A person with naturally brown or dark skin can spend years hearing that they do not need to worry about skin cancer. That message is unsafe. Skin cancer risk in skin of colour is lower, not zero, and delayed diagnosis can make the outcome more serious. In Australia, where UV levels are intense for much of the year, everyone needs to understand what changes deserve medical attention.
Melanin provides some natural protection from ultraviolet radiation, but it is not a force field. Skin cancer can occur in people of every skin tone, including people with Aboriginal and Torres Strait Islander heritage and people of African, Asian, Middle Eastern, South Asian, Pacific Islander and Latin American backgrounds. Knowledge can save your life – particularly when a changing spot appears in an area that is often overlooked.
Why skin cancer can be missed in skin of colour
The lower overall rate of many skin cancers in darker skin is often mistaken for no risk at all. This can lead to less sun protection, fewer conversations about suspicious spots and a longer wait before seeing a doctor. Health professionals can also face challenges identifying early changes when common teaching images show lesions only on very fair skin.
Skin cancer may be diagnosed at a later stage in people with skin of colour. The reasons are complex. A mark may be assumed to be a harmless mole, scar, bruise, fungal infection or injury. It may also develop on the sole of the foot, beneath a nail or on a mucosal surface, where it is harder to see and less likely to be checked.
Later diagnosis is not inevitable. It is a reason to pay attention to your own skin and to seek a clinical assessment promptly when something is new, changing, bleeding, painful or not healing. Every minute counts when a suspicious lesion needs investigation.
Which skin cancers matter most?
Melanoma, basal cell carcinoma and squamous cell carcinoma can all occur in skin of colour. UV exposure remains a significant risk factor, especially in a high-UV country such as Australia. Repeated unprotected exposure can damage skin cells over time, including in skin that tans easily or rarely burns.
However, not every melanoma follows the usual sun-exposure pattern. Acral lentiginous melanoma is a subtype that can occur on the palms, soles and around or beneath fingernails and toenails. It is seen across all ethnic backgrounds and is proportionally more common among people with darker skin. It is not thought to be driven primarily by sun exposure, which is why sunscreen alone is not enough for prevention and early detection.
Squamous cell carcinoma can also develop in areas of longstanding inflammation, scars, chronic wounds or burns. Skin cancer on the lip is another concern, particularly for people with substantial outdoor exposure, smoking history or previous sun damage. Any persistent lip sore or thickened, scaly patch should be assessed.
Signs of skin cancer in skin of colour
Do not wait for a lesion to match a textbook image. Skin cancers can be brown, black, blue-grey, red, pink, purple or skin-coloured. Some are raised; others are flat. A melanoma may look like a dark patch with uneven colour rather than a clearly defined mole.
Check your whole body regularly, including places that receive little sun. Use a mirror for your back, scalp and buttocks, and ask someone you trust to help if needed. Pay particular attention to your palms, soles, between toes, beneath nails, ears, lips and genital area.
Book a skin check or GP appointment if you notice any of the following:
- a new spot, patch or lump that is growing or changing in shape, colour or texture
- a dark streak under a nail, especially one that widens, becomes irregular or extends onto the surrounding skin
- a sore, scaly area, ulcer or wound that does not heal within a few weeks
- a spot that repeatedly bleeds, crusts, itches, hurts or looks different from your other marks
The ABCDE guide can still help: look for asymmetry, an irregular border, varied colour, a diameter that is growing and evolution over time. Yet size is not the deciding factor. A small spot can be concerning if it changes. The “ugly duckling” principle is useful too: a lesion that stands out from the rest of your skin deserves attention.
Sun protection still matters in Australia
Having skin that does not burn easily may change your level of risk, but it does not remove the need for sun-safe habits. UV damage is cumulative, and UV exposure can also worsen pigmentation conditions and contribute to premature skin ageing.
When the UV Index is 3 or above, protect exposed skin. In practical terms, seek shade when possible, wear clothing that covers the arms and legs, choose a broad-brimmed hat and wear sunglasses. Apply broad-spectrum, water-resistant SPF 50+ sunscreen to exposed skin and reapply according to the product directions, especially after swimming, sweating or towel drying.
Sunscreen should be one layer of protection, not a reason to stay in harsh sun for longer. For people with deeper skin tones, concerns about a white cast or irritation can make daily use less appealing. It may take trial and error to find a formula that feels comfortable and suits your skin, but clothing and shade remain highly effective options alongside sunscreen.
Vitamin D is another common concern. Most Australians can maintain vitamin D through incidental sun exposure while following sun-protection advice. If you are worried about vitamin D, particularly if you have darker skin or limited time outdoors, speak with your GP rather than deliberately seeking intense sun.
When to book a skin check
There is no single skin-check schedule that suits every person. Your doctor may recommend a different approach depending on your personal history, family history, number of moles, immune system, work and outdoor exposure. A person who works outdoors, has had a previous skin cancer, takes immunosuppressive medicine or has a close relative with melanoma may need more regular professional checks.
But a changing or non-healing lesion does not need to wait for your next routine appointment. Arrange an assessment as soon as you notice it. A GP, dermatologist or clinician experienced in skin cancer assessment can examine the area with a dermatoscope and decide whether monitoring, treatment or a biopsy is needed.
Before your appointment, note when you first saw the change and whether it has grown, bled, hurt or altered in colour. A clear photo taken in good light can help show change over time, but it is not a replacement for an in-person examination. Do not attempt to remove, freeze or treat a suspicious spot yourself.
Make checking your skin a normal habit
Skin checks are not only for fair-skinned Australians. They are for anyone with skin. For families, this means teaching children and teenagers that darker skin has natural protection but is not immune to UV damage or skin cancer. For adults, it means giving the soles of your feet, your nails and persistent sores the same attention you give a changing mole.
If a spot does not feel right, trust that concern and have it checked. The earlier skin cancer is found, the more treatment options are usually available – and a timely appointment can provide either early treatment or valuable peace of mind.