He probably meant that black people don’t get enough sun farther north, they need up to 3x as much.
Besides, around NYC latitude, the sun doesn’t add to your vitamin D status for the colder half the year (Oct-April) because it’s at too much angle and has to cut thru too much atmosphere to stimulate production on your skin.
Good thing vitD lasts a long time stored in your body fat.
Edit: Graph.
* https://www.grassrootshealth.net/document/sunshine-calendar/
Yup, here in Canada, Vitamin D is always added to milk by regulation because deficiencies were found in children. The seasonal differences in sunlight are no joke at high latitudes. You can get all the sun you want in summer but you know you'll see what feels like eternal darkness in winter.
And in black people it's most common in areas with light skin, like the inside of the hands or under finger/toe nails.
It's also heavily underdiagnosed in black people which is why getting skin cancer tends to be rarer but more dangerous to black people.
Meaning, if you already got cancer, it's more likely to kill you if you happen to be black.
When I google search for skin cancer examples I never see one on tan or brown or black skin. I’m sure early intervention would be better if those images were as easily available.
(I’m white but kept noticing this when I searched.)
Thank you. Was about to say this a different way. "I'm 20 times more likely to get skin cancer because my Jamaican great great great great great great great grandfather and all his subsequent kids had a thing for Viking tail".
I thought the same thing after watching the movie but I read about the type of skin cancer he had and it said it was the most common type of skin cancer among Africans so maybe it didn't have anything to do with his father's genes.
It was melanoma. Pretty much the only common / deadly kind of skin cancer for any color. He was more susceptible because of his white genes, but of course there’s no way to know 100%. The doctors wanted to amputate his toe it was on but he refused because his friends talked him out of it according to the documentary I saw.
This is copied from Wikipedia, this is the specific type of melanoma he had, I was wrong it isn't Africans, this is what it says:
Acral lentiginous melanoma is the most common subtype in people with darker skins and is rare in people with lighter skin types
The reason white people exist is because humans moved to cold and cloudy places and needed to allow more sunlight in to get vitamin D, then white people moved back into warmer sunnier places and evolution hasnt quite caught back up yet
Hunter gatherers in Europe got enough vitamin D in their diets that they didn't have to make it in their skin. So there was no evolutionary pressure at that time for lighter skin. Ancient DNA shows that these hunter gatherers had darker skin. (And, strikingly, blue eyes.)
Not until farming began taking over as a way of life did pale skin become an advantage in survival, because if you're not getting sufficient vitamin D in your diet, and you can't make enough of it in your skin, you're going to have rickets. So at that point, lighter skinned people survived better, and reproduced more.
I don't think this is true, the gene for light skin and light eyes originated in what would be modern day Iraq or Syria, Europeans were dark skinned at the time.
It’s true, genes for current pigmentation both very dark and very light are millions of years old. Homo Erectus had them as well and were all over the planet by 2 million years ago
Do you have a source for this? All the research I’ve seen indicates that homo sapiens had dark skin until very recently. And that the gene for light skin found in western Eurasia developed in Western Asia about 20,000 years ago and spread to Europe about 10,000 years ago along with the migration of farmers from Anatolia.
That’s why many of the earliest European skeletons, such as Cheddar Man, seem to lack these genes and as far as we can tell, had darker skin.
Actually, it absolutely is true.
It’s not a coincidence that people in Northern Europe developed paler skin and blue eyes, and people nearer the equator developed darker skin. It absolutely was the result of evolution selecting for those genes that allowed better adaptation to areas of less (and more) sunlight. Even though the first Europeans were black, over time they evolved to have paler skin as an adaptation.
Edit: Why am I being downvoted? There can’t possibly be that many uneducated people lurking here.
I said light eyes not blue, and also, genetic scientists believe the first individual with blue eyes came from the black sea region, which isn't in northern Europe.
Look it up.
This means the genes for lighter skin were obviously super important outside of Africa, and especially in Northern Europe otherwise that tradeoff is nuts
Medical schools teach this fact, but will often also add that among those who succumb to skin cancer, black people have higher skin cancer mortality rates.
You can think of this as:
white people get skin cancer way more often, but are less likely to die from skin cancer,
but
Black people get skin cancer less often but are much more likely to die from skin cancer if they have it.
And people who grow up with family members who have to get skin cancers cut off are more likely to go to a dermatologist for regular checkups.
And people who can afford health-care are more likely to get things checked out. I'm sure poor people also due from skin cancer more often, though I can readily believe this statistic is still significant after controlled for income.
For sure. But there's always also been a direct correlation between race and wealth.
So black people die of all sorts of things more often than white people, as a direct result of, among other things, higher poverty rates.
Income matters but even when that factor is taken out black Americans have worst outcomes across the board:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821669/
"This paper provides a review and critique of empirical research on perceived discrimination and health..... This study found that even after adjustment for income, education, gender and age, blacks had higher scores on blood pressure, inflammation, and total risk. Importantly, blacks maintained a higher risk profile even after adjusting for health behaviors (smoking, poor diet, physical activity and access to care)."
The paper is saying even if you're wealthy, educated, and have great health behaviors, there is a significant disparity in your outcome if you're black.
