Perhaps the most common skin-care myth in the Black community is that, because we have more melanin than those with lighter skin, we're somehow impervious to the sun's harmful rays. Guess what? This couldn't be further from the truth. In fact, a recent study shows that Black people might be at higher risk for skin cancer — not for lack of SPF application, but because doctors aren't properly trained to spot the signs on darker skin. What?! Yeah, that's what we thought, too.
The study, published this week by STAT News, found that Black Americans are four times more likely than white Americans to be diagnosed with melanoma after their cancer has already spread. According to research from the Society for Investigative Dermatology, 50% of dermatologists reported that their medical schools failed to prepare them to diagnose cancer on Black skin. What's more, the Journal of the American Academy of Dermatology reports that only 1 in 10 residencies include a rotation that focuses on treating patients of color.
Jeanine Downie, MD, founder of Image Dermatology, says she can confirm that racial biases in medical school are very real. She tells us that not only dermatologists should be fluent in differences across a range of skin tones; physicians need to be, too. "Unfortunately, the average physician doesn't study dermatology, so for some patients of color, when they have a suspicious lesion, they're told to not worry about it when they should," she says.
Having these symptoms overlooked can be dangerous, Carlos A. Charles, MD, founder of Derma di Colore, says. "Melanoma, one of the most deadly forms of skin cancer, can occur in all skin colors and ethnicities," he tells us. "In darker skin, it commonly appears on the palms and soles, and can go overlooked for several years. Because of this unique presentation and lack of awareness of skin cancers in darker skin, lesions are often diagnosed in more advanced stages and patients tend to fare worse after diagnosis."
So, what can be done to address these issues? All of the dermatologists we spoke with say that it starts with education. Macrene Alexiades, MD, founder of anti-aging skin-care line Dr. Macrene Skin Results 37 Actives, considers herself well-versed in treating skin diseases in all ethnicities, crediting her exceptional training experience. But she understands that's not the norm. "Some universities or training programs may be located in towns that have a relatively homogeneous population," she says. "This will, by probability and statistics, greatly restrict the variety of skin types to which residents in training will be exposed. The way to compensate for this is to arrange for clinical rotations in other areas of the state, where they can have exposure to different skin types."
By the year 2050, it's projected that close to 50% of the U.S. population will be comprised of people of color. And, as of now, a large number of dermatologists is wildly under-qualified to take them on as patients. We can't ignore the biases. "Diseases don't discriminate," Dr. Charles says, even if some medical schools might.