More than melanin: Skin cancer remains a risk for the black community

This article is part of our series looking at how Black Americans are navigating the healthcare system. According to our exclusive survey, one in three black Americans report experiencing racism when seeking medical care. In a roundtable conversation, our committee of medical experts called for better representation among providers to help address this widespread problem.

key takeaways

  • Although skin cancer is less common among black people, it is still possible to develop the disease.
  • Black people are often diagnosed with skin cancer at a later stage.
  • It’s important to heed the warning signs on your skin and advocate for your health.

In December 2019, while I was sitting in my office, I got a call from a dermatologist. She just had a last minute biopsy on me two days ago. I wasn’t prepared for the news I was about to receive.

“You have skin cancer,” she told me. Within minutes of that call, I was diagnosed with Dermatofibrosarcoma Protuberans (DFSP).

My body was hot with shame. It has probably been over a year since I noticed a strangely shaped, raised bruise on my upper body. I spend too much time before my dermatology consultation as recommended by my primary care doctor.

I was also shocked that I, a black woman, might even have been diagnosed with skin cancer.

What are the most common skin cancer symptoms?

The black community rarely talks about skin cancer and how it affects us. While mass-produced T-shirts and apparel boast our “sun-kissed skin,” our melanin doesn’t save us from a skin cancer diagnosis. Melanin is a dark pigment found in the skin, eyes and hair, giving them their color and protecting them from the harmful effects of UV rays. While it provides protection, it does not guarantee immunity against skin cancer.

My diagnosis is not sun exposure.

While black people can still get skin cancer from direct sunlight exposure, there are many other skin cancers that aren’t caused by UV rays. DFSP is a rare type of soft tissue sarcoma — a group of cancers that affect tissues such as skin, fat, and muscle. DFSP does not originate from sun exposure, and researchers are still studying what causes tumors.

My dermatologist recommended Mohs surgery and I had surgery to remove the tumor in January 2020. The process should be quick and recovery won’t be long. However, my journey took a drastic turn when my pathology report returned after surgery. The tumor had penetrated deep into my skin, growing like the roots of a tree trunk. I need additional surgery.

What is non-melanoma skin cancer?

Research shows that when black people develop skin cancer, they are often diagnosed at an advanced stage. This makes treatment more difficult.

Delaying a visit to a dermatologist can result in a delayed diagnosis, but even diligent and scheduling appointments can have the same consequences. Many dermatologists are unfamiliar with black skin and/or know that black people are less likely to develop skin cancer than others. As a result, some dermatologists may miss out on diagnosing people with skin cancer early.

For people with melanoma, the delay can become fatal because it spreads quickly.

While blacks are less likely to be diagnosed with melanoma than whites, they also face a greater risk of death. Barriers to care and lack of representation in dermatology only further exacerbate the disparities and institutional racism faced by the black community.

In total, I had 3 surgeries and now have to visit my cancer center every six months to make sure the tumor doesn’t come back. In sharing my journey with others, I found that the lack of skin cancer education has led to the spread of misunderstandings within the black community.

types of skin cancer

How to Take Control of Your Skin Health

Here are four things we as African Americans should do to make sure we don’t ignore what our skin is trying to tell us:

Check your skin

This can be done before or after the shower and should be done at least once a month.

For darkened skin, you need to identify anything that may look like:

  • New black dots (or black dots that have changed in shape and/or size)
  • sores that don’t heal (or heal and return)
  • a rough skin
  • A black line under or around a fingernail or toenail.

Check your body for any unusual skin tags, bumps, or bruises with the help of a mirror or your partner.

Apply sunscreen every day

As a community, we are well aware that our melanin remains our greatest protector. Despite this natural protection, we still need to protect our skin from UV rays.

Best sunscreens for year-round coverage

According to the Skin Cancer Foundation, you should apply a broad-spectrum sunscreen (SPF 15 or higher) every day. You should also try to stay out of the sun, try not to get sunburned, and cover up between 10am and 4pm. You can check out this guide from the Skin Cancer Foundation for more helpful tips on how to protect your skin.

Schedule an annual visit with a dermatologist

Be sure to visit your dermatologist when scheduling your annual checkup.

These doctors are qualified to diagnose and treat skin diseases. If you haven’t done a thorough skin exam yourself, ask them to check your skin. Be sure to use your visit to resolve any issues you may have.

Choosing the Right Biopsy for the Type of Skin Cancer

You’ll especially want to ask for a biopsy if you do notice something on your skin. This is the only way to diagnose skin cancer, and it can be done during your visit.

defend oneself

There is still a lack of diversity in the medical field. Many dermatologists are unfamiliar with dark skin. Research and find the dermatologist you think is best for your needs. For black people, that might mean identifying a dermatologist who looks like you.

If that’s not possible, finding someone who understands melanin skin is key. If your dermatologist doesn’t take your concerns seriously, find one who will.

Most importantly, early detection is critical. Loving our melanin means we must take care of protecting it.