May is Skin Cancer Awareness Month May 14, 2012

If there is one consistent subject that I write about repeatedly in this blog it is sun protection.  There is a very good reason for that – non- melanoma skin cancer has reached epidemic rates in the US.  May is Skin Cancer Awareness Month so I wanted to share some important information about the subject with my readers.

According to The Skin Cancer Foundation:

Skin cancer is a lifestyle disease, affecting young women, older men and everyone in between. One in five Americans will develop skin cancer in the course of a lifetime; 13 million Americans are living with a history of nonmelanoma skin cancer, and nearly 800,000 Americans are living with a history of melanoma, the most dangerous form of skin cancer.

But there is good news: because skin cancer is chiefly lifestyle disease, it is also highly preventable.

“About 90 percent of nonmelanoma skin cancers and 65 percent of melanoma cases are associated with exposure to ultraviolet (UV) radiation from the sun,” says Perry Robins, MD, President of The Skin Cancer Foundation. “Everyone, regardless of skin color, should make staying safe in the sun a priority and incorporate sun protection measures into their daily life.”

In my opinion the scariest phenomena occurring right now is the rapid rise in the cases of melanoma among young women who use tanning beds.  Let me be very clear – tanning beds are not safe!  I wish the FDA would ban them entirely.  If someone tells you that tanning beds aren’t harmful they are lying to you – period.

Since skin cancer is almost entirely preventable the key to protecting yourself (and your loved ones) is in your hands.  Remember to:

• Use a broad spectrum sunscreen – 365 days a year.
• Don’t skimp on sunscreen – apply plenty of sunscreen to all exposed skin and reapply every 2 to 3 hours when outdoors.
• Seek shade and wear protective clothing when outside.
• Don’t burn!
• Never, ever use tanning beds!!
• Do self exam to check your moles and to see if you have developed any suspicious lesions.
• See a dermatologist for a professional mole check yearly.

Sources and Further Reading:

• The Skin Cancer Foundation has an excellent website that includes very important information about skin cancer and its prevention.
• If you know someone who uses tanning beds please, please have them read this article:  A Death by Suntan at Age 26.  Just be forewarned – this story is heartbreaking.
• 5 Facts about Melanoma Prevention – Skin Inc.
• This race is a way to raise awareness and money for skin cancer research
• Five Things to Know about Sunscreen – Renee Rouleau blog

Image from skinsheen.com

Autumn Sun Protection Tips October 20, 2011

Never put your sunscreen away!  Even as the temperatures start to drop you need to remember that sunscreen is as important as always.  If you question my year round committment to sun protection please keep a few things in mind (these facts are from The Skin Cancer Foundation):

The sun’s damaging ultraviolet (UV) radiationcan harm your skin, regardless of the temperature. The majority of the UV rays that hit the earth, in fact, are ultraviolet A (UVA) rays, which are present in about equal intensity throughout the year. Sun protection is a year-round commitment!

Excessive exposure to UV radiation is considered the main cause of approximately 90 percent of all skin cancers, and is also associated with eye damage, including cataracts; premature skin aging; and reduced immune system functioning.

Fall weather is usually nice enough to enable you to spend time outdoors, and many people still participate in outdoor activities this time of year along with being spectators at outdoor sporting events (baseball season isn’t over yet and football season is going strong).  If you are participating in outdoor sports and simply a spectator to a game be sure to not only use sunscreen but to also wear protective clothes, a hat, and sunglasses.  And just like you would in the summer – seek shade when outside particularly between the hours of 10 am and 4 pm.

Make sun protection a year round priority and you’ll reap the benefits of healthy and beautiful skin.

Source and Further Reading:

• Sports Fans, What’s Your Strategy for Fall?   –  The Skin Cancer Foundation

Watch Out for Photosensitivity September 15, 2011

How Your Medications or Medical Condition Could Be Making You More Sun Sensitive

 

What exactly is photosensitivity, and how do you protect yourself from it?

Photosensitivity is an abnormal increase in the skin’s sensitivity to sun exposure brought on by certain medical conditions, medications, and skincare products and treatments.  According to the Skin Cancer Foundation if you are photosensitive your skin can have a few different reactions:

A person who is photosensitive may experience some form of dermatitis, a skin rash caused by an allergy to or physical contact with a particular substance, in this case UVR. The face, outer arms, and upper chest are the most common areas for a rash due to photosensitivity.

