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Dark skin is not immunity, so be aware of the risks

 
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We’ve just completed February, African American History Month. Among much else, it can serve as a fitting reminder about a myth that has persisted for too long: African Americans (and those with darker skin tones) can’t get skin cancer.

In fact, among the African American population, melanoma — the most serious kind of skin cancer — is much more deadly than among Caucasians. In fact, it does not matter what color your skin is: Everyone is prone to developing skin cancer.

You may have heard that naturally dark-skinned people have less chance of getting skin cancer, and that is true. Darker skin naturally has more melanin, the dark pigment that protects against the sun’s UV rays. But the simple fact is no one is immune to skin cancer.

The Skin Cancer Foundation shares these facts:

• The overall five-year melanoma survival rate for African Americans is only 77 percent, versus 91 percent for Caucasians.

• 52 percent of non-Hispanic Black patients receive an initial diagnosis of advanced stage melanoma, versus 16 percent of non-Hispanic white patients.

• Melanomas in African Americans (and other nationalities, including Asians, Filipinos and Indonesians) most often occur on non-exposed skin with less pigment. Up to 75 percent of tumors arise on the palms, soles, mucous membranes and nail regions.

• Squamous cell carcinoma (SCC) is the most common skin cancer among African Americans. It tends to be more aggressive and carry a 20-40 percent risk of metastasis (spreading).

Skin cancer comprises one to two percent of all cancers in African Americans. One reason is that the familiar story about how darker skin has a higher SPF than lighter skin (which it does) has for too long translated into “My advice.on the beach.webdark skin prevents me from getting skin cancer” (which it doesn’t). It’s important to keep skin cancer top of mind; early diagnosis is often critical in successfully treating melanoma and other skin cancers.

The relatively higher incidences of skin cancers among Caucasians — and therefore the related training for physicians — makes it more difficult for professionals to diagnose skin cancer among African Americans and other ethnic groups. The lesions, moles and other symptoms that commonly help with a skin cancer diagnosis do not always appear as readily on someone with darker skin. Skin cancer in African Americans is also more apt to develop in harder-to-find areas such as under fingernails or toenails.

Education is one of our most effective tools to combat skin cancer. No matter what color your skin is, sun protection is the key. Use a broad spectrum sunscreen. I recommend VaniCream Broad Spectrum SPF30. Apply it 30 minutes before sun exposure and reapply it every 60 minutes. Use sun protective clothing whenever possible. I recommend Coolibar sun protective clothing (www.coolibar.com).

Establish care with a board-certified dermatologist and have regular skin checks. Your dermatologist will let you know how often to have a skin exam. And remember: See spot, see spot change, see your dermatologist!

 

Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.

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