Darker skin not immune to damage from sun's rays

By BEN LEACH

For the last three months, Jose Aponte, 32, of Egg Harbor Township, has spent 10 or more hours a day along the Atlantic City boardwalk as part of Massett's Building construction crew. In the 15 years he's worked in construction, he's never once been sunburned.

"For the most part, I stay the way you see me," Aponte said. "I might get a little dark, but it doesn't bother me."

It's easy to attribute Aponte's lack of sunburns and other problems to the color of his skin. People with African, Asian, Latino and Middle Eastern backgrounds have a greater level of protection from the sun thanks to a pigment in the skin called melanin.

"Melanin is the skin's major natural protection against skin damage," said Dr. Isaac Mordecai, a dermatologist affiliated with AtlantiCare Regional Medical Center. In people with Irish backgrounds, their lack of melanin leaves them with almost no ability to repair skin damage.

But that extra protection doesn't have all the answers. Melanoma, the most serious form of skin cancer, kills more people with skin of color than fair or light-skinned people.

For example, a Washington Cancer Institute study found that more than 32 percent of blacks with melanoma had an advanced stage of the cancer, compared with about 12 percent of whites.

Another study from Duke University showed that the risk of developing skin cancer in a mucocutaneous zone - a place on the body like the lips where nerves are closer to the skin - is more than 10 times greater in blacks than in whites.

"Most of the time, you're going to see it on their lips, palms or the soles of their fingers and toes," said Dr. Anthony Campo, a dermatologist associated with Shore Memorial Hospital in Somers Point. "They get them in areas that don't affect other people."

While these areas are more commonly affected, people with naturally darker skin have many of the same risks.

Magdi Hassan, 49, of Atlantic City, pushes a rolling chair along the boardwalk. Originally from Egypt, he's used to the sun, but he's starting to get burned from sun exposure. He only uses one form of protection.

"I have my hat," Hassan said, showing his brimmed straw hat he wears while pushing tourists around.

Many people used burned skin as the barometer for whether or not they are protected, but Dr. Susan Taylor, spokeswoman for the American Academy of Dermatology and author of "Rx for Brown Skin," said there are four major risks that people with darker skin have beyond getting burned.

First of all, a person can still get skin cancer without getting an accompanying sunburn.

The other risks can cause negative effects in both appearance and health. For example, hyperpigmentation often happens in people with darker skin.

"People often come in and ask me why the skin on their face is darker than the rest of their body," said Taylor. Sun-exposed skin darkens even already dark skin over time. It also often happens when an acne spot heals on dark skin.

But not every darker spot means hyperpigmentation or cancer, and most dermatologists can tell right away whether a patient has a problem, even if they have naturally darker skin.

"Normally, if I see people with darker skin, I see many brown moles and pigmented lesions," said Mordecai. "This pigmentation is normal and most of the time I can reassure them."

The other two risks are advanced aging and a weakened immune system. Langerhan cells - cells found in the skin that protect against harmful bacteria and other foreign bodies - are lost if the sin is exposed to too much sunlight. And wrinkles might only appear later in life.

Self examination is important with everyone, not just people with fair skin. Any changes in the skin can warrant a visit to the dermatologist.

"I don't care what your ancestry is, everyone has to come in for an exam," Taylor said.

Early detection through examination really does make a difference. Australia has the highest incidence of melanoma in the world, but an aggressive education campaign has been successful enough that Australians have a lower mortality rate from melanoma than Americans.

With beach season underway, regular applications of high-SPF sunscreens, umbrellas, hats and natural shade are recommended for anybody.

"You can still enjoy the beach," said Taylor. "But go when the sun isn't at it's strongest."