The reaction may be either photoallergic or (more commonly) phototoxic, often in response to a specific medication. A phototoxic reaction typically shows up as an exaggerated sunburn, usually occurring within 24 hours of sun exposure. Photoallergic reactions, however, do not occur until one to three days after the substance has come into contact with the body, since they require activation of the immune system to mount the response. Photoallergy, like other allergies, tends to occur in previously sensitized individuals; repeat exposure to the same allergen plus UVR exposure can prompt a typical pruritic (itching) and eczematous reaction (red bumps, scaling, and oozing lesions, as in eczema).

There are more than a few medical conditions that can cause photosensitivity.  They include but are not limited to: lupus, dermatomyositis, actinic prurigo, chronic actinic dermatitis, polymorphous light eruption, solar urticaria, and xeroderma pigmentosum.  (For more information on each of these diseases and how they cause photosensitivity see the article Photosensitivity – A Reason To Be Even Safer in the Sun on the Skin Cancer Foundation website.)  If you happen to have one of these disorders or know someone who does be sure to check with your doctor on how to properly protect your skin from sun exposure.

Furthermore, many medications can cause photosensitivity.  According to Dr. Ellen Marmur in her book Simple Skin Beauty (pages 146-147):

Be sure to check with your pharmacist or doctor about what sun-related side effects your medications could give you.  Antibiotics such as tetracycline and sulfamethoxazole (Bactrim), some diuretics and antihistamines (such as Benadryl), nonsteroidal anti-inflammatory drugs (Feldene, Naproxen, Motrin), and some antidepressants can be phototoxic after exposure to UV light.  Researchers have found that taking these drugs also increases the risk of skin cancer if you are exposed to the sun.

For a very comprehensive list of medications that can cause photosensitivity see the chart in the Skin Cancer Foundation article Photosensitivity – A Reason To Be Even Safer in the Sun.

But before you despair if you have a medical condition or take a medication that causes photosensitivity keep a few things in mind.  Once again I’ll quote the Skin Cancer Foundation article:

Since many of the medications are vital in maintaining or restoring health and quality of life, it is important not to “throw out the baby with the bath water.” Rather than eliminating these treatments, some combination of sun avoidance and sun protection is the preferred strategy to prevent the unwanted effects of photosensitivity. By seeking shade and staying out of direct sunlight between 10 AM and 4 PM (generally the sun’s most intense hours); employing high-SPF broad spectrum sunscreens (SPF 30 or higher is advisable for photosensitive individuals); and wearing sun-protective clothing, including wide-brimmed hats and UV-blocking sunglasses, patients can continue to reap the benefits of these medications while avoiding sun damage.

Skincare Treatments and Products That Can Cause Photosensitivity

Since skincare treatments like chemical peels and microdermabrasion that cause photosensitivity are done by choice and not a health necessity you have a lot of control over when to them and how to protect your skin afterwards.  Both chemical peels and microdermabrasion remove the layers of dead skin cells on the epidermis (the top layer of the skin) which then causes sun sensitivity.  So it is advisable not to have a chemical peel or a microdermabrasion treatment done right before a tropical vacation or an outdoor adventure.  After either of those treatments be very careful to consistently reapply your sunscreen every 3 hours or so if you are outside or even if you are just sitting by a window in your office or driving around in your car.  If you get too much sun exposure following one of these treatments you could erase all the positive effects of the treatments.

As for skincare products like Retin-A that increase sun sensitivity be sure to apply them at night in order to get all the positive effects of the products without the sun sensitivity side effect.  Furthermore, according to Dr. Marmur:

Retinoids such as Retin-A, any AHA, even facial scrubs – anything that exfoliates the top layers of your skin – will make you more vulnerable to the elements.  You should probably stop using any of them one week before going on a beach vacation.  If the stratum corneum doesn’t have that dead keratinocyte barrier on top of it, you’re setting the skin up for irritation by salt water, chlorine, wind, and most of all the sun.

So be sure to error on the side of caution and speak to your doctor about this issue when receiving a prescription for any new medication.  And be smart about your timing for any skincare treatments that cause sun sensitivity.

