Darker Skin Tones Miss More Melanoma Diagnoses in South Florida

There's a persistent myth in dermatology that skin cancer is mostly a white person's problem. It's understandable where that idea comes from — fair skin, light eyes, and a history of sunburns are real risk factors. But that belief has a serious downside: it causes people with darker skin tones to skip screenings, dismiss unusual spots, and get diagnosed far later than they should.

In South Florida, where the population is beautifully diverse and the sun is relentless year-round, this gap in awareness can be genuinely dangerous.

Skin Cancer Absolutely Affects Darker Skin — It Just Looks Different

People with brown, Black, olive, or deeply pigmented skin can and do develop skin cancer. The difference is where it tends to show up and how it tends to look — which is exactly why it gets missed so often.

If you've been wondering about the 7 types of skin cancer, here's a plain-language breakdown of what's most relevant to know:

  1. Basal cell carcinoma (BCC) — The most common type overall. It often appears as a shiny or pearly bump, but in darker skin it can look darker, flatter, or more pigmented than the classic descriptions suggest.
  2. Squamous cell carcinoma (SCC) — The second most common. In people with darker skin tones, SCC is actually the most frequently diagnosed skin cancer. It often develops in areas that aren't sun-exposed, like the lower legs, genitals, or sites of old scars and chronic wounds.
  3. Melanoma — The most dangerous form. In darker skin tones, it tends to develop in places doctors and patients don't always think to check: under the fingernails, on the soles of the feet, or on the palms of the hands — areas with less pigment.
  4. Merkel cell carcinoma — Rare and aggressive. It appears as a flesh-colored or bluish-red nodule, usually on sun-exposed skin, though it can occur elsewhere.
  5. Dermatofibrosarcoma protuberans (DFSP) — A slow-growing but locally invasive tumor that starts in the deep layers of skin. It can look like a scar, bruise, or firm patch — easy to dismiss.
  6. Sebaceous carcinoma — Uncommon, but it affects the oil glands and often appears on or near the eyelids.
  7. Cutaneous T-cell lymphoma (CTCL) — A type of skin cancer that starts in white blood cells and can mimic eczema or psoriasis for years before a correct diagnosis is made. It's been documented more frequently in patients with darker skin, in part because it's more often confused for other conditions.

That last point is worth sitting with: several of these cancers are more likely to be misdiagnosed or diagnosed late in patients with darker skin tones — not because the cancers behave differently, but because providers and patients alike aren't always looking for them in the right places.

Can Skin Cancer Be Light Colored? Yes — and That's Part of Why It Gets Missed

One of the reasons skin cancer goes undetected in people with darker complexions is the assumption that it always shows up as a dark spot. That's simply not true.

Can skin cancer be light colored? Absolutely. Basal cell carcinoma, for example, frequently presents as a pale, pearly, or translucent bump — the kind that might be written off as a pimple that won't heal or a harmless cyst. On darker skin, that light-colored lesion can be even easier to overlook because it contrasts less obviously with the surrounding skin tone.

Squamous cell carcinoma can appear as a pink or flesh-toned scaly patch. Amelanotic melanoma — a form of melanoma that lacks the typical dark pigment — can be pink, red, or skin-colored, making it particularly easy to miss.

The takeaway: don't rely on color alone to decide whether something needs attention. A bump that's new, growing, or not healing is worth having looked at — regardless of what color it is or what color your skin is.

Which Skin Cancer Is the Most Dangerous?

Melanoma is widely considered the most dangerous form of skin cancer because of how quickly it can spread to other organs if it's not caught early. It's responsible for the vast majority of skin cancer deaths despite being less common than basal or squamous cell carcinoma.

Here's what makes melanoma particularly risky in people with darker skin: it's often diagnosed at a later stage. Bob Marley's death from acral lentiginous melanoma — a subtype that develops on the hands, feet, and under the nails — is one of the most well-known examples of how a late diagnosis can have devastating consequences. And acral lentiginous melanoma is disproportionately found in Black and Asian patients.

The five-year survival rate for melanoma caught early (while it's still localized to the skin) is well above 90 percent. When it's caught after it has spread to distant organs, that number drops sharply. Early detection isn't just helpful — it's the difference between a straightforward procedure and a serious fight.

Our team at Dermatology Experts performs year-round skin cancer screenings in South Florida precisely because the UV exposure here doesn't take a winter break, and neither should your vigilance about your skin.

Why South Florida Creates Specific Risk Factors for Everyone

South Florida's UV index is among the highest in the continental United States. Year-round sun, high humidity, and an outdoor lifestyle mean cumulative sun exposure that adds up over decades — regardless of your skin tone.

For people with darker complexions, the challenge is compounded by several factors:

If you enjoy time on the water, it's also worth knowing that boating and fishing dramatically increase your melanoma risk — a concern that applies to everyone in South Florida, regardless of skin tone.

What to Watch For on Your Own Skin

The classic ABCDE rule for melanoma still applies — Asymmetry, Border irregularity, Color variation, Diameter larger than a pencil eraser, Evolution or change over time — but there are a few additions worth knowing for darker skin:

The scalp is another commonly missed area. Our post on scalp sunburn and its dangers goes into more detail on why that area deserves attention, especially if you wear your hair in styles that leave parts or sections exposed to direct sun.

The Role of Spray Tans and Self-Tanners

One more thing worth mentioning: if you use spray tans or self-tanners to deepen your skin tone, those products can mask moles and spots in ways that make self-checks less reliable. We've written about how self-tanners can hide dangerous skin changes — it's worth a read if that applies to you, regardless of your natural skin tone.

Getting Checked Is Straightforward — and It Matters

A full-body skin exam at Dermatology Experts takes less time than most people expect. Dr. Ayar and the team look at everything — including your nail beds, the soles of your feet, and areas that are easy to miss during a self-check. If something looks concerning, we'll tell you clearly and explain exactly what the next step is. No runaround.

If you haven't had a skin check in the past year — or ever — this is a good time to schedule one. Miami-Dade, Broward, and Palm Beach County residents can be seen at our offices in Miami, Parkland, and Tamarac.

Skin cancer is treatable. Caught early, most types are highly manageable. The goal is to make sure it doesn't get missed simply because of assumptions about who it happens to.

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