The Hidden Risk: Understanding Skin Cancer in People with Skin of Colour

Skin cancer is often associated with fair-skinned individuals who spend a lot of time in the sun. But this common perception can lead to dangerous outcomes for those with darker skin tones. While people with skin of colour – including African, Asian, Middle Eastern, Pacific Islander, and Hispanic backgrounds – are less likely to develop skin cancer, when they do, it is often more serious.

In Australia, where public health campaigns focus heavily on sun safety, it is vital to recognise that skin cancer can and does affect people with darker skin. However, it may go undetected until it has progressed.

This article explains why early skin cancer screening is important for people with skin of colour, the types of skin cancer they are more likely to develop, and what clinicians and patients can do to prevent poor outcomes.

Why Skin Cancer Is Often Missed in Skin of Colour

Darker skin contains more melanin, which offers some protection against the damaging effects of ultraviolet (UV) radiation. As a result, skin cancer is less common in these populations. But this protection is not complete.

In people of colour, skin cancers are often diagnosed at later stages. Delayed diagnosis leads to more aggressive disease and higher death rates. There are several reasons for this:

  • Lack of public awareness

  • Fewer targeted education campaigns

  • Misdiagnosis due to unusual presentation

  • Low suspicion among both patients and clinicians

Types of Skin Cancer in People with Darker Skin

1. Squamous Cell Carcinoma (SCC)

SCC is the most common skin cancer in people with darker skin. Unlike in light-skinned people, SCC in darker skin is not usually linked to sun exposure. Instead, it tends to develop in areas of chronic inflammation, scarring, burns, or wounds. Common sites include the lower legs, mouth, and genital area.

2. Melanoma (Acral Lentiginous Melanoma)

Melanoma in people with darker skin often appears on non-sun-exposed areas. Acral lentiginous melanoma is a particularly aggressive form and can appear on the soles of the feet, palms of the hands, under nails, or in the mouth. This type of melanoma is harder to spot and often diagnosed late.

3. Basal Cell Carcinoma (BCC)

While BCC is less common in darker skin, it can still occur, usually in sun-exposed areas like the face. BCC may look like a raised bump, scaly patch, or sore that does not heal.

Risk Factors Other Than the Sun

In fair-skinned individuals, UV exposure is a major cause of skin cancer. In skin of colour, other risk factors play a larger role:

  • Chronic inflammation or ulcers

  • Previous burns or scars

  • Viruses like HPV (linked to some SCCs)

  • Family history of skin cancer

  • Certain genetic conditions

These factors are often overlooked, making routine skin checks even more important in these groups.

What Clinicians in Melbourne Should Know

Doctors and skin cancer clinics in Melbourne must be aware that people of all skin tones can develop skin cancer. GPs and skin cancer screening providers should:

  • Examine non-sun-exposed areas, especially feet, nails, and mucous membranes

  • Take patient concerns seriously, even when lesions appear in unusual places

  • Encourage regular skin self-checks and education

  • Offer culturally sensitive care and communication

In areas with high ethnic diversity, like Melbourne, recognising skin cancer in skin of colour should be part of every comprehensive skin cancer check.

What Patients with Skin of Colour Should Watch For

When to See a Doctor:

  • Any new or changing spot, especially on the palms, soles, under nails, or mouth

  • Dark streaks or discolouration under the nails

  • Longstanding sores that do not heal

  • Growths in scars, burns, or previously injured skin

Regular self-checks and annual visits to a skin cancer clinic in Melbourne can make all the difference.

Prevention and Early Detection: What You Can Do

  • Get regular skin checks at a clinic that understands the nuances of skin of colour.

  • Do monthly self-exams using a mirror to check the whole body, including hard-to-see areas.

  • Report any unusual skin changes early — even if they are not painful.

  • Don’t assume you’re not at risk just because you don’t burn easily.

  • Encourage family members to learn about skin cancer signs as well.

Final Thoughts

Skin cancer can affect anyone — regardless of their skin tone. While people with darker skin are less likely to develop skin cancer, they are more likely to be diagnosed at a later stage. This leads to worse outcomes that could often be prevented with earlier detection.

If you or someone you know has darker skin and notices a persistent skin change, it is worth visiting a skin cancer clinic in Melbourne for a professional check. Early detection saves lives — no matter your skin colour.

References:

  • Halder RM, Bridgeman-Shah S. Skin cancer in African Americans. Cutis. 1995;55(3):140-145.

  • Sinclair R. Skin Checks. Australian Family Physician. 2012;41(7):464–469.

  • Culp B, et al. Skin cancer in skin of colour: A review of the literature and implications for clinical practice. PubMed