Help Support Skin Cancer Research May 26, 2011

 

As May, Skin Cancer Awareness Month, comes to an end I wanted to highlight a few ways all of us can help support skin cancer research.

Consider donating to the Melanoma Research Alliance and/or The Skin Cancer Foundation.

Or if you prefer to donate in a more roundabout way – consider buying from one of these companies.  When you do a donation will be made to The Skin Cancer Foundation.

And remember to always set a good example when it comes to sun protection.  Never use a tanning bed and educate others on the risks of tanning beds (see my post Teens and Tanning Beds for more information).  Always apply sunscreen daily.  Wear a hat and sunglasses when you are outdoors.  Get a skin cancer screening. 

Also help out by signing a “ letter to the Surgeon General asking her to urge the FDA to enact stricter regulations and more oversight of tanning beds”.  The letter is sponsored by The Skin Cancer Foundation.

The Skin Cancer Foundation offers even more sun safe tips.

Have a great and sun safe Memorial Day Weekend!

Teens and Tanning Beds April 28, 2011

Hopefully you don’t know a teen who uses a tanning bed, but the scary thing is that too many teens do use tanning beds since they are completely unaware of the dangers involved with their use.  Once a teen starts tanning it is really hard to get them to stop (it has even been proven that tanning is addictive which is very scary).  The US lags behind other nations in banning the use of tanning beds by teens; for instance the UK has banned the use of tanning beds by anyone under the age of 18.

According to The Skin Cancer Foundation:

Despite a link between indoor tanning bed use and an increased risk of melanoma, the deadliest form of skin cancer, 2.3 million teenagers visit tanning salons every year. In the spring, many tanning salon patrons are college students getting ready for spring formals, and high school students gearing up for prom season. So it’s no surprise that melanoma is now the most common form of cancer in young adults 25-29 years old, and the second most common form of cancer in adolescents and young adults ages 15-29.

“The damage caused by the ultraviolet (UV) radiation from tanning beds and the sun is cumulative and often irreversible, and the earlier people start to tan, the higher their risk of developing skin cancer in their lifetimes,” said Perry Robins, MD, President, The Skin Cancer Foundation. “In fact, melanoma risk increases by 75 percent when indoor tanning begins before age 35.”

If the threat of skin cancer isn’t enough to scare young people away from tanning salons, they should know that 90 percent of visible skin changes commonly attributed to aging are caused by exposure to UV radiation. Tanning accelerates the signs of aging, including wrinkles, leathering and fine lines, which can be seen as early as in one’s twenties.

Despite the fact that The American Academy of Pediatrics supports a ban on the use of tanning beds by minors it is still legal for teens to use tanning beds.  The Skin Cancer Foundation points out:

In the US, tanning is regulated by the states, some of which allow children as young as 14 to tan. The US Food and Drug Administration (FDA) classifies UV-emitting tanning machines as Class I Medical Devices, meaning that it considers them to “present minimal potential for harm to the user.” Last year, the General and Plastic Surgery Devices Panel of the FDA’s Medical Devices Advisory Committee unanimously recommended that the FDA upgrade its classification of tanning devices to better reflect the serious health risks tanning machines pose. The majority of the panel was also in favor of an age restriction to limit minors’ access to UV tanning devices.

So until the FDA and/or the federal government ban the use of tanning beds by minors what can you do to prevent teens from using tanning beds?  First and foremost, I think education is key.  If scaring a teen with the risk of cancer isn’t enough to get them to stop using a tanning bed appeal to their vanity by explaining that they are aging their skin tremendously by using a tanning bed.  If you want to do even more write to the FDA and/or your senator or congressperson asking them to support a ban on tanning bed use by minors.  Recommend to a teen who really likes how their skin looks tan to get a spray tan or fake a tan with a home applied tanning lotion.  There are a tremendous number of products on the market in all price ranges so there is really no excuse not to try one if you like the way your skin looks tan.

If any of the above tactics don’t stop the teens you know from tanning have them hear a personal story about the dangers of tanning beds.  I found this story on the FDA website:

Brittany Lietz Cicala of Chesapeake Beach, Md., began tanning indoors at age 17. She stopped at age 20 when she was diagnosed with melanoma, the deadliest form of skin cancer. The former Miss Maryland says she used tanning beds at least four times a week, and sometimes every day.

