Dark skin doesn’t need sunscreen, right? Wrong. It’s a common but mistaken belief that having more melanin, the biological pigment in skin that determines its shade, protects darker-skinned people from the sun.
But people with dark skin tones, of any race or ethnicity, are still susceptible to sun damage such as sunburn, hyperpigmentation, skin cancer and premature aging.
“Melanin is thought to be about an SPF of 4, so it is not enough to protect you from the sun,” says UNC Health dermatologist Priyanka Vedak, MD.
How the Sun Damages Skin—Even Darker Skin
Sun damage can occur no matter your skin tone. Ultraviolet rays from the sun cause cellular damage in the skin. Any time you get a sunburn, that’s a sign of damage to your DNA. The greater your exposure to the sun, the greater your risk of damage.
Darker skin may not show visible signs of sun damage as readily, but it’s still happening. In a survey of people of African ancestry based in the United Kingdom, 52.2 percent reported a history of sunburn.
“While it may be harder to notice redness on sunburned skin in darker skin tones, patients will still frequently experience warmth, increased skin sensitivity, tightness and itchiness,” Dr. Vedak says.
Sun damage can also lead to hyperpigmentation, in which patches of skin become darker than the normal surrounding skin. Post-inflammatory hyperpigmentation occurs when your skin produces too much melanin after it has been irritated or injured, such as by the sun.
“Excess sun exposure can worsen skin conditions that result in hyperpigmentation, and many patients with darker skin types visit a dermatologist due to concerns regarding skin pigment changes,” Dr. Vedak says.
Topical creams, gels or a trip to a dermatologist can help treat hyperpigmentation, but sometimes the condition is permanent.
Lastly, excess sun exposure leads to photoaging, which is premature aging of the skin that tends to worsen over time because of chronic sun exposure. This can happen in all skin tones. Photoaging manifests as fine lines, wrinkles, skin texture changes and benign lesions.
How Skin Cancer Happens
In short, if you have skin, you can develop skin cancer. There are three types: basal cell, squamous cell and melanoma, which is the most serious.
“Squamous and basal cell skin cancers will often look like nonhealing lesions that may be painful, grow quickly or bleed easily,” Dr. Vedak says. “In regard to acral melanoma, the most common type of melanoma in darker skin tones, lesions can be determined by their color, size and development over time.”
According to the Skin Cancer Foundation, the estimated five-year melanoma survival rate of Black patients is only 71 percent, compared with 93 percent for white patients. Black patients are more than three times as likely to be diagnosed with melanoma at a more advanced stage than non-Hispanic white patients. This could stem from a lack of awareness and socioeconomic factors such as barriers to care. In the past two decades, melanoma incidence has risen by 20 percent among Hispanic people.
With this in mind, it is critical for people of color to increase their awareness of skin cancer prevention strategies, including skin self-examination, protecting themselves from ultraviolet exposure, and starting a discussion with a primary care doctor or dermatologist to see how often they should be screened for skin cancer.
“There are no universal guidelines on skin cancer screening frequency. It is helpful to have a baseline skin exam with a dermatologist to determine how frequently you should be seen,” Dr. Vedak says.
How People of Color Can Protect Their Skin
Because skin cancer can result from the long-term effects of sun damage, it’s important to protect your skin throughout your life, Dr. Vedak says. Here’s how.
1. Wear sunscreen.
Everyone, including those with darker skin, needs to wear sunscreen every day. Putting on broad-spectrum sunscreen that blocks both UVA and UVB rays can help decrease your risk of skin cancer. Sunscreen also helps prevent hyperpigmentation and premature skin aging, including wrinkles, sagging and age spots. Dr. Vedak recommends SPF 30 or higher.
“Using tinted sunscreen with iron oxide can be beneficial for skin of color, as it protects against the visible light spectrum, and the visible light spectrum plays a role in skin disease of pigmentation. There are also several clear sunscreens that do not leave an ashy residue on the skin,” Dr. Vedak says.
2. Wear sun-protective clothing.
When possible, wear long-sleeved shirts and long pants or skirts to protect your skin from UV rays. Hats are a great way to protect your head, face and eyes. Make sure the hat has a brim all the way around that shades your face, ears and the back of your neck. Stay in the shade as much as possible, especially when the sun’s rays are at their hottest, between 10 a.m. and 4 p.m.
3. Schedule a visit with a dermatologist.
If you notice something new, changing or unusual about your skin, make an appointment with a dermatologist. Even before then, a skin check from head to toe will give your dermatologist a baseline for your skin and help develop a plan for any needed treatment or prevention strategies.
Ask your doctor about a head-to-toe skin check to look for signs of skin damage or cancer. Need a doctor? Find one near you.