Melanoma in People of Color

Most skin cancer warnings are directed towards fair skinned individuals with blue eyes and blond or red hair who sunburn easily, as these individuals are at greatest risk. Given this fact, one may mistakenly assume that people with darker skin types such as Hispanics, Asians and African-Americans do not need to worry about melanoma.

This is not correct. It is true that darker-skinned races produce more melanin, the pigment that gives color to skin and hair and protects the skin against damage from ultraviolet radiation. However, increased pigmentation does protect individuals from UV – induced melanomas, but there is a type of melanoma called acral lentiginous melanoma (ALM) that occurs even without UV exposure.

This type of melanoma, which also occurs, though less frequently, in the White population, is sometimes ignored or mistaken for an injury or a nail fungus. Because this particular form of melanoma is often misdiagnosed or ignored, it is often more deeply invasive when it is finally discovered.

Common Locations for ALM

  • On the soles of the feet
  • The palms of the hands
  • Between toes and fingers
  • Under toenails and fingernails (especially the large toenail and thumbnail).

Late Diagnosis

  • By the time many African-Americans are diagnosed, melanoma has often spread to other parts of the body. A recent Washington Cancer Institute research study of 649 people with melanoma showed that 32% of African-American patients were diagnosed with Stage III or Stage IV melanoma, while only 13% of White patients were similarly diagnosed.
  • One factor that may prevent African-Americans from seeking early treatment is that they usually develop melanoma in areas that are different from Whites. A recent study showed that while 90% of White patients develop melanoma on skin that is regularly sun-exposed, only 33% of African-American patients developed it in sun-exposed areas.


Studies have shown that once African-Americans are diagnosed with melanoma, their long-term survival is significantly lower than that of Whites.

5-year survival rate:

  • 66% African-Americans
  • 94% Whites1

Note: Based on data from 2008-2014.


1. American Cancer Society. “Cancer Facts and Figures 2018”. Atlanta: American Cancer Society; 2019.

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