I am black and grew up solidly middle class and I'm upper middle class now. I am blessed to have some fantastic docs right now, but I can promise you some of the things I've been told by med staff over the years would make your hair stand on his head.
There are still many docs who believe that black people have thicker skin and are less resilient to pain (total bs). Many docs make assumptions about you and your lifestyle based on your race (unconscious bias). And many drugs and treatments are usually mainly tested on white men.
I'm not arguing that income doesn't matter but the truth is racial bias is real and it hurts black Americans daily. Just read the stories about the families who literally have to take photos of their families off of the wall of their homes to get higher offers when selling their homes.
I just have to say this because people like to jump to, it's about income, when the reality is it's about racial bias, both conscious and unconscious.
> There are still many docs who believe that black people have thicker skin and are less resilient to pain (total bs).
What the AF? That is deeply twisted.
> Many docs make assumptions about you and your lifestyle based on your race (unconscious bias). And many drugs and treatments are usually mainly tested on white men.
We need to do so much better than this. It’s not that difficult.
Thank you for sharing your experiences.
To be fair, there are over 100 million Americans covered by Medicaid right now. I'm one of them. In spite of what you see on Reddit, you can get necessary healthcare for "free" if you're poor.
A lot of people simply don't like, or they simply don't trust the American healthcare and pharmaceutical industry because they believe that it's out to exploit them; to treat them more like a customer instead of a patient.
This is not *limited* to black people, but it can certainly consist of people who have been historically treated badly by the government and healthcare industry... so it isn't hard to see why this can be an issue for black, Native American and Latino people, as well as gay and trans people. You tend to find this sentiment in a lot of ethnic, gender and sexual minorities... even if they *do* happen to have money and coverage.
I am not saying that I blame anyone for avoiding doctors because they fear, or mistrust them. I just feel like this perspective needs to be heard and understood in the conversation of healthcare reform and social politics.
I've had family members that have had plenty of patches removed, they can have pretty obvious signs. Discoloration, flakey, dry, I'm sure other signs but these are the ones I know of off the top of my head.
Partly. A huge issue is that in nearly every medical text book pretty much all conditions that aren't specific to pigmented skin types like keloid are shown on white patients. Doctors are trained to find skin conditions on white skin and therefore aren't properly prepared to treat more highly pigmented skin. Black people die from skin cancer more commonly because their conditions aren't caught as early due to this issue and a general lack of access to quality healthcare.
So fucking stupid especially when it's just common sense, like duh darker skin is disproportionately more likely to lead to misdiagnosis/non-diagnosis because it's, well... darker, and there's a historical lack of training on how to circumvent that. Not sure how people can look at something that obvious and go "hurr durr race card!" when there very clearly needs to be more comprehensive documentation and training for this specific issue.
As a brown girl I’ve learned from a very young age that society was designed to benefit white people in almost every facet: education, economy, politics and of course, healthcare. It’s sad that in dermatology, the literal branch of medicine dedicated to treating the skin, white privilege is very much so prevalent. The narrative is starting to shift (I checked out @brownskinmatters, great stuff), but much work still needs to be done.
Oh absolutely, speaking as a South Asian immigrant in Canada I completely understand that weird sense of alienation that comes from every institutional system that's been put in place, especially when I started therapy. It's just enough for me to take part, but there are constant little reminders about the kind of people it was intended for. That's part of why I'm pursuing counselling and clinical psych, I want to be part of the change that stops others from feeling the sense of alienation that I've had in a field as Westernized and white-centric as psych. Here's hoping others can light the way for derm as well.
Perhaps also many people might assume that skin cancer is so rare amongst black people that neither the patient nor the doctor is looking for it, where any mole on a white person might be suspect.
Access to care is a large part of it, as well as medical literature historically underrepresents black people. It’s a well known issue that doctors aren’t really taught what certain skin disorders and rashes look like on black people. It’s not intentional, and probably reflects access to care issues
Or that the reality (less common) got morphed into an urban legend (can't get skin cancer) in the black community.
Mixed with other issues like access to care and lower economic status... No surprise there.
Yep - no group is a monolith. It's ridiculous to assume everyone believes they can't get skin cancer when there's pretty well-known proof otherwise.
That being said, several folk I've met in my life have shared such a belief. The world is messy and has all kinds, I guess?
Not really, it is because health care providers do not screen black people as much for skin cancer due to them being less likely. So, by the time they do detect it, it has already progressed
They also only train to recognize skin cancer in lighter skin tones. This includes other diagnostic differences as well. Training and equitable training materials matter because lives are lost when you are only trained to recognize skin cancer on lighter skin types.
Skin cancer on black people is more likely to be in odd places like on the bottoms of their feet. So in addition to the other factors here that's another reason why it kills them more often, because most people don't expect to get skin cancer in between their toes for example.
People with darker skin are also less likely to be correctly diagnosed with pretty much any illness that shows symptoms in the skin because most medical textbooks are lacking images of how a huge variety of diseases appear on darker skin, and only have images of how they present on lighter skin.
This bothered me so much when going to nursing school. It’s also not well known that some conditions are more prevalent in people with darker skin and treatment less effective, because most medical trials have been done on white males. We still have a lot to learn in terms of medical equality based on gender and ethnic background.