“Growing up, until I started using tanning beds, my parents were very strict about me wearing sunscreen,” says Cicala. Although she also tanned in the summer sun during her 3 years of tanning bed use, Cicala estimates that 90 percent of her UV exposure was in tanning beds during this period.

In the 4 years since she was diagnosed with melanoma, Cicala’s surgeries have left her with about 25 scars. Cicala gets a head-to-toe skin exam every 3 months, which usually results in removal of a suspicious growth.

 

Sources and Further Reading:

•  An ABC World News segment about the dangers of indoor tanning including the personal story of a young woman battling melanoma.
• Lots of information about the dangers of indoor tanning can be found on this page of The Skin Cancer Foundation website.
• Indoor Tanning: The Risks of Ultraviolet Rays from the FDA.
• Teens and Melanoma – Skin Inc.
• Indoor Tanning Encouraged by Parents, Peers– Skin Inc.

   

 

 

Winter Sun Care December 15, 2010

Just because it is cold doesn’t mean you should put away your sunscreen.  Just the opposite, especially if you are going to participate in outdoor winter sports.  According to an online article in Skin Inc:

… researchers found that while UV levels can be just as high atop a snowy mountain as on a sandy beach in mid-summer, skiers and snowboarders don’t always protect their skin accordingly.  “It’s a little counterintuitive,” lead researcher Peter A. Andersen, of the School of Communication at San Diego State University in California, told Reuters Health. “But there’s an inordinate amount UV at that elevation, reflecting off the snow and coming at you from all directions. Skiers are bathed in radiation.”  … 

Andersen and his colleagues visited 32 high-altitude ski resorts in western North America, where they took a total of 4,000 UV readings—some pointed directly at the sun, others at the sky away from the sun or at the snowy slope of the mountain. On the same days, they interviewed guests on chairlifts and observed their sun-protective clothing and equipment.Not surprisingly, UV radiation peaked at midday, and was more intense during spring than winter, with clear skies and at higher altitudes and lower latitudes. Higher temperatures also played a small role. Of course, avoidance of these peak conditions does not mean absolute UV protection, the researchers say. Although UV can drop by as much as half with cloud cover, for example, there is still plenty of skin-damaging radiation that sneaks through.

“Depending on the conditions, the UV index at a ski resort can potentially be as powerful as Waikiki on a bright, sunny day,” he said, referring to the Hawaiian beach. He pointed out that his team had multiple readings of 10, or “very high,” based on the U.S. Environmental Protection Agency’s UV index. But people’s behavior didn’t always match the UV intensity, report the researchers in the Archives of Dermatology.

 

So what can you do to protect yourself from the sun while participating in outdoor winter sports?    Apply a sunscreen with spf 30 or higher every two hours while outdoors or reapply after sweating.  Cover up with gloves, hats with brims, and sunglasses while outdoors.  Any exposed skin should have sunscreen on it so be sure to apply sunscreen to your neck and ears.  And don’t forget your lips!  They need sunscreen as well – always. 

And remember these tips are for everyone even if you don’t spend a lot of time outdoors during the winter.  You still need your sunscreen if all you are doing is driving back and forth from work in your car.   Sun protection is  year round committment – never put your sunscreen away!

 

Sources and Further Reading

 

• UV Radiation as Prominent in the Snow as on the Beach – Skin Inc. – December, 2010
• Your Winter Face – The Skin Cancer Foundation
• My posts –  Winter Skincare Tips and Dos and Don’ts and Winter Skincare

Support Stricter Tanning Bed Regulations – It’s Very Easy! November 30, 2010

I recently received my monthly email update from The Skin Cancer Foundation which contained a request to help increase tanning bed regulation by sending an email to your Congressional representative about a bill that is going before Congress this month.  It turns out it is super easy to help get this cause the recognition and support it desperately needs. 

 

 

Why You Should Support Stricter Tanning Bed Regulations

 

According to The Skin Cancer Foundation :

Indoor tanners are 74 percent more likely to develop melanoma than those who have never tanned indoors.  Yet the U.S. Food and Drug Administration (FDA) currently regulates tanning beds the same way as gauze, bandages, and tongue depressors.

