People with dark skin also need sunblock

Video: UC Davis dermatologist Dr. Oma Agbai provides quick tips for sun protection.

May is National Skin Cancer Awareness Month, but for someone like UC Davis dermatologist Oma Agbai, every day is the right time to recognize the dangers of sun exposure and avoid skin cancer. Everyone, she says, including people of color, needs sun protection to reduce the risk of skin cancer and remain healthy.

“It is true that the more melanin, or pigmentation, you have in your skin, the more protection you naturally have from the sun’s rays,” says Agbai, who is an assistant clinical professor of dermatology based in Sacramento. “But that protection is not 100 percent. People of color also have a risk of skin cancer, and unfortunately there’s a common misconception that people with darker skin types don’t need to use sunscreen or worry about skin cancer.”

Can people with dark skin also get skin cancer?

Agbai notes that because of a greater risk, the health focus over the years naturally has been on light-skinned populations and their need for sun protection. But African Americans, as well as Hispanics and others, also need protection from the sun’s harmful ultraviolet (UV) rays.

“In darker-skinned individuals, the sun not only can cause discoloration and pigmentation, but it can also cause skin cancer,” says Agbai, who was the lead author of a peer-reviewed study highlighting skin cancer and the need to increase public awareness about its dangers for people of color. “When skin cancer occurs in non-whites, it is often found at a more advanced stage and, as a result, the prognosis is often worse compared to white patients.”

Oma Agbai“In darker-skinned individuals, the sun not only can cause discoloration and pigmentation, but it can also cause skin cancer.”
— Oma Agbai, M.D.

How to spot skin cancer in dark skin

There are three types of skin cancer – basal cell carcinoma, squamous cell carcinoma and malignant melanoma – and each can appear differently in people of color than in lighter-skinned individuals. 

Basal cell carcinoma

Although rare in people of color, cases of basal cell carcinoma can appear as a dark or brown spot on a sun-exposed area of the body, such as the face, neck or hands. The spot may not seem to heal, or it may bleed or feel sore to the touch.

Squamous cell carcinoma

Squamous cell carcinoma doesn’t just occur in sun-exposed areas of the body. People with dark skin may notice a crusty bump on their face or head, or they may discover a slow-healing ulcer on their legs or even in a covered area such as the genitals.

Dr. Ogbai’s keys to reducing skin cancer risks:

  • Apply sunscreen year-round with an SPF of at least 30
  • Apply sunscreen every two hours when in the sun
  • Reapply sunscreen within one hour of exposure to water, toweling or sweat
  • Wear sun-protective clothing from 10 a.m. to 4 p.m.
  • Wear 100 percent UV-blocking sunglassesUse a spray tan for a bronzed look

Melanoma

Melanoma, the deadliest form of skin cancer, often appears on the backs of men who have a history of severe sunburns. In women, it is often found on the backs of legs. In people with darker skin types, melanoma can appear as pigmented or dark spots in sun-exposed areas of the body, including on the bottom of the feet, on the lips or even inside the mouth.

Agbai advises people of color to ask their physician to check for possible signs of skin cancer.

“Don’t be shy or think it’s not important enough,” Agbai says. “Start the conversation if you have to.  Just say, ‘Do you mind taking a look at my back and feet? It’s hard for me to see in the mirror.’

Know the ABCDEs of melanoma

To help increase self-awareness, Agbai tells people to think about the ABCDEs of melanoma:

  • A is for “asymmetry,” meaning a spot on the skin may not be nice and even looking
  • B is for “border,” where the skin spot has an irregular border
  • C is for “color,” to remind people to be on the watch for different colored skin spots
  • D is for “diameter,” in which the spot is larger than a pencil eraser
  • E is for “evolution” because the spot is growing or changing

Use sunscreen, cover up

Sunscreen, with an SPF of at least 30, should be used when outdoorsEveryone, including people with dark skin, needs to use a sunscreen of at least SPF 30 and reapply after getting wet.

The best way to protect against skin cancer is to avoid the sun’s harmful rays. Along with hats and clothing, using sunscreen is a must, she says.

"My general recommendation is to wear sunscreen 365 days a year, rain or shine,” Agbai says.  I do it myself, and I think we should all do it. Even on a cloudy day, your skin can absorb 80 percent of the UV rays, and it’s something that adds up over time. And even if the risk for skin cancer is lower in people with darker skin types, it’s still important to reduce sun exposure by using a sunscreen with a sun protection factor – SPF – of at least 30. In short, everybody needs to cover up!”

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Skin cancer and photoprotection in people of color

Dude! Where's my sunscreen?

Be Safe In the Sun

Oma Agbai, M.D.