Dr. Adeline Kikam was driven to become a board-certified dermatologist because of her own struggles she faced with skincare during adolescence. During her dermatology residency, she launched the social media platform Brown Skin Derm to share scientifically backed skincare advice that specifically caters to Black and Brown women. Here, she dispels some of the most common myths associated with caring for skin of color.
1. Darker skin tones don’t get skin cancer
Skin cancers are less common in people of color compared to Caucasians and tend to occur in non-sun exposed areas of the body. However, we still see UV induced skin cancers in people of color, especially given the wide range of complexions from light to much darker skin tones that exists in Brown people.
When we do get skin cancers, it is worth knowing also that we have the poorest outcome of any group. No skin tone is immune from skin cancer.
2. People of color don’t get melanoma
Fact: Melanoma can occur in all people and racial groups. As a matter of fact, people of African descent have the lowest survival rate of melanoma of any racial group in the United States. For Caucasians, most lesions occur in sun-exposed areas of the body, whereas in darker skin patients, they tend to occur more in non-sun-exposed areas.
In people of color, and Black individuals especially, the most common subtype of melanoma is acral lentiginous melanoma. It typically presents in palmar, plantar, and subungual areas (under nails). On nails, lesions present as solitary, rapidly evolving irregular brown to black linear streaks often greater than three 3mm.
Advanced stage diagnoses of melanoma are more common in Black and Hispanic people. They have a two- to three-fold higher risk of mortality compared to Caucasians diagnosed at the same stage.
Regular self-skin exams, as well as yearly skin checks by dermatologists with particular attention to pigmented lesions in non-sun exposed acral areas, mouth, and genitalia in people of color is important.
3. Skin of color does not need sunscreen
The misconception that melanin in our skin is all-protective and we don’t need sunscreen is pervasive. Black and Brown people have increased melanin that offers some measure of protection from the sun’s harmful rays, but it is not all-protective as many would like to believe.
Overexposure to UV radiation can induce DNA damage, resulting in sunburns, premature aging, worsened hyperpigmentation by overstimulating melanin production, and skin cancers. These are all conditions people of color are susceptible to and whose risks are decreased with proper sun protection.
Sunscreens are effective in preventing skin cancer, sunburns, premature aging, and hyperpigmentation. The American Academy of Dermatology recommends using a broad-spectrum SPF of at least 30, reapplied every 2 hours for adequate protection against the impact of UVR on every skin tone.
4. Skin of color does not get sunburns
It takes longer exposure for skin of color to burn, but prolonged sun exposure can eventually lead to sunburns. Sunburn in a very light-skinned person may occur in less than 15 minutes of noonday sun exposure, while a dark-skinned person may tolerate the same exposure for hours.
Because darker skin and/or skin of color can mask the erythema or redness of UVR-induced inflammation during sunburns, active sunburn may go unnoticed by individuals of color, leading to continued sun exposure in the setting of active sunburn.
