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Melanoma Education

Skin of Color & Melanoma

Melanoma doesn’t discriminate.

What is skin of color?

According to the Skin of Color Society, “People with skin of color are of diverse racial and ethnic backgrounds, and include African Americans, Asians, Hispanics or Latinos, Native Indians and Pacific Islanders primarily, as well as individuals from these groups who have intermarried.”

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Although melanoma is relatively uncommon in people of color, when it is diagnosed, it is often diagnosed in later stages, making treatment more difficult. Studies consistently show that people of color are more likely to die from skin cancer compared to whites.1
A research study has shown that the 5-year survival rates for skin cancer for the non-white population is 70% as compared to 92% for whites.2,3 The reasons for the high mortality in people of color is that for most forms of skin cancer, symptoms are not easily visible and thus, diagnosed later.
Studies reveal that people of color receive little or no skin education from their doctors about the risk and prevention of skin cancer.5

In Caucasians, more than 90% of cutaneous (skin) melanomas are thought to be linked to UV exposure.6 This includes UV rays that come from either natural sunlight or from artificial sources like tanning beds or sun lamps.

While UV exposure plays less of a role in the development of melanoma in people of color, other risk factors include:

  • Depressed immune system
  • Radiation therapy
  • Preexisting pigmented lesions
  • Albinism
  • Burn scars

However, in people of color melanomas that occur on the palms of the hands, soles of the feet, under nails and in mucous sites like the mouth, nasal passages or genitals are more common than cutaneous melanomas.8 These types of melanomas may be classified as acral lentiginous melanomas or mucosal melanomas. Melanoma can also occur in the eye and is known as ocular melanoma.

Facts & Stats for Melanoma in Skin of Color in the U.S.2

Melanoma incidence rates vary by racial group:

African-American

1 PER 100,000

Asian/Pacific Islander

1.6 PER 100,000

Hispanic

4.9 PER 100,000

Alaskan/Native Indian

7 PER 100,000

Non-Hispanic White

37 PER 100,000

What does melanoma look like?

Having your skin checked once each year by a dermatologist, as well as checking your skin at home each month, may help melanoma be caught in its earliest stage. Although melanoma can only be diagnosed with a biopsy, the ABCDE rule can help you and your dermatologist identify a melanoma.

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A
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Asymmetrical Shape
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Asymmetrical Shape

Melanomas are often irregular, or not symmetrical, in shape. Benign moles are usually symmetrical.

B
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Border
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Border

Typically, non-cancerous moles have smooth, even borders. Melanomas usually have irregular borders that are difficult to define.

C
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Color
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Color

The presence of more than one color (blue, black, brown, tan, etc.) or the uneven distribution of color can sometimes be a warning sign of melanoma. Benign moles are usually a single shade of brown or tan.

D
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Diameter
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Diameter

Melanomas are often greater than 6 millimeters in diameter (approximately the size of a pencil eraser).

E
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Evolution
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Evolution
(OR CHANGE)

The evolution of your mole(s) has become the most important factor to consider when it comes to diagnosing a melanoma. Knowing what is normal for YOU could save your life. If a mole has gone through recent changes in color and/or size, bring it to the attention of a dermatologist right away.

How can YOU detect skin cancer early?

The key is early detection, and it starts with YOU. The best way to find skin cancer is to check your own skin. This is crucial because when performed monthly, you can find changes to spots in your skin and get treated appropriately. When detected early, skin cancer can be treated, and often cured. However, in later stages, skin cancer can turn deadly, making treatment difficult.

Here’s what dermatologists recommend for people who have skin of color:

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Skin self-exam: a full body exam of your skin

mirror

Use: a full-length mirror and a partner or a handheld mirror

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Do: monthly

Things to look for

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Things to look for:

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Sore that won’t heal or heals and then returns.

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Sore that has a hard time healing. Pay special attention if the sore appears in a scar or on skin that was previously injured.

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Patch or spot on skin that feels rough and dry.

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Dark line or spot underneath or around a fingernail, toenail, or palms of hands and feet.

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Dark spot, growth, or darker patch of skin that is growing, bleeding or changing in any way.

Where to look

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Where to look:

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Look at your skin from head to toe.

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Examine the top of your head and back using a handheld mirror.

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Check places that get minimum exposure — bottoms of your feet, toenails, lower legs, groin, buttocks, inside of your mouth, around and underneath your fingernails.

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If you find something, consult a dermatologist.

To learn more about how to conduct a self-screen exam, please click below.

LEARN MORE

Things you can do to protect yourself:

1Stay in the shade whenever possible.

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2Wear sun-protective clothing.

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3Stay away from tanning beds.

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4Wear sunscreen daily.

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  • Dermatologists recommend: SPF 30+, broad-spectrum sunscreen, and water resistant.
  • Apply sunscreen 15-30 minutes before going outside.
  • Reapply every 2 hours and more regularly if you’re sweating or getting wet.

Learn More downarrow

Additional Resources

Citations:

  1. Merrill SJ, Subramanian M, Godar DE. Worldwide cutaneous malignant melanoma incidences analyzed by sex, age, and skin type over time (1955–2007): Is HPV infection of androgenic hair follicular melanocytes a risk factor for developing melanoma exclusively in people of European-ancestry? Dermato-Endocrinology. 2016;8(1). doi:10.1080/19381980.2016.1215391
  2. Wu XC, Eide MJ, King J, et al. Racial and ethnic variations in incidence and survival of cutaneous melanoma in the United States, 1999-2006. J Am Acad Dermatol. 2011;65(5 Suppl 1):S26-S37. doi:10.1016/j.jaad.2011.05.034
  3. Gohara MA. Skin cancer in skins of color. J Drugs Dermatol. 2008;7:441–45
  4. Pipitone M, Robinson JK, Camara C, Chittineni B, Fisher SG. Skin cancer awareness in suburban employees: A Hispanic perspective. Journal of the American Academy of Dermatology. 2002;47(1):118-123. doi:10.1067/mjd.2002.120450
  5. Kim M, Boone SL, West DP, Rademaker AW, Liu D, Kundu RV. Perception of skin cancer risk by those with ethnic skin. Archives of Dermatology. 2009;145(2). doi:10.1001/archdermatol.2008.566
  6. Lucas RM, McMichael AJ, Armstrong BK, Smith WT. Estimating the global disease burden due to ultraviolet radiation exposure. Int J Epidemiol. 2008;37(3):654-667
  7. Gloster HM, Neal K. Skin cancer in skin of color. J Am Acad Dermatol. 2006;55:741-60
  8. Acral lentiginous melanoma: Incidence and survival patterns in the United States, 1986-2004. Journal of the American Academy of Dermatology. 2009;60(3). doi:10.1016/j.jaad.2008.11.582

Updated March 2022