It’s a common myth that people with darker skin can't develop skin cancer. But the truth is, anyone can — regardless of skin tone — even without a history of frequent sunburn.

“When skin cancer in people with darker skin is diagnosed later — often because some features are less visible or it’s not expected — it can lead to more advanced disease and worse outcomes,” explains Dr. Kundu. “Skin cancer awareness, early detection and prevention remain important for skin of color.” 

Why Skin Cancer Looks Different in People With Darker Skin

Melanin, the pigment that gives skin its color, offers some protection against ultraviolet (UV) radiation. This means people with darker skin are less likely to get sunburn than people with lighter skin. However, that protection is not complete.

People with darker skin can still develop skin cancer — and it often appears in less obvious places.

In people with lighter skin, skin cancer frequently develops on areas exposed to the sun, such as the face or arms. In people with dark skin, it is more likely to appear in areas, such as:

• The soles of the feet
• The palms of the hands
• Under or around fingernails and toenails
• Inside the mouth or on mucous membranes

While people of all skin tones can develop skin cancer in less obvious areas, it is more common in people with darker skin. These differences can make skin cancer harder to recognize early.

Types of Skin Cancer in People With Darker Skin

There are three main types of skin cancer, and each can affect people with darker skin tones.

Basal Cell Carcinoma

Basal cell carcinoma is the most common type of skin cancer overall. It often develops in areas exposed to the sun, such as the head and neck. In people with darker skin, it may appear as:

• A pearly bump
• A dark or translucent growth
• A sore that does not heal

Squamous Cell Carcinoma

Squamous cell carcinoma is the most common type of skin cancer in Black patients. It can develop in areas of chronic inflammation, scarring or injury — not just sun-exposed skin.

For example, it may appear in areas affected by burns, scars or long-standing wounds. It may look like:

• A firm, crusted bump
• A scaly patch
• A sore that bleeds or crusts

Melanoma

Melanoma is the deadliest form of skin cancer. In people with darker skin, the most common form is acral lentiginous melanoma (ALM).

This type of melanoma often develops on non-sun-exposed areas, especially:

• The soles of the feet
• The palms of the hands
• Under the nails

“ALM often arises on the lower extremities, especially acral sites like the soles of the feet,” says Dr. Kundu. “This makes focused awareness and careful examination of these areas important for early detection.”

Because these areas aren’t routinely checked, melanoma may go unnoticed until it reaches a more advanced stage.

Risk of Skin Cancer: What Increases It?

Although people with darker skin have a lower risk of skin cancer than those with lighter skin, several factors can increase that risk:

• Sun exposure
• Even without burning, repeated UV exposure can damage skin cells over time.
• Chronic wounds or scars
• Certain medical conditions or medications
• Family history of skin cancer

People of all backgrounds should know their own risk factors and practice regular skin checks.

Why Early Detection Matters

Skin cancer is highly treatable when caught early. But when found late, especially melanoma, it can become life-threatening.

Research shows that Black patients and other people with darker skin are more likely to be diagnosed with advanced melanoma and have lower survival rates than white patients. This is often due to delayed detection rather than biological differences.

“Raising awareness of how skin cancer can present in darker skin — where it may appear in less obvious body sites or look different than typical images — is a critical step toward earlier detection,” says Dr. Kundu. “Ultimately, this can improve outcomes.”

Even if you rarely get sunburn, it’s still important to pay attention to changes in your skin.

What To Look For: Skin Cancer Signs

Performing a monthly skin self-exam can help detect changes early. Use a mirror or ask a partner to help check hard-to-see areas.

Watch for:

• Dark spots or patches that are new or changing
• New skin growths
• Sores that do not heal or keep returning
• Bleeding or crusting areas
• Changes in existing moles
• Dark, irregular lines under or along a fingernail or toenail

Pay close attention to areas that are not typically exposed to the sun, such as the soles of the feet. You can check moles or growths for signs of melanoma using the ABCDE guide.

If anything looks unusual, consult a dermatologist.

Sun Safety for Darker Skin

Sun protection is important for everyone — including people with darker skin tones. While melanin provides some natural protection, it does not eliminate the risk of skin damage or skin cancer.

Use sunscreen daily

• Choose a broad-spectrum sunscreen with SPF 30 or higher.
• Reapply every two hours, or more often if swimming or sweating.
• Look for mineral (physical) blockers like zinc oxide or titanium dioxide.
• Consider tinted sunscreen to avoid a white cast on darker skin.

Daily sunscreen use can also help prevent hyperpigmentation, a common concern for people with darker skin.

Wear protective clothing

• Wide-brimmed hats
• Sunglasses
• Long sleeves and pants when possible
• Shoes that cover the tops of the feet and toes

Limit direct sun exposure

Avoid prolonged time in the sun during peak hours (10 am to 4 pm), when UV rays are strongest.

The Role of Specialized Care

Founded by Dr. Kundu, the Northwestern Medicine Center for Ethnic Skin and Hair is one of the first centers in the United States specifically dedicated to treating skin, hair and nail conditions in people from a range of racial and ethnic backgrounds — such as Black, Asian, Indigenous, Latino and people who are multiracial.

“Specialized care that recognizes how skin conditions can appear differently across diverse populations is essential to improving diagnostic accuracy,” says Dr. Kundu. “This helps us deliver more effective treatment.”

Taking Action: Protecting Skin Health

Everyone can take steps to reduce the risk of skin cancer and help catch it early:

• Perform monthly skin self-exams.
• Schedule routine skin checks with a dermatologist.
• Practice daily sun protection.
• Be aware of skin changes, especially in less visible areas.

“Skin cancer can impact anyone, regardless of skin color,” says Dr. Kundu. “Early detection and timely treatment remain key to improving outcomes and saving lives.”

Recognizing warning signs, practicing sun safety and checking skin regularly, including the soles of the feet and sun-protected areas, can make a lifesaving difference.