[ad_1]
Melanoma is a life-threatening form of skin cancer associated with overexposure to the sun's ultraviolet (UV) rays. The sunscreen can block UV rays and thus reduce the risk of sunburn, which ultimately reduces the risk of developing melanoma. Thus, promoting sunscreen as an effective melanoma prevention strategy is a reasonable public health message.
While this may be true for fair-skinned people, such as people of European descent, this is not the case for people with darker skin or ancestry. African.
The public health messages promoted by many clinicians and public health groups regarding sun protection recommendations for dark skinned people do not match the evidence available. Media messages exacerbate the problem, title after title, warning that blacks can also develop melanoma and that blacks are not immune. Certainly, blacks can contract melanoma, but the risk is very low. In the same way, men can develop breast cancer, but we do not advocate mammography as a strategy to fight breast cancer in men.
This message is important to me as a black dermatologist and health services specialist at the Dell Medical School of the University of Texas at Austin, where I head the Pigmented Lesion Clinic. As such, I am taking care of patients at high risk of melanoma.
Melanoma in blacks is not associated with UV exposure
In the United States, melanoma is 20 to 30 times more common among whites than among blacks.
In blacks, melanoma usually develops in parts of the body that are less exposed to the sun, such as the palms of the hands and the soles of the feet. These cancers are called "acute melanoma" and sun protection will do nothing to reduce the risk of these cancers.
When was the last time you had a sunburn on your palms or soles? Even among whites, there is no relationship between sun exposure and the risk of acral melanoma. Famous, Bob Marley died of acral melanoma on his big toe, but sunscreen would not have helped.
Research on the association of ultraviolet radiation and melanoma among blacks is lacking. Most studies evaluating the relationship exclude patients with darker skin types. In the largest study of this issue so far, no link has been found between UV index or latitude and melanoma among blacks.
Racial disparities in melanoma results are not related to UV exposure
Many dermatologists often point out that black patients tend to report to the doctor with melanoma at a later stage, which is true. However, this is an issue of access and awareness, which has nothing to do with the application of sunscreen. Blacks should be aware of the growths on their skin and consult a doctor if they have changing, bleeding, painful or other spots, especially on the hands and feet.
However, the idea that the regular application of a daily sunscreen will reduce an already extremely rare event is nonsense.
UV rays affect dark skin and can damage DNA; however, the damage is seven to eight times less than that caused to the white skin, given the natural protective effect of increasing melanin on darker skin. To be clear, the use of regular sunscreen can help reduce other effects of sun rays such as sunburn, wrinkles, photoaging and freckles, which are all positive, but it is unlikely that a sunscreen for a black person will reduce his low risk of melanoma. no further
If sun protection was important in the prevention of melanoma in dark-skinned patients, why have we never heard of a melanoma epidemic in sub-Saharan Africa, a region of intense sunlight, with lots of blacks and little sunscreen?
In certain subpopulations of black people, such as those with sun sensitivity disorders, albino patients or patients with weakened immune systems, the use of sunscreen may reduce the risk of melanoma. But if you're not in one of these categories, it's unlikely that applying sunscreen will actually mitigate the risks.
Public health messages on melanoma must change
With regard to the public health message related to sun protection, skin cancer and blacks, a unique approach does not hold. The facts simply do not agree with the recommendation of sunscreen as a way to prevent melanoma among blacks. Many dermatology and skin cancer organizations (of which I am a member) are promoting the public health message of using sunscreen to reduce the risk of melanoma in black patients. However, this message is not supported by evidence. There is no study demonstrating that sunscreen reduces the risk of skin cancer in blacks. Period.
This issue of regular use of sunscreen among blacks has become even more urgent after the publication of a study on the absorption of sunscreen published in the Journal de l'American. Medical Association last week. This study has shown that significant amounts of certain sunscreen chemical ingredients can enter the bloodstream maximum conditions, with unknown impacts on human health. For me, the most shocking part of the study was that most of the participants were black, the group least likely to derive significant health benefits from sunscreen while being exposed to potentially dangerous product concentrations. chemical.
As dermatologists and public health advocates, we can better inform patients and the public about melanoma prevention without promoting public health messages based on fear and / or lack of evidence. Blacks should be informed that they may develop melanoma, but this risk is low.
Anyone with dark skin that develops a new, changing or symptomatic mole should consult their doctor, especially if the mole is on the palms of the hands or on the soles of the feet. We do not know what are the risk factors for melanoma in people with dark or dark skin, but they are certainly not UV rays.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
[ad_2]
Source link