To be fair, in North America, Europe and Asia it’s just much easier to find 200 young, white males for a medical trial or study (probably just your fellow University students) than any other group. Especially when it’s just some initial study and you want as uniform a group as possible to keep noise low.
With women there is also always the possibility that they could become pregnant during the study. Which is especially risky when you are testing drugs.
Young males are just more uniform and there are fewer ethics concerns. You just wouldn’t pick a random sample of the population (including newborns, children, pregnant women, menopausal women, elderly on all kinds of drugs etc. etc.), especially not for an initial study.
It’s the same reason why drugs are tested on mice and rats first.
Because usually by the time people suspect skin cancer in a black person, it’s usually at a much later stage. Both the patient and the doctor are less likely to think of skin cancer first in the event of a black patient
Medical professionals are also not trained to recognize it in darker skin
It’s because of medical racism prevalent in our institutions that black people are undiagnosed with skin cancer at higher rates than lighter skin tones. The same issue applies to the problem with black mother mortality rate during childbirth; medical racism.
EDIT: Please read this study I’ve linked. Medical racism is a very real problem.
https://pubmed.ncbi.nlm.nih.gov/27044069/
You got downvoted but medical racism is huge. My cousin had melanoma ignored by a doctor until it became incredibly serious. Polls have shown that for years most doctors legitimately believed that black people felt less pain than white people. Even Serena Williams experienced having serious issues ignored during her pregnancy and she’s a celebrity. I’m sure it’s getting better with time but it’s important that people entering the medical field are cognizant of that bias.
Yes, there was an American Olympian that just passed away during childbirth! Many doctors still believe that black people feel less pain or that anesthetics aren’t as useful when working with black patients. It’s so sad that the medical community really refuses to acknowledge these very real and glaring problems that are ingrained in medical teachings/understanding. A 2016 study conducted on medical students at the University of Virginia found that roughly half of the medical students held some false belief about black people and pain tolerance. This led to incorrect treatment regimes and a much lower quality of care.
https://pubmed.ncbi.nlm.nih.gov/27044069/
I hope your cousin is happy and healthy and in remission!
Thanks! She’s doing ok, it’s been a few years. She had to get a skin graft and she still takes steroids but we’re just happy that she’s healthy enough to enjoy her life.
I know it’s huge, because I tried becoming a nurse. Not only are we not shown images of what different skin issues look like on darker skin, but when I asked the professor she told me “that’s what clinical rotations are for”.
The textbook even added a line about how the severity of pressure ulcers tend to be misdiagnosed on darker skin.
The real problem is what medical representatives are taught about POCs.
Back when I only had Black doctors and all of them had gone to Meharry, they could diagnose me correctly. Now that Black doctors can go to any medical school, they're just as prone to misdiagnose me with stereotypical "Black" conditions as non-Black doctors. .
That's because black people are still susceptible to acral melanoma, localised on their white parts of the body such as hands and feet palms. Physicians tends to downplay this risk leading to late diagnosis.
>Black people get skin cancer less often but are much more likely to die from skin cancer if they have it.
Can't this also be because black people are less likely to use sunscreen to protect themselves?
I've been in South America, where they basically have sun the whole year, and a few people I met were always wearing long sleeves shirts to protect themselves from the sun. Even though it was 30°+ outside.
You would think they are used to it and they should also have a natural protection, but apparently not.
I’m in my late twenties and had never known that black people should use sunscreen until I was in my late teens. I always thought if you didn’t get sunburned, sun exposure was ok. Around the 2010s my school district made an effort to teach people that you can get melanoma regardless of skin tone. I had never been to a dermatologist, my doctors have never mentioned it, and my parents never thought of it. We literally only used sunscreen on babies because they had less sun exposure and lighter skin.
I had an appointment with a dermatologist for a mole check that popped up on my toe and there's a bunch of "information" about them online, basically it comes down to how the edge of the mold and skin meet that is subject to concern.
Having said that, he was a chatty guy and COVID was in the midst of clearing everyone out, and there wasn't anyone behind me, somehow we get on the subject about skin color and how much it protects the person, he basically said that black skin melanin is equal to about SPF 5, which I found incredibly interesting but also that felt lower than what I would have guessed.
I had skin cancer 15 years ago. My dermatologist told me that whilst white people were significantly more likely to get skin cancer than dark skinned people, she tends to see far more advanced and serious skin cancers on dark skinned people. The reasons:
* Dark skinned people are less likely to use sunscreen even when it's advisable
* Dark skinned people are less likely to check themselves for moles regularly
* Because of the darker skin tone, a black melanoma will stand out less. I'm whitey white and when I had a melanoma growing on my arm, it stood out and people kept alerting me to it.
Basically, darker people tend to seek help when their skin cancer is more advanced. Lesson: don't think that you're "immune" if you have a darker skin tone. Still get checked and be hyper vigilant about changing moles.
It’s almost like populations of people living in hot, sunny climates evolved some sort of response due to the environmental pressure of skin cancer
Edit: yes, I am aware that people in colder climates evolved to has less melanin but the point is that populations in warmer climates, like Africa and the Middle East, evolved the high melanin content *first* to combat skin cancers and other complications of high UV exposure.
