More Than Melanin: Skin Cancer Is Still a Risk for the Black Community

As I sat in my office in December of 2019, I received a phone call from my dermatologist. She had just completed a last-minute biopsy on me two days prior. I wasn’t prepared for the news I was about to receive.

“You have skin cancer,” she told me. Within those few minutes of that call, I was diagnosed with dermatofibrosarcoma protuberans (DFSP).

My body felt hot with shame. It had likely been over a year since I had noticed an oddly shaped, raised bruise on my upper torso. I had allowed too much time to pass before going in for a dermatology consult, as advised by my primary care physician.

I was also shocked that I, a Black woman, could even be diagnosed with skin cancer.

The Black community rarely talks about skin cancer and its impact on us. Despite the massive production of t-shirts and apparel bragging about our “sun-kissed skin,” our melanin won’t save us from a skin cancer diagnosis. Melanin is a dark pigment found in the skin, eyes, and hair, which gives them color and can protect them against the harmful effects of UV light. While it offers protection, it does not promise immunity from skin cancer.

And it wasn’t basking in the sun that led to my diagnosis.

While Black people can still develop skin cancer as a result of direct sun exposure, there are many other skin cancers that are not a consequence of UV rays. DFSP is a rare form of soft tissue sarcoma—a group of cancers that affect tissues such as skin, fat, and muscle. DFSP does not stem from sun exposure, and researchers are still examining what causes the tumor.

My dermatologist recommended Mohs surgery, which I underwent in January of 2020 to remove the tumor. The process was supposed to be quick, and recovery wouldn’t be long. However, my journey took a sharp turn when my pathology report returned post-surgery. The tumor had made its way into the deep layers of my skin and grew like the roots of a tree trunk. I would need to undergo additional surgery.

Research shows that when Black people develop skin cancer, they’re often diagnosed at a late stage. This makes it harder to treat.

Pushing off your visit to the dermatologist can lead to a late diagnosis, but even being diligent and scheduling an appointment may yield the same consequences. Many dermatologists are unfamiliar with Black skin and/or are aware that Black people get skin cancer at a lower rate than others. Because of this, some dermatologists may miss the opportunity to diagnose an individual who has skin cancer early.

For individuals who have melanoma, a delay can turn deadly as it can quickly spread.

While Black people are less likely to be diagnosed with melanoma compared to White people, they also face a much greater risk of death. Barriers to care and lack of representation in dermatology only further reinforce the disparities and institutional racism the Black community faces.

In total, I underwent three surgeries and now have to visit my cancer center every six months to ensure that the tumor does not return. In sharing my journey with others, I’ve found that there is a lack of skin cancer education that lets misconceptions spread within the Black community.

How to Take Charge of Your Skin Health

Here are four things we should be doing as African Americans to ensure that we don’t ignore what our skin is trying to tell us:

Check Your Skin 

This can be done before or after showering and should be done at least once a month. 

For melanated skin, you’d want to identify anything that may look like a: 

• New dark spot (or one that changes in shape and/or size)
• A sore that won’t heal (or heals and returns)
• A rough patch of skin
• A dark line underneath or around a fingernail or toenail. 

Utilize a mirror or the assistance of a partner to check your body for any unusual skin tags, bumps, or bruises.

Wear Sunscreen Daily

As a community, we are well aware that our melanin remains our greatest protector. Despite this natural protection, we still need to shade our skin from the power of UV rays.

According to the Skin Cancer Foundation, you should wear a broad-spectrum sunscreen (SPF 15 or higher) daily. You should also try to stay out of the sun between the hours of 10 a.m. to 4 p.m., do your best not to get sunburned, and cover up. You can check out this guide from the Skin Cancer Foundation for more helpful tips on how to protect your skin.

Schedule an Annual Visit With a Dermatologist

When scheduling your annual exams, be sure to include a visit to your dermatologist. 

These medical practitioners are qualified to diagnose and treat skin disorders. Ask them to check your skin if you were unsuccessful in thoroughly completing a skin check on your own. Be sure to utilize your visit to address any concerns you may have.

If you do notice something on your skin, you’ll specifically want to ask for a biopsy. This is the only way to diagnose skin cancer and can be done during your visit.

Advocate For Yourself

There is still a lack of diversity in the medical field. Many dermatologists are unfamiliar with Black skin. Research and find a dermatologist that you believe can best fit your needs. For Black people, this may mean identifying a dermatologist who looks like you.

If that’s not possible, finding one who understands melanated skin is key. If your dermatologist won’t take your concerns seriously, find one who will.

Above all, early detection is crucial and key. Loving our melanin means we must place an emphasis on protecting it.