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The 2022 UK Heatwave triggered a campaign to remind people with darker skin that they need to use sunscreen. The myth of natural protection, which is partial and variable, needs to be set aside.
An article recently appeared on the BBC about a patient of West African origin who contracted melanoma. A smart young lady who still believed the same myth, that “…being black meant I couldn’t get skin cancer.”
Thankfully she is free of the condition following treatment but research confirms that a core issue continues. Those with darker skin are less likely to suffer from skin cancer but when they do, 5 year survival rates are around 35% lower than for fair skin.
An unacceptable situation and one where blaming the patient is an easy route. Awareness does matter but the causes are more complex.
Medical Training
Becoming a doctor rightly involves long, intensive training but this can have an inbuilt bias. For many years, medical books and educational aids focused on fair skin, a problem which is only now being addressed.
General practitioners, or dermatologists became more confident in identifying skin conditions on lighter skin compared to darker skin. For skin cancer, where early diagnosis is vital, this has been detrimental to patients.
Steps are being taken to close the gap, in what is a very visual field of medicine. Medical staff are pleased to see this but time will be required to bring equality, seeing a specialist experienced in conditions on darker skin may help.
Close Examination Needed
About half of the basal cell carcinomas seen on darker skinned patients are themselves pigmented. Other forms of skin cancer can look a little different and more importantly, may take hold in varying places.
Acral melanomas (on the hands and feet) are more common on dark skin but understandably, less likely to be seen. Skin cancers can also appear under nails, or on the scalp, where skin tone, or hair type can disguise them.
Although important for everyone, this gives greater reason to carry out a self examination once a month. A check that should include the soles of your feet, palms, toenail and fingernail beds, your scalp, groin and buttocks.
Self checking should be backed up by a full body examination from a dermatologist at least once a year. A visit is also essential if you see something unusual, a new, or changing mole, or growth, or a sore that doesn’t heal.
Taking Protective Steps
Our core concern is skin cancer but the sun’s UV rays inflict wider damage on dark skin. Higher melanin levels delay photoaging to a degree but do not prevent many signs, not least the hyperpigmentation which is prevalent on darker skin.
To protect against this and skin cancer, broad spectrum sunscreen with an SPF of at least 30 should be applied every couple of hours. Loose clothing can be comfortable and protect, as can taking shelter in the shade.
Sharing the message will help others, if you have skin, you can get skin cancer. Should this happen, we offer advanced diagnosis and skin cancer treatment for darker skin but would prefer that you didn’t need them.