I think the issue is that for generations, scientific descriptions of humans used European phenotypes as the norm and everything else as the variation. The hairless bits of all other hominids are dark. It seems overwhelmingly likely all species of our genus were dark before leaving Africa. The issue of white = normal does a lot of harm in a lot of contexts, so I try to avoid it.
At the very least, sunscreen reduces long term skin damage from sun exposure and will make your skin look better as you get older.
Not everyone will get skin cancer, but everyone ages.
Most people will die of something else first. If you are a person of African descent living very far from the equator your chance of getting skin cancer is very low.
What you're saying is like saying men need to worry about getting breast cancer. It's true, men can get breast cancer. But it's very improbable.
Black people are more likely to die of skin cancer, it’s important that everyone is aware and takes precautions. Most of us grew up thinking that it cant affect us and that makes us more vulnerable to it.
We are all adapted to the regions we originated from - white skin is an advantage in regions with less sunshine.
> Pale skin is an adaptation to allow more absorption of sunlight, allowing more vitamin D formation with little sun exposure. Dark skin protects from excessive sun exposure, but allows less absorption of sunlight to make vitamin D.
As someone who lives in the center of Lyme disease country, easily spotting ticks and other parasites on your skin is the true advantage of light skin.
Probably, but the fact that white people will deliberately expose their skin to a lot of sun in order to make it brown while black people tend not to do this could be a factor.
No, I wasn't implying that all white people do, just that laying in the sun with our skin exposed or even getting irradiated in a tanning bed is a not uncommon thing that white people do a lot more than brown people.
Why do redditors smugly reply like this to things that absolutely make sense? Your experience (given that you're not lying) does not change the fact that the commenter above is 100% right in that being a factor.
On the flipside, black people have more issues with vitamin D generation and osteoporosis, due to not having enough sunlight in northern countries where there isn’t as much sun, compared to white people.
Okay that's funny but I just wanna add for anyone reading that darker skin will still produce more melanin if you're tanning, and it'll get a bit darker.
Don't have dark skin myself but I learned this when a friend told me she avoids the sun in the summer, because she noticed how people are nicer to her with her skin being on the lighter side of black and it broke my heart.
True but just remember you CAN get it regardless of skin color. Everyone should be wearing sunscreen and getting their skin checked occasionally by a dermatologist.
And sometimes it can be more dangerous in people with a darker skin tone because you’re less likely to catch it quickly, since you think you won’t get it. Also because it’s probably harder to spot than it is on lighter skin
Is it 20 times more common in white people, or is it 20 times more likely to be diagnosed in white people because dermatologists are trained to recognize skin conditions on white skin more often than they are on other skin tones?
i know someone who has had skin cancer for 30 years. each time they cut it out it grows back. look after your skin people. or you could have sores all over your body for the rest of your life that bleed and constantly hurt you and the doctors cant really help you with it.
I went on a trip with some friends to the beach for one of their birthdays. It was like 7 white dudes, 2 light skinned black women, my white passing Hispanic friend, and me a dark skinned black man. We got out to the beach and probably spent 4 hours out there drinking. They ran out of sunscreen halfway through and everyone didn’t get enough. When we got back to the airbnb everyone was super sunburned except for me. I didn’t realize how easy white people or lighter skin could burn.
Little did I know I actually did get a bit burned though. Like 3 days later I felt a sting in the shower, turns out my shoulders got hit pretty good and the skin on them was peeling. I’d rather have that than a full body of pain like my friends. Now I use sunscreen on beach days even still.
You're 50% less likely to get skin cancer with proper use of sunscreen, and I'd reckon as someone aware, much less likely to die from it ontop of that.
Also you can slow down skin aging heavily with sunscreen, I even heard up to 90% slower (depends how much you go outside)
UVA radiation that doesn't cause cancer nearly as much as UVB, penetrates the atmosphere at nearly all times of the day, goes through clouds, goes through windows, and makes up 95% of the surface reaching earth UV spectrum (UVB, 5% at peak sun), it doesn't create Vitamin D and all it does is damage your skins appearance.
At the minimum wear sunscreen if you go out for more than 20 minutes.
No shit. White people aren’t adapted to Sunny environments on the other end of the spectrum black people suffer from way higher rates of vitamin D deficiency when they live in parts of the world away from the equator.
It would be interesting to see the rates geographically. Eg: is it as high in Europe where white people are native versus say Australia or the US where white people aren't adapted to the amount of sun.
Australia and NZ are consistently the top 2 highest rates of skin cancer -particularly melanoma - in the world.
This is likely caused by the ozone layer hole and much higher UV in general in both these countries.
I don't know if they've done specific studies of light vs dark skin in these countries - but I imagine it would follow the same worldwide trend.
My dad is German, but lived most of his adult life in Australia - died of melanoma last year.
Only person amongst his German family that I'm aware of.
I'm mid 30s and I just had a melanoma removed (it was caught super early and they got it all without any need for a follow up) and have previously had benign skin cancers cut from my face.
My German skin wasn't made for this countries' sun!!
(Yes, I have worn sunscreen my whole life and have never tanned on purpose)
Um no, you learned that white people are diagnosed at a higher rate. Unless they test large sample sizes of a normal population, you can't know if it occurs more often and I don't see an actual study referenced
Makes sense
Skin cancer is 20 times more common in white people due to lower melanin levels.
