Skin cancer on Black skin can be harder to detect because many lesions are black or brown. Many dermatologists also lack familiarity with Black skin, which can delay diagnosis.

People of all skin tones can get skin cancer.

Dark skin produces larger melanocytes, which are skin cells that makes the pigment melanin. Having larger melanocytes and producing more melanin does offer some protection against skin cancer and sunburns. Despite this, people with more melanin should still use sunscreen.

Although having more melanin makes the skin less vulnerable to sun damage, it also makes many people think they cannot get skin cancer, which is not true.

This lack of awareness, as well as the fact that lesions are often dark in color, can make skin cancer on Black skin hard to detect.

Additionally, many dermatologists do not have experience diagnosing skin cancer on darker skin. This, coupled with mistaken beliefs about Black people’s vulnerability to skin cancer, can delay diagnosis.

This delay may be fatal. Late diagnosis can make cancer harder to treat. As a result, Black people are more likely to die of skin cancer, adding yet another racial inequity in healthcare.

Read more to learn about what skin cancer on Black skin looks like, how to detect it, and when to contact a doctor.

Darker skin has more melanin, a pigment that determines skin tone. Having more melanin can absorb and deflect UV radiation, protecting the skin from sun damage.

Because their skin is less vulnerable to damage, Black people have lower rates of skin cancer. For example, melanoma occurs in about 1 in 38 white people compared with 1 in 1,000 Black people.

However, this does not mean people with darker skin cannot get skin cancer. When they do get it, it often goes undiagnosed until it has reached a more advanced stage. Because advanced cancer is harder to treat, Black people are more likely to die from skin cancer.

There are three main types of skin cancer:

  • basal cell carcinoma
  • squamous cell carcinoma
  • melanoma

Both carcinomas are common and relatively easy to treat. Melanoma is more serious. It can spread quickly, and it usually requires aggressive treatment.

Basal cell carcinoma

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Squamous cell carcinoma is the second most common form of skin cancer. It develops as a result of accelerated production of squamous cells, a type of skin cell present throughout the body.
Image credit: The Pan African medical journal

Basal cell carcinoma (BCC) is most common in Hispanic and Black individuals. It looks like a dark, pearly, almost shiny growth.

BCCs are usually confined to one area and are most common on the:

  • head
  • neck
  • shoulders
  • back

Some signs of BCC to look for include:

  • a new or unusual growth on the skin
  • a smooth patch with a translucent bump
  • a growth with jelly-like contents
  • a lesion that bleeds spontaneously

Black individuals commonly get BCC that is darker and less pearly in appearance.

Squamous cell carcinoma

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Image credit: Dermnet New Zealand
Basal cell carcinoma is the most common form of skin cancer and usually occurs in areas commonly exposed to the sun. It may have rolled edges and may look like a brown or black bump on darker skin.

Squamous cell carcinoma (SCC) is the most common form of skin cancer in African Americans and Asian Indians. It usually looks like a scaly patch with a raised growth.

It can appear on any part of the body, including those that are not exposed to the sun.

Signs of SCC to look for include:

  • a hard, raised lesion
  • a flaky, scaly texture
  • soreness
  • a bump that grows over weeks or months
  • a bump that rapidly doubles in size

In its early stages, it is called Bowen’s disease, or squamous cell carcinoma in-situ. When caught early, SCC is treatable. However, it can metastasize (spread) to other parts of the body.

People who have had a kidney transplant should see a dermatologist regularly, as they are at a higher risk of SCC.


Melanoma is an aggressive form of skin cancer. Although it is less common, it is fast-growing, so it usually requires aggressive treatment.

People with darker skin have higher rates of melanomas on skin not exposed to the sun. They also are more likely to have melanomas on mucous membranes, like the:

  • eyes
  • mouth
  • genitals

Additionally, melanomas can be found:

  • under the nails
  • on the soles of the feet
  • between the toes

One reason melanomas can go undetected is because in Black skin, they most often occur on the feet, and people are less likely to examine these areas.