Tanning bed users have 2.5 times the risk of squamous cell carcinoma and 1.5 times the risk of basal cell carcinoma. These nonmelanoma skin cancers (NMSC) are the two most common skin cancers, and both can be highly disfiguring if not caught and treated in a timely manner. Basal cell carcinoma (BCC), the most common form of skin cancer, affects over a million Americans annually. Squamous cell carcinoma (SCC) can metastasize if not caught early; approximately 2,500 people in the US die every year from SCC. People with a history of NMSC face twice the risk of developing other malignancies, like lung, colon, and breast cancer.

The tanning industry relies on two misleading arguments: first, that since melanoma is mainly caused by sunburn, “controlled” tanning helps prevent melanoma by building up the protective pigment melanin; second, that UV exposure makes the skin produce vitamin D, which helps prevent breast, prostate and colon cancer, as well as other diseases.

Medical experts refute these arguments. They point out that our diet (especially vitamin D-rich foods such as dairy products and salmon) generally provides all the vitamin D we need. Furthermore, tanning to increase melanin is counterproductive. Tanning, like burning, causes genetic damage to skin cells. “You can’t protect the skin by damaging it,” said James M. Spencer, MD, director of dermatologic surgery at Mount Sinai Medical Center in New York City. “Tanning not only increases the risk for melanoma and squamous cell carcinoma, but accelerates skin aging.”

There have been several attempts made to regulate the industry, by physician groups as well as state and national congresspeople and the World Health Organization, with limited success. The FDA is weighing stricter controls over tanning devices, but has not yet instituted any changes. The tanning industry has fought all of these measures. “Tanning manufacturers and salon owners keep lobbying the FDA and state agencies to soften regulations, claiming that tanning is healthful,” said Dr. Spencer.

 

The Bill Before Congress

 

The bill that is going before Congress at the end of the month asks the FDA to look at the classification of tanning beds and reclassify them as dangerous to consumers.   That’s it.  So far there is no bill that calls for a ban on tanning beds.

What You Can Do

  

Simply fill out this online form on The Skin Cancer Foundation website.  It literally takes 30 seconds to do this.  After you’ve filled in your information the site automatically fills in the name of your representative.  Then you send the email.  Very, very simple.  I even received a reply from my congresswoman that her office had received my email the same evening that I sent my email letter.

 

Please share this information with friends and family.  It can save lives!

 

For more information about the dangers of indoor tanning please see this page on The Skin Cancer Foundation website.

 

Sunburn Relief August 16, 2010

What can I say?  I wish I didn’t have to write this post at all.  But even when you have the best intentions when it comes to sun protection sometimes you can still get a sunburn.  Hopefully once you’ve had one sunburn you’ll remember to religiously use your sunscreen in order to prevent another one because sunburns are actually a very dangerous injury to the skin, a massive trauma.  According to Allure “getting just six sunburns in your lifetime will increase your chances of developing melanoma by 50 percent”.

What is a Sunburn?

 

According to Dr. Ellen Marmur in her book Simple Skin Beauty (page 145):

The reason your skin is hot [after a sunburn] is that the sun is not only cooking you from the outside but also causing your blood vessels to dilate fully.  That redness is 100 percent due to increased vasodilation, rushing all of your repair mechanisms to the skin through the circulatory system.  When you blister, it’s because there’s a shift of fluid from where it should be, in the cells and blood vessels, to the skin tissue, making it bubble up.  A sunburn also kills basal cells, which then lose their ability to grip on to the dermis, and the loosening of the epidermis from the dermis generates blisters too.  …  To make matters worse, sunburn continues to develop for twelve to twenty-four hours after the initial burn takes place.  It’s no wonder that a sunburn (or a lot of them) can lead to skin cancer.

Signs You’re Getting a Sunburn

If you start to feel that your skin is stinging, feels sensitive, or tender you are getting a sunburn.  Of course if your skin turns red you have a sunburn.

 

What to Do Once You’ve Burned

 

• Getting a burn is actually an inflammatory response by the body so consider taking an aspirin (or two) or ibuprofen to help calm the inflammation.
• Apply fresh aloe vera to the burn.  Aloe has both anti-inflammatory and humectant properties which will help sooth the burn.  Be sure to use pure aloe vera.  Aloe vera creams and gels can contain alcohol which is drying.
• Other anti-inflammatory ingredients that can soothe your burn: black tea (apply by soaking a washcloth in the tea), shea butter, olive oil, cucumber, and allantoin.  You can even try hydrocortisone cream.
• Drink lots of water since your body loses fluids when you burn.
• Stay out of the sun for a free days after your get burned because you are at a risk to burn again.

