sunscreen wouldn't have saved bob marley from melanoma, and it won't help other dark-skinned people

adewole s. adamson , university of texas at austin

melanoma is a potentially deadly form of skin cancer linked to overexposure to ultraviolet (uv) rays from the sun. sunscreen can block uv rays and therefore reduce the risk of sun burns, which ultimately reduces the risk of developing melanoma. thus, the promotion of sunscreen as an effective melanoma prevention strategy is a reasonable public health message .

while this may be true for light-skinned people, such as individuals of european descent , this is not the case for darker skinned people, or individuals of african descent.

the public health messages promoted by many clinicians and public health groups regarding sunscreen recommendations for dark skin people is incongruent with the available evidence. media messaging exacerbate the problem with headline after headline warning that black people can also develop melanoma and that blacks are not immune. to be sure, blacks 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.

melanoma in black people is not associated with uv exposure

in the u.s., melanoma is 20 to 30 times more common among whites compared to blacks.

when was the last time you had a sunburn on the palms or soles? even among whites, there is no relationship between sun exposure and the risk of acral melanomas . famously, bob marley died from an acral melanoma on his great toe, but sunscreen would not have helped.

the research on the association of uv radiation and melanoma among blacks is lacking. most studies assessing the relationship exclude patients of darker skin types. in the largest study of this question to date, no connection was found between uv index or latitude and melanoma among black people.

racial disparities in melanoma outcomes are not related to uv exposure

many dermatologists often point out that black patients tend to show up to the doctor with later stage melanoma , which is true. however, this is an issue of access and awareness and has nothing to do with sunscreen application. black people should be aware of growths on their skin and seek medical attention if they have any changing, bleeding, painful, or otherwise concerning spots, particularly on the hands and feet.

uv radiation does affect dark skin and can cause dna damage; however, the damage is seven to eight times lower than the damage done to white skin, given the natural sun-protective effect of increased melanin in darker skin. to be clear, using regular sunscreen may help with reducing other effects of the sun’s rays such as sun burns, wrinkling, photoaging and freckling, which are all positive, but for the average black person sunscreen is unlikely to reduce their low risk of melanoma any further.

melanoma public health messaging must change

this issue of regular sunscreen use in black people was made even more pressing after the release of a study last week on sunscreen absorption in the journal of the american medical association . this study showed that significant amounts of certain chemical sunscreen ingredients can get in the blood when used at maximal conditions , with unknown impacts on human health. to me, the most shocking part of the study was that most of the participants were black, the group least likely to derive any meaningful associated health benefits from sunscreen, while being exposed to potentially harmful levels of chemicals.

as dermatologists and public health advocates, we can do a better job educating patients and the public about melanoma prevention, without promoting public health messages that are grounded in fear and/or lack evidence. black people should be informed that they are at risk of developing melanoma, but that risk is low.

any dark skinned person who develops a new, changing or symptomatic mole should see their doctor, particularly if the mole is on the palms or soles. we don’t know what the risk factors are for melanoma in black or dark skinned people, but they certainly are not uv rays.

this article is republished from the conversation under a creative commons license. read the original article .

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sunscreen wouldn't have saved bob marley from melanoma, and it won't help other dark-skinned people

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