For those who think their skin color exempts them from having to worry about sun protection, dermatologists have a message: Damaging UV rays can penetrate all types of skin, regardless of your ethnicity, so even people with dark skin need sunscreen.
And while skin cancer rates are significantly lower in African Americans and Hispanics than in Caucasians, low risk doesn’t mean no risk. The annual incidence of melanoma is 5 in 100,000 for Hispanics and 1 in 100,000 for African Americans (compared with 26 in 100,000 for Caucasians), according to the American Cancer Society.
Some of the facts about your risk for sun damage might surprise you, but knowing the truth will help you stay safer in the sun.
UV Rays Damage Everyone’s Skin
“Dark skin does have built-in SPF,” says Amy Wechsler, M.D., a dermatologist based in New York City and assistant clinical professor of dermatology, SUNY Downstate Medical College. That’s because darker people naturally produce more melanin, the pigment that gives skin its color, and the more melanin you have, the fewer UV rays penetrate your skin. For example, a National Cancer Institute study noted that medium dark skin filters out about twice as much UV (ultraviolet) radiation as white skin.
Melanin increases in response to sun exposure and skin gets darker, but that “tan” isn’t protecting your skin; it’s a sign of sun damage. “UV exposure causes cell damage, and the body produces more melanin as a protective mechanism,” says David Bank, M.D., director of The Center for Dermatology, Cosmetic and Laser Surgery in Westchester County, N.Y.
Although people of color might not burn as quickly as people with light skin, they can and do get sunburned. In a 2014 study, researchers at the Centers for Disease Control and Prevention and the National Cancer Institute reported that 13 percent of African Americans and 31 percent of Hispanics surveyed said they had experienced at least one sunburn in the past year. Redness, the telltale sign of sun damage, might not be as evident on darker skin, but skin can still feel hot, tight, and painful.
Time in the Sun Will Age Your Skin
The damage caused by UV exposure will also make your skin look older. “Photodamage in people of color will lead to sagging of the skin, loss of volume from the face, and hyperpigmentation,” says Jeanine Downie, M.D., a dermatologist in private practice in Montclair, N.J. “While people with lighter skin tones tend to see fine lines and wrinkles show up first, people of color will see changes in pigmentation that lead to dark patches and uneven skin tone.”
You Can Find a Sunscreen to Suit You
Regardless of the color of your skin, the American Academy of Dermatology recommends applying a sunscreen with an SPF 30 or higher and reapplying it every 2 hours or immediately after swimming or heavy sweating.
CDC researchers surveyed more than 4,000 Americans asking how often they used sunscreen on their faces or exposed skin on their bodies when they were outside in the sun for longer than an hour. Among men, 4 percent of blacks and 16 percent of Hispanics used it on their faces, and 7 percent of blacks and 12 percent of Hispanics used sunscreen on their bodies. Women had a higher rate of regular sunscreen use, with 15 percent of black women and 36 percent of Hispanic women using it on their faces and 10 percent and 26 percent, respectively, using it on their bodies.
It’s true that some sunscreens are thick, pasty, and white—none of which is ideal for darker skin tones. “You don’t want to end up looking ashy,” says Wechsler. “It may require some trial and error, but looking for formulas that are more liquid and sheer will be your best options.”
Several of the sunscreens in Consumer Reports’ tests did not leave a white cast on dark skin.
Any Unusual Skin Changes Could Be a Sign of Trouble
Even though skin cancer occurs less frequently in people with dark skin than in Caucasians, Africans Americans and Hispanics both have high mortality rates if they do develop the disease. In part, that’s because skin cancer often isn’t diagnosed in people of color until a later stage, when the disease is more advanced. In a 2006 study published in the Archives of Dermatology, researchers analyzed 1,690 melanoma cases. They found that 26 percent of those diagnosed in Hispanics and 52 percent of those in African Americans were advanced (compared with 16 percent in Caucasians).
One reason people of color aren’t diagnosed with skin cancer until the disease has advanced is that the early warning signs often go unnoticed. “Skin cancer can look different in different skin types,” says Downie. “And often doctors don’t think about skin cancer when they’re treating people of color.” But Downie warns that any skin changes—such as a new mole or one that grows or changes, a patch of skin that changes color, a scab that won’t heal, or a dark spot under your nail—are worth getting looked at by a dermatologist.
Skin Cancer Can Occur Even in Spots That Rarely See the Sun
While Caucasians typically develop skin cancer in areas that get the most UV exposure, African Americans often experience the opposite. Common sites for skin cancer to occur in people of color include the bottoms of the feet, palms of the hands, and underneath fingernails and toenails (the singer Bob Marley died from melanoma that began under his toenail).
Existing Scars Can Be Skin Cancer Danger Zones
If you have any scars—especially those that resulted from a thermal or chemical burn—keep a close eye on them (and protect them carefully from the sun). People of color are more likely to develop nonmelanoma skin cancer in an area that’s scarred or inflamed. And it can be life-threatening if left unchecked. According to a National Cancer Institute study, when squamous cell cancer develops in a person of color at the site of a long-standing scar, there is a 20 to 40 percent risk of spreading. If you notice a scar suddenly changing, becoming inflamed or otherwise altered, see your dermatologist.