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Detecting Skin Cancer in All Skin Tones

Over five million cases of skin cancer are diagnosed every year in the United States. If detected early enough, it is up to 99 percent curable and survivable. But when it’s not caught in time, skin cancer has a high mortality rate because it can spread rapidly throughout the body.

Another factor leading to skin cancer deaths is that historically, preventive and screening measures have primarily been designed for people with lighter complexions. There’s been a lack of representation among people of color in clinical trials, medical illustrations and among dermatologists. This underrepresentation contributes to racial disparities in skin cancer diagnoses and survival rates. For example, melanoma is 20 times more common in White people than Black people, yet the five-year melanoma survival rate for Black patients is 71 percent, versus 93 percent for White patients. People often aren’t taught how to detect skin cancer on darker skin tones, which leads to later-stage diagnoses in people of color. Doctors have actually self-reported only being trained to identify skin cancer on light skin tones. Since skin cancer survival is so dependent on how early it is detected, this has to change.

There is also an extremely common misconception that the higher levels of melanin in darker skin provide immunity to skin cancer. Many people of color have been told that because their skin tans easily and doesn’t burn, they don’t need to wear sunscreen or take precautions against the sun. While melanin in darker skin tones does offer some sun protection (up to SPF 13), this protection is often overestimated and is not enough to prevent skin cancer.

Historically, public health messaging and marketing around sun protection has excluded people with dark skin. There’s been a recent push for more inclusion in these conversations, more education on the risks, warning signs and preventive measures for skin cancer in dark skin and better sunscreen options for people of color. As a result, the dermatology field is seeing more specialization in treating skin of color and more sun protection manufacturers are becoming attuned to the needs of these groups. For example, many mineral sunscreens leave behind a white film, which doesn’t affect those with fair skin, but discourages people with dark skin from using it. However, recent conversations have pushed manufacturers to create sun filters that work on all skin tones and encourage darker complexions to use adequate sun protection.

How to Detect Skin Cancer

Regardless of complexion, early detection is the key to curing skin cancer if it does develop. Everyone can perform monthly self checks for any unusual growths or lesions, though these growths can present differently on different skin types. If you find any spots that look suspicious, check with your dermatologist for further evaluation. When checking your skin, keep these tips in mind:

  • Look at your skin from head to toe. Use a handheld mirror or solicit the help of a friend or family member to check hard-to-reach areas.
  • Check places that get little sun, like the bottoms of your feet, under your toenails, the lower legs and groin. Malignant growths are often found in these non-sun exposed spots in skin of color.
  • Ask your hairdresser or barber if you have any unusual-looking spots on your scalp.
  • The ABCDE principle may not always apply to people of color. If you have darker skin, look out for:
    • Dark spots, growth or a darker patch of skin that’s growing, bleeding or changing
    • Sores that won’t heal or that heal and return
    • Patches of skin that feel rough or dry
    • Dark lines underneath or around fingernails or toenails

Skin Cancer Prevention

Some evidence suggests UV radiation plays less of a role in skin cancer among people of color. However, we know for certain that sun exposure is proven to increase skin cancer risk – at varying degrees – for everyone. Therefore, the best way to prevent skin cancer is to avoid excess sun exposure and use proper sun protection, including:

  • Seeking shade whenever possible.
  • Wearing clothing that protects you from the sun (e.g., wide-brimmed hats, shoes that cover the entire foot).
  • Wearing broad spectrum, water-resistant sunscreen with at least SPF 30 every day, even when it is cloudy. Reapply sunscreen every two hours or after sweating or going in the water.
  • Avoiding tanning beds and sunlamps.

How Can the LHSFNA Help?

The LHSFNA’s Sun Sense Plus campaign raises awareness about the dangers of skin cancer and heat illness by distributing products and educational materials to LIUNA members. LIUNA District Councils, Local Unions, training centers, LECET funds and signatory contractors can order sunscreen, lip balm, neck flaps, cooling cloths, insect repellent towelettes, tick keys and educational materials including posters and pamphlets here, free of charge.

[Hannah Sabitoni]

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