 

What NOT to do After a Burn

 

• Avoid applying topical products with alcohol, witch hazel, menthol, peppermint, calamine, or benzocaine to your burn.
• Don’t apply milk to your burn since the lactic acid in milk can exfoliate the already injured epidermis.
• Don’t apply just plain water to the burn.  Once the water evaporates it dehydrates the skin and makes the burn feel worse.  Make sure your cold compresses are soaked in aloe or have a cream on them before applying to the burn.
• When you skin begins to peel do not pull on the peeling skin or use a body scrub on it.

 

Sources and Further Reading: 

• Simple Skin Beauty by Ellen Marmur, MD – pages 145-146
• Insider’s Guide:  How to Treat a Sunburn  – Allure July 2010
• Treating Sunburn – The Skin Cancer Foundation

Sun Protection While Driving August 6, 2010

I know there will be some people who will see the title of this post and think that I have really gone overboard with my continuing efforts to get people to use sunscreen everyday, all day.  I know many people feel they don’t need sunscreen when they only spend a small portion of their day outdoors.  Perhaps, if you are lucky, your commute to work is short.  Why do you need sun protection in that case?

Ok so think about these facts (courtesy of The Skin Cancer Foundation) for a moment:

A recent study in the Journal of the American Academy of Dermatology revealed that nearly 53 percent of skin cancers in the US occur on the left, or drivers’ side of the body.  If you’re one of the approximately 208 million licensed drivers in the US, take heed: “The increase in left-sided skin cancers may be from the UV (ultraviolet) exposure we get when driving a car,” said Susan T. Butler, MD, coauthor of the study.

The sun’s ultraviolet radiation is associated with most cases of skin cancer, which will affect one in five Americans over a lifetime.  UV radiation reaches us in the form of shortwave UVB and long-wave UVA rays, but glass blocks only UVB effectively.  Although car windshields are partially treated to filter out UVA, the side windows let in about 63 percent of the sun’s UVA radiation; rear windows are also unprotected, leaving back seat passengers exposed. 

So even your short, daily commute to and from work can expose you to unwanted UV rays and leave you vulnerable to skin cancer (not to mention wrinkles).

 

Keep a Well Stocked Car

 

Be sure to keep sunscreen in your car so that it is always around in case you need to apply it or reapply it.  When you are going on longer drives have a hat to wear in the car if you have a sun roof or drive a convertible, and don’t forget sunglasses as well.

Get protective films on your car windows that screens out UVA and UVB rays.  You can even get shades or window films that you install yourself for the back side windows in order to protect your kids from too much sun exposure while they are in the car.

 

Further reading:  Sun Safety in Cars – The Skin Cancer Foundation

Skin of Color and Skin Cancer – Everyone is at Risk July 31, 2010

There is a very simple reason why I chose to place a photo of Bob Marley at the beginning of a post on skin cancer and skin of color – Bob Marley died of melanoma at the age of 36.

The Skin Cancer Foundation has devoted a page to this subject (written by Mona Gohara, MD and Maritza Perez, MD) their website which does an excellent job at explaining the skin cancer risks that people of color face:

Caucasians are the primary victims of skin cancer. However, everyone, regardless of skin color, can fall prey to it. Unfortunately, many patients and even some physicians are under the impression that non-Caucasian people are immune to this disease. That is one reason people of color are diagnosed with skin cancer at later stages. These delays mean that skin cancers are often advanced and potentially fatal, whereas most skin cancers are curable if caught and treated in a timely manner. Tragically, this is what happened to legendary reggae musician Bob Marley: What was dismissed as a soccer injury under his toenail turned out to be an aggressive form of melanoma that ultimately caused his death at 36. Mr. Marley’s story reminds us why both medical providers and the public need to be educated about skin cancer and skin of color.  …