Some signs to look for include a mole or freckle that:

  • changes in size or shape
  • has an irregular shape
  • is an irregular color
  • is swollen or oozing
  • is multicolored

Learn more about how to identify melanomas.

Other skin cancers

The following are other forms of skin cancer. On Black skin, they can look like:

  • Dermatofibrosarcoma protuberans: a small, raised, reddish-brown patch
  • Merkel cell carcinoma: a painless, purplish lump that grows quickly
  • Sebaceous carcinoma: a round, painless lump that usually begins in the eyelid
  • Cutaneous T-cell lymphoma: an unexplained rash or round, light patches that mimic eczema

Many dermatologists do not have experience in treating people with darker skin. Implicit bias during assessment and diagnosis can also play a role, so it is important that Black people know the signs of skin cancer.

No matter what type of skin cancer a person has, detecting it early improves their outlook. Knowing the signs and symptoms of skin cancer can help a person detect suspicious skin growths early.

An individual can try:

  • Doing regular skin checks every few months: When a person is familiar with their skin, it makes it easier to detect potentially harmful changes in moles and freckles.
  • Visiting a dermatologist for an annual skin cancer screening: This is particularly important if a person has a family history of skin cancer.
  • Wearing sunscreen in the sun: Black people can burn, too. The melanin in Black skin has an estimated 13 SPF built in, but more protection is needed when spending time outside.
  • Never using tanning beds: These cause unnecessary damage.

Skin cancer usually begins as a change in the skin. This can be a new growth — like a freckle or a mole — or changes to an existing growth.

Being familiar with their skin can help a person detect abnormalities. Regular skin self-exams can help a person get to know their skin and how their moles and freckles typically look.

When people find a questionable mole or freckle, they can wonder whether or not it may be melanoma. Try using the acronym ABCDE to check growths when doing a skin exam:

  • Asymmetry: Normal moles and freckles are typically circular, and cancer can be asymmetrical. The color or shape may be irregular.
  • Border: An irregular or uneven border may signal cancer. Look for jagged edges or shifts in the color near the outside of a lesion.
  • Color: Look for irregular color patterns, like a mole that is dark in one area and light in another. Color changes in an existing mole may also signal cancer.
  • Diameter: Larger growths are more likely to be cancerous because most moles and freckles are small. Look for growths that are larger than a pea or a pencil eraser.
  • Evolving: A hallmark of cancer is that it grows — and often quickly. Sudden changes in a mole or freckle, including changes in size, shape, or color, may be an early sign of cancer.

Diagnosing skin cancer starts with an exam. A doctor will use a scope to look at suspicious skin growths.

If the growth resembles cancer, a doctor will order a biopsy. This procedure takes a small sample of the growth that a lab can test for cancer cells.

In some cases, a doctor may remove the entire growth as part of the biopsy. This prevents it from growing larger if it is cancerous. A doctor may also order blood work or additional tests if they suspect the cancer may have spread.

The first step is to surgically remove the cancerous growth. For BCC and SCC that have not spread, this is usually enough to get rid of the cancer. A doctor will then cauterize, or lightly burn, the area to stop bleeding and reduce the risk of infection.

If a person has melanoma or their cancer has spread, they may also need:

  • chemotherapy
  • targeted cancer drugs
  • additional surgeries to remove cancer that has spread to other areas of the body
  • radiation
  • topical treatments to kill the cancer

Skin cancer is highly treatable, especially in the early stages. Non-melanoma cancers, like basal cell and squamous cell carcinoma, usually require minimal treatment.

However, skin cancer often goes undiagnosed in Black individuals. This is because:

  • it can be harder to spot
  • many doctors are not experienced in catching it
  • some people think those with darker skin cannot get skin cancer

Regular skin exams are critical to diagnosing skin cancer. People who have moles or other growths on their skin should consider taking photos to monitor changes over time. They should also see a doctor for an annual skin check.