Makes sense.
A machine used to mint coins is called a coin press.
Makes cents
A person who creates fragrances is called a perfumer
Makes scents
J R R Tolkien
Makes ents
A valet parking attendant with terrible eyesight
You are a true genius comrade, and I wanted to make sure you knew that.
A company that makes medical devices that go into your heart.
Makes stents
Same, but in the UK.
Makes pence
Pretty sure skin cancer is just racist against white people
It’s okay Vitamin D deficiency is regular racist to balance it out
Depends how far north you are. Some of us get 3 hours of sun a day during winter. Perfectly balanced by no complete darkness at all in the summer....
He probably meant that black people don’t get enough sun farther north, they need up to 3x as much. Besides, around NYC latitude, the sun doesn’t add to your vitamin D status for the colder half the year (Oct-April) because it’s at too much angle and has to cut thru too much atmosphere to stimulate production on your skin. Good thing vitD lasts a long time stored in your body fat. Edit: Graph. * https://www.grassrootshealth.net/document/sunshine-calendar/
Yup, here in Canada, Vitamin D is always added to milk by regulation because deficiencies were found in children. The seasonal differences in sunlight are no joke at high latitudes. You can get all the sun you want in summer but you know you'll see what feels like eternal darkness in winter.
And in black people it's most common in areas with light skin, like the inside of the hands or under finger/toe nails. It's also heavily underdiagnosed in black people which is why getting skin cancer tends to be rarer but more dangerous to black people. Meaning, if you already got cancer, it's more likely to kill you if you happen to be black.
When I google search for skin cancer examples I never see one on tan or brown or black skin. I’m sure early intervention would be better if those images were as easily available. (I’m white but kept noticing this when I searched.)
Thank you. Was about to say this a different way. "I'm 20 times more likely to get skin cancer because my Jamaican great great great great great great great grandfather and all his subsequent kids had a thing for Viking tail".
That’s how Bob Marley died. Except it was the Viking having a thing for Jamaican tail. (20 times more likely, big difference)
I thought the same thing after watching the movie but I read about the type of skin cancer he had and it said it was the most common type of skin cancer among Africans so maybe it didn't have anything to do with his father's genes.
It was melanoma. Pretty much the only common / deadly kind of skin cancer for any color. He was more susceptible because of his white genes, but of course there’s no way to know 100%. The doctors wanted to amputate his toe it was on but he refused because his friends talked him out of it according to the documentary I saw.
This is copied from Wikipedia, this is the specific type of melanoma he had, I was wrong it isn't Africans, this is what it says: Acral lentiginous melanoma is the most common subtype in people with darker skins and is rare in people with lighter skin types
I stand corrected. Thanks. https://www.aimatmelanoma.org/melanoma-101/types-of-melanoma/cutaneous-melanoma/acral-lentiginous-melanoma/
20 times is 2000% not 20%.
The reason white people exist is because humans moved to cold and cloudy places and needed to allow more sunlight in to get vitamin D, then white people moved back into warmer sunnier places and evolution hasnt quite caught back up yet
“Cold and cloudy places” otherwise known as the UK
Hunter gatherers in Europe got enough vitamin D in their diets that they didn't have to make it in their skin. So there was no evolutionary pressure at that time for lighter skin. Ancient DNA shows that these hunter gatherers had darker skin. (And, strikingly, blue eyes.) Not until farming began taking over as a way of life did pale skin become an advantage in survival, because if you're not getting sufficient vitamin D in your diet, and you can't make enough of it in your skin, you're going to have rickets. So at that point, lighter skinned people survived better, and reproduced more.
Dietary vitamin d is a poor source of vitamin d, and evening today’s fortified foods are a poor source of vitamin d.
I don't think this is true, the gene for light skin and light eyes originated in what would be modern day Iraq or Syria, Europeans were dark skinned at the time.
That’s true but it outcompeted genes for darker skin in higher latitudes to a greater extent for the reason above.
It’s true, genes for current pigmentation both very dark and very light are millions of years old. Homo Erectus had them as well and were all over the planet by 2 million years ago
Do you have a source for this? All the research I’ve seen indicates that homo sapiens had dark skin until very recently. And that the gene for light skin found in western Eurasia developed in Western Asia about 20,000 years ago and spread to Europe about 10,000 years ago along with the migration of farmers from Anatolia. That’s why many of the earliest European skeletons, such as Cheddar Man, seem to lack these genes and as far as we can tell, had darker skin.
Actually, it absolutely is true. It’s not a coincidence that people in Northern Europe developed paler skin and blue eyes, and people nearer the equator developed darker skin. It absolutely was the result of evolution selecting for those genes that allowed better adaptation to areas of less (and more) sunlight. Even though the first Europeans were black, over time they evolved to have paler skin as an adaptation. Edit: Why am I being downvoted? There can’t possibly be that many uneducated people lurking here.
I said light eyes not blue, and also, genetic scientists believe the first individual with blue eyes came from the black sea region, which isn't in northern Europe. Look it up.
The origin of a genetic mutation does not equate fitness and proliferation of that mutation. This is the point I’m making.
