dermatologist, it’s a popular belief among minorities that skin of color provides a natural shield and such vigilant care isn’t necessary. “Higher levels of melanin in skin affords you a certain level of protection, but people need to understand that it doesn’t circumvent the risk,” says Downie. “Until that message gets across, I think it’s going to be depressing when it comes to statistics and who dies from skin cancer.”
Results from a recent study on minorities and skin cancer reveal that message is still far from taking hold.
In that survey, 65% of minority respondents said they didn’t consider themselves at risk for skin cancer, while 62% of African American adults said they’ve never even worn sunscreen. Only a meager 31% of minorities have performed a skin cancer check, and 17% have had a full body examination by a dermatologist.
“The bottom line is that everyone needs to wear a full spectrum sunscreen of SPF 30 daily and get a body check at least once a year,” says Downie, who adds that if you have a family history of skin cancer, it should be twice a year, and even more often than that for those previously diagnosed with skin cancers. “I have an under 35-year-old patient who just had a melanoma removed six weeks ago and already we think we’ve just found another one,” says Downie. “That’s unusual, but if you’ve had an unsafe sun history, these spots can pop up fast.”
Experts say environmental change is one reason skin cancer in minorities is soaring. “Ozone depletion makes today’s sun more damaging than ever,” says Dr. Wendy Roberts, medical director of Desert Dermatology Skin Institute in Rancho Mirage, CA.
And a culture seeped in an obsessive love of all things bronze has some entering tanning beds in search of even more color. “The tanning bed sun emits 12 to 15 times the ultraviolet radiation of the sun,” warns Downie. “I have patients who say that tanning gives them a ‘base tan’ of protection. Newsflash: A base tan is literally an SPF of 3.”
But while the risk of skin cancer may be the most important reason to protect yourself against the sun, it’s often vanity that gets people to take action, says Downie. “Most people think, ‘It’ll never be me who gets cancer.’ But when you tell them, ‘It’ll be you who ages faster than your sister,’ then suddenly you get people’s attention.”
The popular quip “black doesn't crack,” may have some truth to it when it comes to wrinkling. But that higher melanin content also makes skin of color more susceptible to discoloration. “African Americans, Asians and Latinos age with patchy areas of pigmentation due to the sun’s rays, whereas signs of aging in Caucasians tend to emerge as fine lines and wrinkles,” explains Downie.
Pigmentation is tricky for dermatologists to treat. Lasers may induce an inflammatory darkening response while deep peels incite similar complications. “If you wear sunscreen every day, you will age slower – and that includes ethnic skin. It’s just a fact,” says Downie.
And then there’s the chalky texture issue with many sunscreen formulas leaving pasty streaks of purple, gray or silver on dark skin. “I hear that excuse from patients all the time,” says Downie, who is herself of African American descent. “There are many micronized varieties now that apply clearly,” she adds.
Whether it’s fear of melanoma or the almighty wrinkle that puts the scare of sunscreen into you, just remember: Skin cancer doesn’t discriminate. We can all afford to be more aware and protected.
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