We spoke with Dr. Brian Brosnan, chief of dermatology for Kaiser Permanente in Panorama City and we ask you the most frequent questions about skin care and the sun to prevent skin cancer
How common is skin cancer in dark skin and why do we mistakenly think that dark skin is more protected from the sun?
Dark complexions have a ‘built-in’ sun protection factor (SPF) of around 13 while lighter skin has an SPF closer to 3. This intrinsic partial UV protection may explain why skin cancers, including melanomas , are less common among people of color compared to people with lighter skin. However, the overall lower incidence of skin cancer has often led to a misconception that people with darker complexions are immune to the damaging effects of ultraviolet rays. This myth resurfaces when celebrities like Bob Marley, Theresa Merritt, Dayanara Torres and Kwame Nkrumah are diagnosed with skin cancer and remind us that this disease can happen to anyone.
The reality is that skin cancer does not discriminate and, in fact, it accounts for about 2% of all cancers in African Americans, 4% of all cancers in Asian people, and 5% of all cancers in Hispanic people.
Perhaps the most significant fact about skin cancer in people of color is that although the overall incidence is lower, the diagnosis of melanoma tends to occur in later and more advanced stages of the disease. According to the American Academy of Dermatology, 5-year survival rates for melanoma are much lower for people with skin of color (67% vs. 92%), exposing disparities in skin health for communities of color.
This staggering statistic points to the urgency of promoting educational efforts aimed at changing long-held myths about skin care that are passed down from generation to generation. Increasing awareness of skin cancer in dark complexions includes normalizing daily use of sunscreen and conducting a monthly self-check. Skin examinations should be performed to look for deformed moles, and the entire surface of the skin (including the inside of the mouth) should be examined, keeping in mind that melanomas can also be located in areas not exposed to the sun, such as plants of the feet.
How should we take care of both dark and light skin to protect ourselves from the sun?
Skin care for any complexion type is similar, focusing on avoiding the sun, wearing protective clothing (hats and long sleeves), avoiding sunbeds / tanning, and consistent, daily application of sunscreen with a minimum SPF of 30 (I recommend 50+ to my patients).
Zinc oxide is a favorite ingredient because it is a “physical” sunscreen that protects the skin from UVA and UVB rays. Remember to apply sunscreen ½ hour before going out in the sun and reapply it every 2 hours if you are outdoors.
It is important to remember that ultraviolet rays both on a cloudy day and on a sunny day have the same intensity. Therefore, sun protection should not be observed according to the season, but rather as a daily and healthy habit.
The best care of your skin starts at an early age. Parents should influence good sun protection habits for children from an early age, as it is estimated that most sun exposure occurs before the age of 20, and this damage may not be apparent for many years later.
What type of sun protection do you recommend for people who live in cities and for those who live in coastal or country areas?
People should get used to good sun protection habits and use sunscreen regularly, regardless of where they live
People with outdoor jobs like construction, childcare (playtime), or farming, have much more exposure to the sun and are at higher risk of getting cancer.
People who reside in rural communities or are frequently outdoors, as is often the case in coastal areas, should take extra precautions by wearing clothing with sun protection included and scheduling breaks to reapply a high sunscreen. FPS.
A study from Texas published in 2019 showed that there is much work to be done to improve skin health habits, especially in rural areas. The study revealed that rural residents were less likely to use sunscreen or seek shade compared to city dwellers. The study also indicated a higher incidence of sunburn for residents of rural communities. (J Rural Health 2019 Mar; 35 (2): 155-166).
What relationship does vitamin D have with the sun and how can we increase it in our body?
Vitamin D (D3) is important for heart health and plays a vital role in maintaining and regenerating the lining of blood vessels. Vitamin D is also essential to promote the absorption of calcium necessary to build strong bones and prevent osteoporosis.
The formation of vitamin D3 is naturally stimulated when the skin is exposed to the sun. Vitamin D3 (25-hydroxyvitamin D) is formed by the reaction of UVB rays with cholesterol precursors (7-dehydrocholesterol) in the skin. Sufficient vitamin D production from natural UV rays is estimated to require around 15 minutes of sun exposure for fair skin and 2 hours of sun exposure for dark skin.
Because sun exposure times are longer for vitamin D3 production in darker complexions, these people are susceptible to lower levels of vitamin D, and nearly 75% are classified as vitamin D deficient.
The best and healthiest way to bridge the gap between routine healthy habits in the sun (i.e. avoiding the sun) and maintaining optimal vitamin D levels is to eat a healthy diet that contains foods with vitamin D and calcium. Fortunately, many of our foods are fortified with vitamin D, and vitamin D supplements are widely available without a prescription.
For more tips on skin protection, visit kp.org and type “skin protection” in the search bar or go to: https://healthy.kaiserpermanente.org/southern-california/health-wellness/health-encyclopedia/he.skin -Cancer-protects-your-skin.uh1310