Black Don't Crack? Think Again.

 

Why black people shouldn’t count on our melanin for skin cancer immunity.

 

Black Don’t Crack. But apparently black skin is not completely impervious to the sun. Or so I learned the hard way.

I went to see the dermatologist to have a “mole” on my face checked. No big deal; I’d had it a long time. But over the past six months it had changed a bit, so after slicing it off the dermatologist had it routinely biopsied. Imagine my surprise when the doctor personally called to inform me that my mole was actually a sun sarcoma containing suspicious cells—this, when another dermatologist a few years ago barely gave it a second look. 

 

My new doctor made it clear that I needed to come in sooner rather than later for treatment. Whoa, suspicious cells. Were they wearing ninja hoodies and meeting in secret to engage in terrorist activities? Kind of. They were basal cells that, if left untreated, would likely grow into a much more serious issue—like skin cancer.

 

Now, African Americans are pretty far down on the list of skin cancer candidates. Still, we shouldn’t count on our melanin for immunity. Granted, the rates in which we get infected are definitely lower than that of other populations. Perhaps because of that, we often don’t bother to get suspicious growths checked. And when we finally do make it to the dermatologist, if the diagnosis is cancer, it’s more advanced—and often more deadly. To prevent that from happening, it behooves us all to brush up on the facts about our skin, the sun and cancer.

 

Skin Cancer 101

 

The two most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma, which is sometimes called nonmelanoma skin cancer.

 

Basal cell carcinoma is the most common form of skin cancer and accounts for more than 90 percent of all skin cancers in the United States. It affects the cells that line the deepest layer of the epidermis. It’s typically a slow-growing cancer that seldom spreads to other parts of the body. 

 

Squamous cell carcinoma arises in the cells that make up the skin’s uppermost layers and can occur on all parts of the body, including mucous membranes and genitals. It rarely spreads but does so more often than basal cell carcinoma. 

 

Actinic keratoses are precancerous growths, usually caused by sun exposure. They typically look like red, scaly spots and may later develop a hard, wart-like surface. If untreated, about 1 percent develops into squamous cell carcinoma.

 

Skin cancer is found mainly on areas of the skin that are exposed to the sun—the head, face, neck, hands and arms—but it can occur anywhere. Ultraviolet radiation from the sun is the main cause of skin cancer. But artificial sources of UV radiation, like sunlamps and tanning booths, can also cause skin cancer. And there are other risk factors, like having burns or scars on the skin, a weakened immune system, previous exposure to radiation therapy and chronic skin diseases such as lupus.

 

Early Detection Is the Key to Survival

 

With any type of skin cancer or precancerous condition, early detection and treatment is critical because those abnormal cells can invade and destroy nearby tissue.

 

The first line of defense is to know your own body intimately so you you’ll be aware when something changes. Every six months, give yourself a full body exam, or have your partner check you out. Who better than your significant other to tell you that cute little heart-shaped mole on your butt is no longer so cute or so little? The most common warning sign of skin cancer is a change on the skin, especially a new growth, or a sore that doesn’t heal. It may start as a small, smooth, shiny, pale or waxy lump. It also may appear as a firm red lump that might bleed or develop a crust.

 

When checking moles, use the ABCDE’s of warning signs:

 

Asymmetry: When half of the mole does not match the other half in size.

Border: When the edges or borders of a mole are irregular, blurry and jagged.

Color: When the color of a mole is not the same. Normal spots are usually one color. A mole with more than one hue is suspicious.

Diameter: When the diameter of the mole in question is larger than the size of a normal pencil eraser.

Elevation: When part of the mole is raised or becomes elevated from the rest of the skin on the mole.

 

Treatment

 

Treatment for skin cancer and precancerous skin lesions varies, depending on the size, type, depth and location of the area. Sometimes the initial biopsy removes the entire growth and no further treatment is necessary. In my case, some of the precancerous cells remained after the excision so the doctor opted for cryosurgery. She used what looked liked a small blowtorch. Instead of a shooting out a flame, though, it shot a blast of liquid nitrogen that essentially froze the cells to death. A similar treatment is laser therapy, which uses a precise, intense beam of light to vaporize the growths. The abnormal cells can also be destroyed with topical chemotherapy medications—creams or lotions containing anti-cancer agents that are applied directly to the skin. And if surgery isn’t an option, radiation is used to destroy the cells.

 

Prevention

 

Most skin cancer can be prevented, so follow these tips to decrease your chances of getting skin cancer. The tips also help prevent wrinkles … uh, not that I’m worried about that. 

 

Wear sunscreen with an SPF of 30 or higher. Check the label and make sure it says “broad spectrum,” so it will protect from both UVA (long-wave ultraviolet rays) and UVB (short-wave ultraviolet rays).

 

Reapply sunscreen. You should re-lube every two to three  hours while in the sun and after swimming or sweating.

 

Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.

Stay out of the midday sun (from 10 in the morning to 4 in the afternoon), which is the strongest; if you must be outdoors, seek some shade.

 

Familiarize yourself with your skin. Get a thorough exam every six months.

 

So I learned my lesson. I still spend the majority of my waking hours outdoors, but now I don’t set foot outside the house without slathering on the sweat-proof, practically bulletproof, active-sport, 30-plus SPF sunscreen. And after what I’ve been through, I’ll be checking in with my dermatologist every six months—to make sure those suspicious cells aren’t planning another uprising. 

 

Alicia Villarosa is a regular contributor to The Root.