One summer Saturday in high school, I piled into a minivan with a bunch of friends and went to Six Flags amusement park. I'm a roller coaster enthusiast, and that day, after a full afternoon of corkscrew turns and topsy-turvy screaming stole my energy, I decided to sit one out and partake in a giant frozen lemonade. I nursed my treat under the unfiltered August sun, waiting for my buddies to return. About a half hour later, when I reunited with my friends, I tried to stand up and couldn't — something was really wrong. My feet, which had no sunscreen on them, appeared to be massively sunburned.
You see, while I was wearing a baseball cap, which protected my face and neck, my feet were fully exposed, and slowly baked under the sun without me noticing. I honestly didn’t feel a thing until that moment, either. It turns out though, that I was suffering from such a severe sunburn that it classified as sun poisoning, and a side of sun blisters grew on the painful ride home.
Confession: Much like Kanye on this notable verse, teenage me was in deep denial about Black people getting sunburned. I certainly learned the truth that day, via that searing pain. The misconception that darker-skinned people don’t burn (and the even sillier idea that we do not tan) has a long, storied history. And well, a simple Google search on “Can Black people sunburn?” produces more than 27 million results. That’s a lot of wondering. So, I’m here — older and wiser — to clear up a few common misconceptions on how Black skin reacts to the sun.
“Black people absolutely can sunburn,” says Kemunto Mokaya, a Black, Tennessee-based dermatologist. And though I’m sure many dermatologists of many different backgrounds can speak on skin of color in an informed way, I wanted to speak to experts that literally share my skin experience. “While dark skin has more melanin — which is excellent at absorbing the sun’s damaging ultraviolet rays — extra melanin does not make dark skin invincible and Black people can still get sunburns. Additionally, dark-skinned people are still susceptible to sun-induced skin damage like uneven pigment, sunspots, wrinkles, and even skin cancer.” It should be noted that Black and brown people are less likely to get skin cancer — but, melanoma can be deadlier for us if we do get it.
Oftentimes, the skin conditions Mokaya describes are misread as rashes, and then ignored. What sucks more is that, even when Black people opt to go to a dermatologist, they’re sometimes misdiagnosed, which is pretty awful. A 2019 NPR report found that there are significant gaps in dermatology training that result in a lack of knowledge of Black skin.
That inexperience treating darker skin tones reminds me of a Brooklyn dermatology “boutique” that once prescribed me $140 tube of cream to clear up a rash, only to call me three days later to re-prescribe me something completely different, because the doctor “rethought what she saw.” (Neither of them worked, either. And I did not get a refund.) This incident informs the reality that dermatology is overwhelmingly white — only 3% of dermatologists are Black, even though Black people make up 13.4% of the population in America.
All these facts add up to it being uniquely hard for someone like me to find a doctor that truly understands my skin. One physician-in-training who's tackling this important work co-authored a book on identifying clinical features on dark skin, which is helping fill a profound void on the topic.
So, when it comes to protecting our largest organ, what is a Black or dark-skinned person like me supposed to do? First of all, wear sunscreen. “Black people need sunscreen for a number of reasons,” starts Peterson Pierre, a Black California-based dermatologist. “First, we need protection against ultraviolet radiation to decrease our risk of skin cancer.” he says. “Also, ultraviolet radiation causes the development of free radicals which not only lead to the development of cancers but also accelerates the aging process.” Sun damage — wrinkles and other physical signs — occur at a slower, and less noticeable rate in people with darker skin, Mokaya adds, but they do indeed occur.
“Melanin is better at protecting us from UVB rays than it is from UVA rays. However UVA rays penetrate deeper into the skin and are responsible for photoaging and some skin cancers.” For a little clarification, UVB rays are what cause sunburns (and my poor aching teenage feet), but UVA rays are the long-term worry, as they play a role in skin cancer.
Mokaya also notes — and this is important — that commonly used medications can make people sensitive to the sun. These include antibiotics and antifungals, cholesterol-lowering drugs, antihistamines, diuretics, birth control pills, and some diabetes medication. She encourages everyone to talk to their doctor about any potential side effects of anything they’re prescribed. Many Black people are on one or more of these medications — particularly ones that treat diabetes — which Black people are 60% more likely to experience than their white counterparts. These folks definitely need to wear sunscreen to protect them from the photosensitizing effects of these medications, Mokaya says.
Also, because rates of skin cancer are significantly lower in Black people, our community tends to not be as vigilant about signs. That means that when skin cancer is diagnosed, it’s often at a more advanced stage, Mokaya says. For example, a 2017 study noted that Black people are four times more likely than white people to be diagnosed with advanced stage melanoma (hence, why it’s more deadly). And, just to mention it, lupus, an autoimmune disease that affects many Black people, makes affected people more sensitive to the sun.
If all of this information is making you cancel that socially distanced trip to the beach, don’t worry too much, since there are precautions you can take. First, both Mokaya and Pierre suggest wearing protective clothing when in the sun (like hats, sunglasses, UV protective clothing, and swimsuits) and to make sure you have enough sunscreen to reapply it every 1-4 hours, because sweating and being in the water will inevitably wash it away, regardless of the SPF number.
“I'm all for going out there and enjoying life” Pierre adds. “But, it’s important to use a mineral-based sunscreen with zinc oxide as it provides full spectrum protection against the harmful effects of ultraviolet radiation. There are several products on the market that work well on Black skin and rub in completely without leaving a gray hue.” Some great ones are Umbra Sheer Physical Defense and Black Girl Sunscreen.
That feels like sage advice to someone like me who was planning on wearing a caftan and sneakers outdoors for the rest of the summer.