Debunking the myth about dark skin and skin cancer

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The sun doesn’t care. 

It doesn’t care if you call yourself Black, if you’re biracial, if you check the “Hispanic” box on a form, or if you’re a dark-skinned Southeast Asian who considers yourself white. 

All it cares about is how much melanin is in your skin, and its degree of protection from damaging ultraviolet (UV) rays. 

People with darker skin can get skin cancer, and when they do, it is often diagnosed at a later, and more dangerous, stage. Photo courtesy of Getty Images

“UV rays do not care how you identify,” said Dr. Jeanine Downie, director of image Dermatology in Montclair, and co-host of “The Gist” on YouTube. “Sun rays do not discriminate at all.” 

The risk of developing skin cancer is far greater for whites, particularly those with blue or green eyes, and blond or red hair. However, people with darker skin can get skin cancer, and when they do, it is often diagnosed at a later, and more dangerous, stage. Scientists still don’t know if this is because Blacks have less access to health care, or because the types of skin cancer to which they are susceptible can avoid detection. 

Downie said the prime example that jolts her patients of color into taking their risk of skin cancer seriously is Jamaican reggae star Bob Marley. 

Marley had a classic subungual melanoma — a skin cancer that grows under the nail. In Marley’s case, the sore on his big toe was initially misdiagnosed as a bruise from a soccer injury. By the time it was properly diagnosed as cancer, it had traveled to his brain. He died at the age of 36. 

Subungual melanoma can appear to be a bruise under the nail, or a dark streak running the length of the nail. It most often affects the thumb, index finger or big toe. Photo courtesy of WebMD

Skin cancer often strikes people of color on the palms or soles of the feet, including the heel. In addition, melanomas can begin under the nail, showing up as a dark streak that runs from the cuticle straight up to the nail’s edge. 

Yet, most of her nonwhite patients don’t realize they need to wear sunscreen — even her Southeast Asian patients. “They think they don’t need sunscreen because they’re already tan,” she said. 

While having darker skin pigmentation does offer some protection from sun damage, that protection is modest: The skin tone of the average African American is equivalent to a sunscreen SPF rating of just 8, according to Dr. Carolyn J. Heckman, a licensed psychologist and co-leader of the Cancer Prevention and Control Program at Rutgers Cancer Institute of New Jersey. “So, it’s not enough,” she said. 

Kathleen O’Brien was a longtime columnist and health writer for The Star-Ledger. She continues to report on all facets of the health care industry for Jersey’s Best.

This article originally appeared in the Summer 2021 issue of Jersey’s Best. Subscribe here for in-depth access to everything that makes the Garden State great.