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Skin cancer doesn’t just affect the fair-skinned. Here are five things people of color need to know.



There is a misconception that those with darker skin tones don’t need to worry about skin cancer. Find out what you can do to protect yourself.

If you have darker skin, you may think: Skin cancer doesn’t happen to people like me.

Unfortunately, it does. And when it strikes, it’s likely to appear differently and be detected later—when it’s harder to treat—than in fair-skinned people.

Here are five things you need to know.

1. Skin cancer is often diagnosed in later stages in Black people and others with darker skin tone.

There is less public awareness of skin cancer among people of color, according to the Skin Cancer Foundation.

It’s true that skin cancer is more common for those with fair skin. Melanin is what gives skin its color and darker skin has more melanin, which offers some sun protection from the sun’s harmful ultraviolet (UV) rays. That’s part of the reason skin cancer is less prevalent in people of color. However, the Skin Cancer Foundation explains skin cancers among people of color tend to be diagnosed at a later stage, when they can be less treatable.

Not only are many people of color less aware of skin cancer risks, but health professionals often are as well, according to Horizon Blue Cross Blue Shield of New Jersey’s (Horizon BCBSNJ) Chief Medical Officer, Dr. Don Liss.

“We must do a better job of getting the word out about skin cancer and people of color and do more to increase access to care. Limited awareness, later diagnoses and in many cases, lack of access to proper, timely care all contribute to poorer health outcomes,” Dr. Liss said.

There are three major types of cancer: basal cell, squamous cell and melanoma. Basal cell and squamous cell as more prevalent and highly treatable when diagnosed early. Melanoma is far more serious, especially if not diagnosed early.

The Skin Cancer Foundation cited two studies, one that found an average five-year melanoma survival rate of 67 percent in Black patients as opposed to 92 percent in white patients, and another that showed late-stage melanoma diagnoses to be more common in Hispanic and Black patients versus white patients.

2. Skin cancer looks different in people of color versus fair-skinned people and can be harder to detect.

Those with darker skin are more likely to develop squamous cell cancer and melanomas in areas that aren’t exposed to the sun, such as the palms of their hands and soles of their feet.

According to the Skin Cancer Foundation, about half of basal cell cancers are brown in darker-skinned patients. But most pictures of basal cell cancers depict what they look like on fair-skinned people, with more pinkish tones.

So, what can you do?

The American Academy of Dermatology recommends a monthly full-body check, looking for the following signs:

  • A dark spot/growth/darker patch of skin that is changing or bleeding
  • Sores that heal slowly, don’t heal at all or that return after healing
  • Rough, dry patches of skin
  • A dark underline beneath or around a fingernail or toenail

Learn more about how to conduct a skin self-exam and what to look for.

3. Your skin cancer risk depends upon your ethnicity, family history and, depending on the type of cancer, sun exposure.

According to research, skin cancer risk for people of color depends on different factors:

Squamous cell cancer

  • Most common in African Americans and Asian-Indians
  • In African Americans, likely to appear in the legs, bottom or private parts

Basal cell cancer

  • Most common in Hispanics, Chinese and Japanese people
  • Usually seen in the head and neck
  • Associated with too much sun exposure


  • In African Americans, Asians, Hawaiians or Native Americans, it’s most likely to appear in the mouth, under fingernails or toenails, or on the palms of hand or soles of feet.
  • In Hispanics, it usually appears on the feet of those with darker skin, or on the torso or legs on those with lighter skin.

4. People of color use sunscreen much less frequently than their fair-skinned peers.

Part of the reason is the lack of awareness of skin cancer risks. But another is that it has historically been difficult to find sunscreen that doesn’t appear waxy or otherwise unflattering. The Melanoma Research Alliance suggests sunscreens described as sheer, ultra-sheer or invisible.

Sunscreens work by reflecting or absorbing the sun’s UV rays: UVA rays (which can prematurely age your skin) and UVB rays (which cause burning).

Experts recommend getting water-resistant, broad-spectrum (UVA and UVB) protection sunscreen. Opt for a sun protection factor (SPF) of 30 or higher (that said, SPF beyond 50 offers limited additional protection).

Other ways to avoid sun exposure:

  • In addition to using sunscreen, wear sun-protective clothing, including long-sleeved shirts, pants, sunglasses and wide-brimmed hats.
  • Consider clothing designed with built-in protection, called UPF (Ultraviolet Protection Factor) clothing. The higher the level, the better the protection.

5. More research needs to be done on skin cancer and people of color.

Even the experts are in search of more expertise when it comes to skin cancer and people of color. That’s because the majority of skin cancer research has traditionally been conducted in white people.

As Dr. Liss says, “The more we learn about skin cancer and people of color, the more we can help educate and protect all New Jerseyans. Skin cancer can affect anyone. Our goal is to protect everyone.”

The Skin Cancer Foundation recommends you get a full-body, professional skin exam by a dermatologist once a year, or more if you are at a higher risk. Check your Horizon BCBSNJ insurance plan for information about coverage.