WALNUT CREEK, Calif. - Like most children, Shoko Kiyono of El Cerrito, Calif., spent countless hours of her youth playing under the sun. Kiyono, who grew up in Japan, never wore sunscreen. No one spoke about the sun's harmful rays, though she was encouraged to wear a hat to keep her face "light and pretty," she says.
The hat only did so much. Contrary to commonly held myths about skin of color, Kiyono, now 51, deals with sun damage. She burns. She has moles. And she suffers from melasma, hyperpigmentation that is exacerbated by sun exposure; and solar lentigines, or splotchy freckles, caused by the sun.
As summer nears, it is imperative that those with skin of color relinquish the idea that they are immune to sun damage, wearing sunscreen and even skin cancer. While it is true that extra melanin provides added protection against the sun's UV rays, those from African-American, Asian and Latino backgrounds have a higher mortality and morbidity rate for malignant melanoma than their white counterparts, according to Susan Taylor, a Philadelphia dermatologist and author of "Brown Skin: Dr. Susan Taylor's Prescription for Flawless Skin, Hair and Nails" (Amistad).
In eight years of dermatology, Kiyono's doctor, Tomi Wall, has seen hundreds of skin cancer in patients of color. Basal and squamous cell carcinomas are the most treatable because they often appear in visible areas such as the hands and face, and can be removed, Wall says.
Melanoma, if detected early, can be treated, but it is often discovered late for a variety of reasons: Not all melanoma is related to sun exposure; tumors often appear in places people don't look every day, such as the feet; and people with skin of color believe they are immune to skin cancer, and so do their general practitioners, Wall says.
Dermatologist Marie Jhin, who practices in San Carlos, Calif., tells of an olive-skinned Spanish patient with melanoma. Her family doctor in Spain had removed a mole when the girl was 18 and skipped the biopsy because she had "darker skin."
By the time she reached Jhin, the patient was 20 and the cancer had metastasized, spreading to her other organs.
"If you wait until it spreads to other areas, the cure rate for melanoma drops to less than 15 percent," Wall says. "I tell all my patients of color that they are at risk."
The problem is that not all skin of color is dark, and those who think they're immune don't see a specialist regularly, says Terri Dunn, a Berkeley, Calif., dermatologist.
"We do full skin checks from head to toe," Dunn says. "We check the scalp, groin, between the fingers and the toes."
Jhin's recommendation: Daily use of a sunscreen with SPF 15 is sufficient for skin of color unless there is a family history. "If you are at risk, I'd go with SPF 30," Jhin says.
Dunn concurs, adding that you should always choose a broad spectrum sunscreen, such as Neutrogena with Helioplex, and reapply sunscreen every two hours if outdoors. Today, Kiyono, of El Cerrito, is vigilant about sun protection, especially when it comes to her daughter. "I've slathered sunscreen on her since she was in preschool," she says. "I'm very aware."
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SUN AND SKIN OF COLOR
For more information, visit www.brownskin.net. To find a local dermatologist who specializes in skin of color, customize your search by visiting the American Academy of Dermatology at www.aad.org.
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(c) 2008, Contra Costa Times (Walnut Creek, Calif.). Distributed by Mclatchy-Tribune News Service.