 Basal cell carcinoma is the most common skin cancer in Caucasians, Hispanics, Chinese, and Japanese Asians,^8-10 and the second most common skin malignancy in African Americans and Asian Indians.⁸ In all races, basal cell carcinoma is usually linked to UV light exposure. Basal cell carcinomas are mainly found on body parts that receive the most sun exposure (Figure 2). A study from Howard University, Washington, DC, revealed that 89 percent of basal cell carcinomas on naturally brown skin occur on the head or neck.⁶ The correlation between UV light and basal cell carcinoma in darker skin types explains the relatively higher incidence of this malignancy among darker-skinned populations living in sunnier climates, such as Hispanics residing in New Mexico and Arizona.^8,15

Basal cell carcinomas rarely metastasize (spread to other parts of the body). However, one study showed that when Hispanic patients develop basal cell carcinomas they are more likely to have multiple lesions either at the time of presentation or in ensuing years.¹⁶ Risk factors other than UV light for basal cell carcinoma in minority populations include previous radiation therapy, albinism (a group of genetic disorders that causes people to have a partial or total lack of melanin), trauma, burn scars (particularly among Asian Indians), other chronic scarring processes, arsenic exposure, solid organ transplantation, and genetic skin conditions.

Squamous cell carcinoma (SCC) is the most common skin malignancy among African Americans and Asian Indians, and the second most common skin cancer among Hispanics and Chinese/Japanese Asians.^6,8,17-19 Information from the Singapore Cancer Registry suggests that UV light plays an appreciable role in skin cancer development among fair-skinned Asian populations,¹⁰ and a Hawaiian study revealed that the incidence of basal cell carcinoma, squamous cell carcinoma, and Bowen’s Disease (a type of squamous cell carcinoma) was at least 45 times higher in the Japanese population of Kauai, Hawaii (a sunny climate) than among the Japanese population in Japan (a temperate climate).²⁰

UV light is not the primary risk factor for the development of squamous cell carcinoma in brown-skinned persons within the African Diaspora, and the head and neck are not the most common sites for squamous cell carcinoma. Among African Americans and native Africans, squamous cell carcinomas occur mainly on the legs, followed by the anogenital region (including both the anus and genitals) (Figure 2).^6,8,21-23 Skin conditions that result in scarring or chronic inflammation, such as discoid lupus; leprosy; burn scars and non-healing skin ulcerations are the main risk factors, along with radiation therapy and physical or thermal trauma.^6,8,21-23 Unlike the squamous cell carcinomas that most Caucasians develop, those occurring in people of African descent due to scarring or chronic inflammation can be aggressive, and have a higher tendency to lead to metastasis and death (Figure 3). One reason for this is, again, later detection and treatment.

Melanoma is the third most common type of skin cancer among all racial groups. Although UV light plays a role in the etiology of melanoma in Caucasians, the primary risk factor for melanoma in people of color is undetermined⁸, though incidence among Japanese and Hispanics residing in both Puerto Rico and South America and Hispanics residing in New Mexico have increased.^8,24-26 Among African Americans and others of African descent, Asians, Hawaiians, and Native Americans, melanomas are most likely to appear in the mouth, or in the form of acral lentiginous melanoma — melanomas on the palms of the hands, soles of the feet and under the nails (as in Bob Marley’s case) (Figures 2, 4). Among fair-skinned Hispanics, evidence suggests the trunk and legs as the most likely areas of involvement, and the feet as the most common location in dark-skinned Hispanics.

Figure 4. Acral Lentiginous Melanoma in a brown-skinned patient.

Other reported risk factors for melanoma in minority populations include: albinism, burn scars, radiation therapy, trauma, immunosuppression, and preexisting moles (especially on the palms/soles and mouth).

Due to delayed diagnoses and advanced stage at disease presentation, the five-year mortality rates of non-Caucasians who have melanoma are higher (in many instances significantly) than those of their Caucasian counterparts.²⁷

The doctors conclude their article by writing:

The US Census Bureau projects that by the year 2050, 50 percent of the US population will be comprised of Hispanics, Asians, and African Americans.²⁸ Now, more than ever, it is pivotal to raise awareness of skin cancer in people of color.

EVERYONE needs to use sun protection on a daily basis.  No matter what color your skin is if you see a suspicious lesion anywhere on your body be sure to have a dermatologist look at it immediately.

Further Reading:  Dark-skinned Clients Encouraged to Receive Skin Cancer Screenings  Skin Inc.  July, 2010