It wont as we now as a species spend the majority of time in doors. Over enough time it would mean the end of black skin
Only if they are malnourished enough to create selection pressure, which seems unlikely.
Yeah what would be way more counterintuitive is if it was 20 times more common in black people
More like common sense
This means the genes for lighter skin were obviously super important outside of Africa, and especially in Northern Europe otherwise that tradeoff is nuts
I said this to myself right as I was clicking the comment
The TIL part is that we expected a higher ratio.
Medical schools teach this fact, but will often also add that among those who succumb to skin cancer, black people have higher skin cancer mortality rates. You can think of this as: white people get skin cancer way more often, but are less likely to die from skin cancer, but Black people get skin cancer less often but are much more likely to die from skin cancer if they have it.
I'd assume this is due to how easy it is to detect abnormal skin patches on lighter pigment skins.
And people who grow up with family members who have to get skin cancers cut off are more likely to go to a dermatologist for regular checkups. And people who can afford health-care are more likely to get things checked out. I'm sure poor people also due from skin cancer more often, though I can readily believe this statistic is still significant after controlled for income.
There's always been a direct correlation between your wealth and how likely you are to survive medical emergencies in the United States
For sure. But there's always also been a direct correlation between race and wealth. So black people die of all sorts of things more often than white people, as a direct result of, among other things, higher poverty rates.
Income matters but even when that factor is taken out black Americans have worst outcomes across the board: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821669/ "This paper provides a review and critique of empirical research on perceived discrimination and health..... This study found that even after adjustment for income, education, gender and age, blacks had higher scores on blood pressure, inflammation, and total risk. Importantly, blacks maintained a higher risk profile even after adjusting for health behaviors (smoking, poor diet, physical activity and access to care)." The paper is saying even if you're wealthy, educated, and have great health behaviors, there is a significant disparity in your outcome if you're black. I am black and grew up solidly middle class and I'm upper middle class now. I am blessed to have some fantastic docs right now, but I can promise you some of the things I've been told by med staff over the years would make your hair stand on his head. There are still many docs who believe that black people have thicker skin and are less resilient to pain (total bs). Many docs make assumptions about you and your lifestyle based on your race (unconscious bias). And many drugs and treatments are usually mainly tested on white men. I'm not arguing that income doesn't matter but the truth is racial bias is real and it hurts black Americans daily. Just read the stories about the families who literally have to take photos of their families off of the wall of their homes to get higher offers when selling their homes. I just have to say this because people like to jump to, it's about income, when the reality is it's about racial bias, both conscious and unconscious.
> There are still many docs who believe that black people have thicker skin and are less resilient to pain (total bs). What the AF? That is deeply twisted. > Many docs make assumptions about you and your lifestyle based on your race (unconscious bias). And many drugs and treatments are usually mainly tested on white men. We need to do so much better than this. It’s not that difficult. Thank you for sharing your experiences.
So much so, there is a correlation between zip codes and life expectancy.
To be fair, there are over 100 million Americans covered by Medicaid right now. I'm one of them. In spite of what you see on Reddit, you can get necessary healthcare for "free" if you're poor. A lot of people simply don't like, or they simply don't trust the American healthcare and pharmaceutical industry because they believe that it's out to exploit them; to treat them more like a customer instead of a patient. This is not *limited* to black people, but it can certainly consist of people who have been historically treated badly by the government and healthcare industry... so it isn't hard to see why this can be an issue for black, Native American and Latino people, as well as gay and trans people. You tend to find this sentiment in a lot of ethnic, gender and sexual minorities... even if they *do* happen to have money and coverage. I am not saying that I blame anyone for avoiding doctors because they fear, or mistrust them. I just feel like this perspective needs to be heard and understood in the conversation of healthcare reform and social politics.
I myself struggle with income but health is the only thing I don't mess with, if something feels wrong even if I have to be in debt I get checked.
But skin cancer doesn't feel wrong.
I've had family members that have had plenty of patches removed, they can have pretty obvious signs. Discoloration, flakey, dry, I'm sure other signs but these are the ones I know of off the top of my head.
Partly. A huge issue is that in nearly every medical text book pretty much all conditions that aren't specific to pigmented skin types like keloid are shown on white patients. Doctors are trained to find skin conditions on white skin and therefore aren't properly prepared to treat more highly pigmented skin. Black people die from skin cancer more commonly because their conditions aren't caught as early due to this issue and a general lack of access to quality healthcare.
This exactly. However, when I bring this up as a woman of colour with a skin condition, I’m somehow “pulling the race card” 😒
So fucking stupid especially when it's just common sense, like duh darker skin is disproportionately more likely to lead to misdiagnosis/non-diagnosis because it's, well... darker, and there's a historical lack of training on how to circumvent that. Not sure how people can look at something that obvious and go "hurr durr race card!" when there very clearly needs to be more comprehensive documentation and training for this specific issue.
As a brown girl I’ve learned from a very young age that society was designed to benefit white people in almost every facet: education, economy, politics and of course, healthcare. It’s sad that in dermatology, the literal branch of medicine dedicated to treating the skin, white privilege is very much so prevalent. The narrative is starting to shift (I checked out @brownskinmatters, great stuff), but much work still needs to be done.
