Ultraviolet Rays Don’t Discriminate: With Summer Sun Comes Increased Need for Safety
People of color just as susceptible to being diagnosed with and dying from skin cancer
Skin cancer, the most common form of cancer in the United States, according to the Skin Cancer Foundation, accounts for nearly 5.5 million cancer diagnoses, resulting in 15,000 deaths per year. This year new cases of melanoma – the most dangerous form of skin cancer – are estimated to exceed 190,000, up nearly 8 percent from 2018.1
And while regular daily use of sunscreen with a sun protection factor or SPF 15 or higher is known to reduce the risk of developing melanoma, many misperceptions exist about sun exposure for people with darker skin. The principal rule should be that sunscreen is a necessity, even for people of color, said Lavdena Orr, MD, a chief medical officer with AmeriHealth Caritas, a national leader in Medicaid managed care and other health care solutions for those most in need.
"The misperception that people of color don't need sunscreen is one we need to change because we do burn and we are susceptible to skin cancer just like everyone else," Dr. Orr said. "Ultraviolet rays don't discriminate against skin type, so avoiding sunburn is the primary way to reduce one's risk of developing melanoma or any other type of skin cancer."
Research shows that melanoma is more prevalent among whites, yet African-Americans are more likely to be diagnosed when the cancer is in its later stages, resulting in more severe prognoses and lower overall survival rates, according to a 2016 study featured in the Journal of the American Academy of Dermatology.2
Dr. Orr said African-Americans or people with darker skin should be proactive when it comes to skin care, making a point to regularly check their skin and visit a dermatologist if they notice something unusual. Ginette A. Okoye, MD, a board certified dermatologist and chair of the Department of Dermatology at Howard University Hospital in Washington, D.C., agreed, adding that she has very different conversations about sun exposure and skin care when it comes to patients with darker skin.
Since melanoma is uncommon in people with skin of color, when it does occur it tends to be found in sun-protected areas such as feet and nails, Dr. Okoye said, citing musician Bob Marley, who died from melanoma in 1981 after discovering a dark spot under a toenail that turned out to be a form of skin cancer called acral lentiginous melanoma.
"In some cases, excessive sun exposure is not necessarily the trigger for this type of cancer in skin of color," Dr. Okoye said, adding that darker skin has a natural SPF of 13. "People with pigmented skin are more likely to be vitamin D deficient since the pigment in our skin filters out sunlight which we need to produce vitamin D in the skin. So when I recommend sunscreen or other sun protective habits to patients, I discuss that these practices can increase their risk of vitamin D deficiency and that they should also consider taking a vitamin D supplement."
She added that increasing intake of vitamin D rich foods like salmon, tuna and mackerel can also help.
Even though excessive exposure to sun may not be a skin cancer trigger in all cases, Dr. Okoye still advises people of all ethnicities to be proactive and take steps to prevent sun damage to their skin. When it comes to sun protection, she believes special attention should be given to the following:
Your face: Uneven pigmentation on the face can occur with sun exposure. Wear a daily sunscreen or wear hats, visors, or caps to protect the face from direct sun exposure.
The left arm and left side of the face: These body parts generally get more sun exposure while driving, so if your commute is a long one, consider applying sunscreen to these areas or wearing a light weight long sleeve shirt for driving.
Scars or cuts: Areas of recent procedures, cuts, bruising or other trauma should be protected from the sun to decrease the intensity of post inflammatory hyperpigmentation.
Additional sun-safe suggestions, according to The Skin Cancer Foundation, include:
- Cover up: Sarongs, long sleeves, wraps and umbrellas will shade your skin and help keep you cool. Clothing is the first line of defense against the sun's rays.
- All About the Accessories: Protect your eyes and surrounding skin with UV-blocking sunglasses and wear a broad-brimmed hat to help protect your scalp, neck, face and ears.
- Made In the Shade: Avoiding the sun during the most intense hours – between 10 a.m. and 4 p.m., will save your skin, so find a large tree or beach umbrella if you must be outdoors in the morning and afternoon.
- Screen Time: Water-resistant sunscreen with an SPF of at least 30 is best for extended time outdoors. Apply 2-3 tablespoons every two hours or immediately after swimming or sweating heavily.