Melanoma is a potentially deadly form of skin cancer that effects people of every racial and ethnic group. The risk factor most closely linked to developing melanoma is exposure to ultraviolet, or UV, rays from the sun. In fact, sunburns have been associated with doubling one’s risk of melanoma.
Sunscreen can block UV rays and therefore reduce the risk of sunburns, which ultimately may reduce the risk of developing melanoma. Thus, the promotion of sunscreen as an effective melanoma prevention strategy is a reasonable public health message.
But while this may be true for light-skinned people, such as individuals of European descent, this is not the case for darker-skinned people, such as individuals of African or Asian descent.
The public health messages promoted by many clinicians and public health groups regarding sunscreen recommendations for dark-skinned people is not supported by the available evidence. Media messaging exacerbates the problem with headline after headline warning that Black people can also develop melanoma and that Black people are not immune.
To be sure, they can get melanoma, but the risk is very low. In the same way, men can develop breast cancer, however, we do not promote mammography as a strategy to fight breast cancer in men.
This message is important to me as a Black board-certified dermatologist and health services researcher at Dell Medical School at the University of Texas at Austin, where I am director of the pigmented lesion clinic. In this capacity I take care of patients at high risk for melanoma.
Melanoma in Black people is not associated with UV exposure
In the U.S., melanoma is 30 times more common among white people than Black people.
In Black people, melanoma usually develops in parts of the body that are not exposed to the sun, such as the palms of the hands and soles of the feet. These cancers are called “acral melanomas,” and sunscreen will do nothing to reduce the risk of these cancers.
When was the last time you had a sunburn on the palms or soles? Even among white people, there is no relationship between sun exposure and the risk of acral melanomas. Famously, Bob Marley died from an acral melanoma on his big toe, but sunscreen would not have helped.