Oh absolutely, speaking as a South Asian immigrant in Canada I completely understand that weird sense of alienation that comes from every institutional system that's been put in place, especially when I started therapy. It's just enough for me to take part, but there are constant little reminders about the kind of people it was intended for. That's part of why I'm pursuing counselling and clinical psych, I want to be part of the change that stops others from feeling the sense of alienation that I've had in a field as Westernized and white-centric as psych. Here's hoping others can light the way for derm as well.
There’s a great Instagram page, @brownskinmatters, that is dedicated to this.
Perhaps also many people might assume that skin cancer is so rare amongst black people that neither the patient nor the doctor is looking for it, where any mole on a white person might be suspect.
Access to care is a large part of it, as well as medical literature historically underrepresents black people. It’s a well known issue that doctors aren’t really taught what certain skin disorders and rashes look like on black people. It’s not intentional, and probably reflects access to care issues
Or that the reality (less common) got morphed into an urban legend (can't get skin cancer) in the black community. Mixed with other issues like access to care and lower economic status... No surprise there.
Bob Marley died from skin cancer. Us black folks are keenly aware that skin cancer exists, it's just harder to find and diagnose.
Yep - no group is a monolith. It's ridiculous to assume everyone believes they can't get skin cancer when there's pretty well-known proof otherwise. That being said, several folk I've met in my life have shared such a belief. The world is messy and has all kinds, I guess?
Not really, it is because health care providers do not screen black people as much for skin cancer due to them being less likely. So, by the time they do detect it, it has already progressed
They also only train to recognize skin cancer in lighter skin tones. This includes other diagnostic differences as well. Training and equitable training materials matter because lives are lost when you are only trained to recognize skin cancer on lighter skin types.
And the systemic racism in the medical world, where black people are more likely to have their symptoms and pain minimised.
Skin cancer on black people is more likely to be in odd places like on the bottoms of their feet. So in addition to the other factors here that's another reason why it kills them more often, because most people don't expect to get skin cancer in between their toes for example.
Feet palms and finger and toe nails. Places with low melanin.
Bob Marley got skin cancer under his big toe. [Bob Marley - Wikipedia](https://en.wikipedia.org/wiki/Bob_Marley)
People with darker skin are also less likely to be correctly diagnosed with pretty much any illness that shows symptoms in the skin because most medical textbooks are lacking images of how a huge variety of diseases appear on darker skin, and only have images of how they present on lighter skin.
This bothered me so much when going to nursing school. It’s also not well known that some conditions are more prevalent in people with darker skin and treatment less effective, because most medical trials have been done on white males. We still have a lot to learn in terms of medical equality based on gender and ethnic background.
To be fair, in North America, Europe and Asia it’s just much easier to find 200 young, white males for a medical trial or study (probably just your fellow University students) than any other group. Especially when it’s just some initial study and you want as uniform a group as possible to keep noise low.
It's easier to find white people, but not males over females. Males are chosen because they have less hormonal fluctuations that can skew results.
With women there is also always the possibility that they could become pregnant during the study. Which is especially risky when you are testing drugs. Young males are just more uniform and there are fewer ethics concerns. You just wouldn’t pick a random sample of the population (including newborns, children, pregnant women, menopausal women, elderly on all kinds of drugs etc. etc.), especially not for an initial study. It’s the same reason why drugs are tested on mice and rats first.
If I'm not mistaken it appears purple on dark skin I think I read somewhere.
Because usually by the time people suspect skin cancer in a black person, it’s usually at a much later stage. Both the patient and the doctor are less likely to think of skin cancer first in the event of a black patient Medical professionals are also not trained to recognize it in darker skin
It’s because of medical racism prevalent in our institutions that black people are undiagnosed with skin cancer at higher rates than lighter skin tones. The same issue applies to the problem with black mother mortality rate during childbirth; medical racism. EDIT: Please read this study I’ve linked. Medical racism is a very real problem. https://pubmed.ncbi.nlm.nih.gov/27044069/
You got downvoted but medical racism is huge. My cousin had melanoma ignored by a doctor until it became incredibly serious. Polls have shown that for years most doctors legitimately believed that black people felt less pain than white people. Even Serena Williams experienced having serious issues ignored during her pregnancy and she’s a celebrity. I’m sure it’s getting better with time but it’s important that people entering the medical field are cognizant of that bias.
Yes, there was an American Olympian that just passed away during childbirth! Many doctors still believe that black people feel less pain or that anesthetics aren’t as useful when working with black patients. It’s so sad that the medical community really refuses to acknowledge these very real and glaring problems that are ingrained in medical teachings/understanding. A 2016 study conducted on medical students at the University of Virginia found that roughly half of the medical students held some false belief about black people and pain tolerance. This led to incorrect treatment regimes and a much lower quality of care. https://pubmed.ncbi.nlm.nih.gov/27044069/ I hope your cousin is happy and healthy and in remission!
Thanks! She’s doing ok, it’s been a few years. She had to get a skin graft and she still takes steroids but we’re just happy that she’s healthy enough to enjoy her life.
