On an episode of the NBC drama “This Is Us” last season, "The Pool," a Caucasian mom (Mandy Moore) takes her African-American son (played by Sterling K. Brown as an adult) swimming at the local pool and is frustrated when she realizes that she has no idea if he needs to wear sunscreen (of course, he does — some of the black moms at the pool set her straight).
The idea that people of color don’t get skin cancer is a myth, and a dangerous one at that. According to SkinCancer.org, the estimated survival rate for blacks with melanoma is just 69 percent, compared with a 93 percent survival rate for whites.
Further, according to SkinCancer.org, 2 percent to 4 percent of all cancers in Asians and 1 percent to 2 percent of all cancers in blacks and Asian Indians. People of color also have higher rates of cancer in skin with less pigment that is not exposed to sunlight often, such as the palms and bottom of the feet (indeed, black reggae musician Bob Marley died of melanoma that started out as a spot under his toenail; it eventually spread to his brain, leading to his death at the young age of 36).
Mount Sinai Health System’s Skin of Color Center specializes in treating the unique needs of patients with pigmented skin, hair and nails. We spoke with Dr. Meera Sivendran, an assistant professor of dermatology at Icahn School of Medicine at Mount Sinai and a physician at Mount Sinai’s Skin of Color Center about some of the myths and facts surrounding people of color and skin cancer.
What are some common misconceptions/myths about skin cancer and people of color?
The most common misconception is that people of color do not get skin cancer.
How common is skin cancer among different ethnicities (African-American, Latino, South Asian, etc.)? Are people of color predisposed to certain conditions/cancers?
Overall, squamous cell carcinoma is the most common type of skin cancer in people of color. Studies show that African-Americans are diagnosed with melanoma at a later stage, have the least overall survival rate and worst prognosis. People of color are also more susceptible to developing skin cancer in non-sun-exposed body parts (bottom of feet, under the nails or the palms) and developing a specific type of skin cancer called acral lentiginous melanoma.
What are the signs and symptoms people should look out for?
New or existing moles that have more than one color, an irregular border, are asymmetrical, larger than a pencil eraser, or have changed over time can be worrisome for melanoma.
Watch out for non-healing, bleeding, or painful growths which can be indicative of a non-melanoma skin cancer like a basal cell carcinoma or squamous cell carcinoma.
What precautions should people of color take with their skin (mole checks, sunscreen, etc.)?
Sunscreen should be applied every two hours or every hour if you're sweating or in the water. Look for a sunscreen with spf 30 or higher with physical blockers such as zinc or titanium.
Skin checks should be done on a yearly basis or sooner if you notice any warning signs.
What age should people start looking out for the signs/seeing a dermatologist regularly? Does risk increase with age? Environmental conditions? Heredity?
There are no definitive guidelines for when you should have your first skin check, but I usually recommend around the age of 25. Risk of skin cancers increase with age as many skin cancers are related to cumulative sun damage. Some skin cancers, especially melanoma, can have a genetic link so it can run in families.
Would you recommend seeing a doctor who specializes in pigmented skin to patients?
All dermatologists are trained in the detection of skin cancer but dermatologists within the Skin of Color Center at Mount Sinai have likely diagnosed and treated more skin cancers in darker skin types. In addition, at the Skin of Color Center at Mount Sinai, we specialize in other skin concerns which tend to be more common in people of color such as alopecia, uneven skin tones, and scars.