In Hawaiʻi, there’s a common misconception that people with darker skin tones aren’t at risk for skin cancer. Contrary to this belief, individuals with darker skin tones are equally susceptible so it’s important for all of us, including Native Hawaiians, to be aware of the risks of sun exposure and how to protect ourselves.
Studies have shown that people with darker skin types are less likely to apply sunscreen or take precautions to protect their skin because of the false impression that their skin is protected. However, although melanin, the pigment that causes darker skin tones, offers some protectionfrom harmful UV rays associated with most skin cancers, that protection is limited. People with darker skin tones can still get sunburnt, leading to UV damage and potentially skin cancer.
The two most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma. Typically, these types of skin cancer grow locally and destroy the healthy tissue around them. Rarely do these skin cancers spread to other parts of the body or metastasize. Warning signs of basal cell carcinoma or squamous cell skin cancer include growing bumps or growths, bleeding, crusting, painful or non-healing (chronic) wounds.
Melanoma is the third most common type of skin cancer. Although melanoma is less common, it is the most serious form of skin cancer. Melanoma can spread to other parts of the body and leads to over 10,000 deaths per year in the United States. Moles with irregularborders, multiple colors, asymmetry, changing moles or larger moles may be a sign of melanoma. People with darker skin should pay attention to areas that may seem protected from the sun as skin cancer has a tendency for occurring in these areas on darker skin tones. High-risk areas include the hands, bottom of the feet, around the fingernails and toenails, inside the mouth or in the genital area.
While skin cancer affects one in every five Americans, the rates of skin cancer in the Native Hawaiian population are not well known. According to a study conducted in the late 2000s, melanoma in Native Hawaiians was more likely to be diagnosed at a later stage (35.6 percent) compared to Caucasians (11 percent). As a result of the delayed skin cancer diagnosis for darker skin tone populations, skin cancer is often more advanced when detected and can result in a worse prognosis. Therefore, while Caucasian people are more commonly diagnosed with skin cancer, when skin cancer is detected in people of color it is often more progressed and potentially deadly. Bob Marley, a beloved Jamaican musician, is a noteworthy example of a late melanoma diagnosis that claimed the life of the reggae legend at the age of 36.
It is crucial to detect skin cancer early, when it is easiest to treat and most likely to be cured. Skin cancer is one of the few cancers that can be caught with a careful skin examination. Consequently, monthly skin self-exams and annual skin exams by a dermatologist are recommended for patients of all skin types, including Native Hawaiians.
Sun protection must be taught to our keiki, as studies have shown that sunburns sustained during childhood increase the risk of developing skin cancer later in life. It is important to use SPF 30 or greater sunscreen on a daily basis and to re-applythroughout the day. Wearing a hat, protective clothing, and UV blocking sun glasses also help protect from the sun’s powerful rays. If possible, you should limit sun exposure between the hours of 10 a.m. and 4 p.m. when the sun’s rays are the most powerful.
As a Native Hawaiian dermatologist who specializes in skin cancer surgery, I urge you to practice sun-safe habits such as wearing sunscreen, becoming aware of changing or new spots on your skin, and scheduling a periodic skin exam or when necessary by a dermatologist. Let’s work together as a community to change the dangerous misconception that Native Hawaiians do not develop skin cancer and instill in our keiki the importance of sun protection before it is too late.