Skin Cancer & Skin of Color

What You Need to Know

It’s a fact: Skin cancer affects people of all colors, including those with darker skin tones who always tan or rarely burn. What’s more, for people of color, it’s often diagnosed too late, making it harder to treat. This includes people of African, Asian, Latino, Mediterranean, Middle Eastern and Native American descent.

Simply put, if you have skin, you can get skin cancers, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma. Furthermore, ultraviolet (UV) radiation from the sun can cause dangerous, lasting damage to your skin.

The most important thing to do is get to know your skin type, protect your skin from the sun, check yourself monthly and see a dermatologist once a year for a full body exam. No matter what, if you notice anything NEW, CHANGING or UNUSUAL on your skin, contact a dermatologist right away.

Skin of Color Stats

melanoma fact
In the past two decades, melanoma incidence has risen by 20% among Hispanics
  • Black patients with melanoma have an estimated five-year melanoma survival rate of 67 percent, versus 92 percent for whites.1
  • Skin cancer represents 1 to 2 percent of all cancers in Blacks.2
  • Skin cancer represents approximately 2 to 4 percent of all cancers in Asians.2
  • Skin cancer represents 4 to 5 percent of all cancers in Hispanics.3
  • Melanoma in people of color most often occurs on areas that get little sun exposure, with up to 60 to 75 percent of tumors arising on the palms of the hands, soles of the feet and the nail areas. 2
  • Black patients are more than three times as likely to be diagnosed with melanoma at a late stage than non-Hispanic white patients. 52 percent of non-Hispanic Black patients and 26 percent of Hispanic patients receive an initial diagnosis of advanced-stage melanoma, versus 16 percent of non-Hispanic white patients.4
  • In nonwhites, the plantar portion of the foot is often the most common site of skin cancer, being involved in 30 to 40 percent of cases.3
  • Squamous cell carcinoma is the most common skin cancer in Blacks.2
  • People of color have higher percentages of acral lentiginous melanoma (ALM, melanoma of the palms, soles and nailbeds) than Caucasians, whereas superficial spreading melanoma is the most frequent subtype in Caucasians and Hispanics.3
References
  1. Cancer Facts and Figures 2021. American Cancer Society.
  2. Gloster HM, Neal K. Skin cancer in skin of color. J Am Acad Dermatol 2006; 55:741-60.
  3. Bradford, Porcia T. Skin Cancer in Skin of Color. Dermatol Nurs 2009 Jul-Aug; 21(4): 170-178.
  4. Hu S, Soza-Vento RM, Parker DF, et al. Comparison of stage at diagnosis of melanoma among Hispanic, black, and white patients in Miami-Dade County, Florida. Arch Dermatol 2006; 142(6):704-8.

Bob Marley was diagnosed with acral lentiginous melanoma (ALM) which ultimately claimed his life in 1981 at age 36. When a dark spot appeared under his toenail, Marley attributed it to a soccer injury. Eventually he was diagnosed with the disease but was not treated. His melanoma spread to other areas of his body and tragically cut his life short.

Ask the Expert

Q: While all types of skin cancer are less common in people of color, their outcomes are dramatically worse. What accounts for this gap?

A: Skin cancers are less prevalent in nonwhite racial ethnic groups, but when they occur, they tend to be diagnosed at a later stage and, as a result, have a worse prognosis. One study showed that late-stage melanoma diagnoses are more common in Hispanic and Black patients than in non-Hispanic white patients.

First, there’s a lower public awareness overall of the risk of skin cancer among individuals of color. Second, from the perspective of health-care providers, there’s often a lower index of suspicion for skin cancer in patients of color, because the chances of it actually are smaller. So these patients may be less likely to get regular, full-body skin exams. And third, the places on the body where skin cancers tend to occur in people of color are often in less sun-exposed, more out-of-the-way areas, which makes detection more difficult. For example, the most common location for melanoma in patients of color is the lower extremities — the soles of the feet in particular. [Read full blog post]

– Andrew Alexis, MDMPH, is chair of the Department of Dermatology at Mount Sinai St. Luke’s and Mount Sinai West in New York City.

Late-stage melanoma diagnoses are more prevalent among Hispanic and Black patients than non-Hispanic white patients

Images

Please note: Since not all skin cancers have the same appearance, these images serve as a general reference to what it may look like.

ACRAL LENTIGINOUS MELANOMA

Acral lentiginous melanoma (ALM) is the most common melanoma found in people of color.

Acral lentiginous melanomaPhoto credit: Hugh Gloster, MD

acral lentiginous melanomaacral lentiginous melanoma

BASAL CELL CARCINOMA

A basal cell carcinoma (BCC) may be pigmented, like this one, on skin of color.

A basal cell carcinoma may be pigmented, like this one, on skin of color.Photo: Andrew Alexis, MD, MPH

Pigmented BCC

Pigmented BCCPhoto: Hugh Gloster, MD

Pigmented BCC behind the ear

Pigmented BCC behind the earPhoto: Hugh Gloster, MD

BCC on the nose of an Asian man

BCC on the nose of an Asian manPhoto: Hugh Gloster, MD

SQUAMOUS CELL CARCINOMA

Squamous cell carcinoma (SCC) on the scalp of a Black man.

CSCC on the scalp of a Black manPhoto: Hugh Gloster, MD

Last updated: Jan 2021

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