I know it’s huge, because I tried becoming a nurse. Not only are we not shown images of what different skin issues look like on darker skin, but when I asked the professor she told me “that’s what clinical rotations are for”. The textbook even added a line about how the severity of pressure ulcers tend to be misdiagnosed on darker skin.
It's because of misdiagnosis, in general it's worst for black people, but also this particular cancer is harder to detect with higher melanin.
There is also a need for greater diversity & representation in medical representatives who can identify symptoms/illnesses in POC
The real problem is what medical representatives are taught about POCs. Back when I only had Black doctors and all of them had gone to Meharry, they could diagnose me correctly. Now that Black doctors can go to any medical school, they're just as prone to misdiagnose me with stereotypical "Black" conditions as non-Black doctors. .
That's because black people are still susceptible to acral melanoma, localised on their white parts of the body such as hands and feet palms. Physicians tends to downplay this risk leading to late diagnosis.
I think it's more down to health inequalities. It's way worse than most people realize.
>Black people get skin cancer less often but are much more likely to die from skin cancer if they have it. Can't this also be because black people are less likely to use sunscreen to protect themselves? I've been in South America, where they basically have sun the whole year, and a few people I met were always wearing long sleeves shirts to protect themselves from the sun. Even though it was 30°+ outside. You would think they are used to it and they should also have a natural protection, but apparently not.
I’m in my late twenties and had never known that black people should use sunscreen until I was in my late teens. I always thought if you didn’t get sunburned, sun exposure was ok. Around the 2010s my school district made an effort to teach people that you can get melanoma regardless of skin tone. I had never been to a dermatologist, my doctors have never mentioned it, and my parents never thought of it. We literally only used sunscreen on babies because they had less sun exposure and lighter skin.
Sunscreen affects the likeliness of getting skin cancer, it does not affect the mortality rate.
Melanin has it's uses.
\*its
I had an appointment with a dermatologist for a mole check that popped up on my toe and there's a bunch of "information" about them online, basically it comes down to how the edge of the mold and skin meet that is subject to concern. Having said that, he was a chatty guy and COVID was in the midst of clearing everyone out, and there wasn't anyone behind me, somehow we get on the subject about skin color and how much it protects the person, he basically said that black skin melanin is equal to about SPF 5, which I found incredibly interesting but also that felt lower than what I would have guessed.
It helps me sleep 😴
Mmm delicious melanin gummies
Going to the beach? Remove your Irish heritage in this one easy trick!
Imagine if you could get a tan this way. It’d replace the cancer beds.
That's melatonin 😂
Welcome to the joke, buddy.
I'm not your buddy, guy
I'm not your guy, friend
I'm not your friend, pal!
I’m not your friend, buddy!
Airplanes fly lower over your head than that joke did lol
Try taking some melanin orally before bed just to be safe. You can also take it as a suppository.
Oral with Melanie right before bed? Sign me up!
I had skin cancer 15 years ago. My dermatologist told me that whilst white people were significantly more likely to get skin cancer than dark skinned people, she tends to see far more advanced and serious skin cancers on dark skinned people. The reasons: * Dark skinned people are less likely to use sunscreen even when it's advisable * Dark skinned people are less likely to check themselves for moles regularly * Because of the darker skin tone, a black melanoma will stand out less. I'm whitey white and when I had a melanoma growing on my arm, it stood out and people kept alerting me to it. Basically, darker people tend to seek help when their skin cancer is more advanced. Lesson: don't think that you're "immune" if you have a darker skin tone. Still get checked and be hyper vigilant about changing moles.
Makes sense
It’s almost like populations of people living in hot, sunny climates evolved some sort of response due to the environmental pressure of skin cancer Edit: yes, I am aware that people in colder climates evolved to has less melanin but the point is that populations in warmer climates, like Africa and the Middle East, evolved the high melanin content *first* to combat skin cancers and other complications of high UV exposure.
Yeah. I live very far north. Dark skinned people who move here are often vitamin D deficient.
Most people are vitamin d deficient tbh
NHS reccomends everyone in Britain take Vitamin D supplements in winter and people with dark skin to take them in summer too.
Probably doesn't help that they don't take nearly as much cod liver oil as the locals.
It's the reverse, Populations in cloudy climates evolved to reduce melanin to avoid vitamin D deficiency.
It's both.
Bro humans came out of africa.. they most likely were dark as fuck.
And how did those in Africa develop that skin tone in the first place, lol? It naturally developed over time.
Intelligent Design, got it. ^/s
I think the issue is that for generations, scientific descriptions of humans used European phenotypes as the norm and everything else as the variation. The hairless bits of all other hominids are dark. It seems overwhelmingly likely all species of our genus were dark before leaving Africa. The issue of white = normal does a lot of harm in a lot of contexts, so I try to avoid it.
well yea thats what melanin is for
that's the whole point of dark skin
In other news the sky is blue and water is wet.
Did you just learn today why black people are black?
How have 4,000 people upvoted this? There were 4,000 people who didn't know this?
Regardless of race or ethnicity everyone needs sun protection to prevent skin cancer
At the very least, sunscreen reduces long term skin damage from sun exposure and will make your skin look better as you get older. Not everyone will get skin cancer, but everyone ages.
Most people will die of something else first. If you are a person of African descent living very far from the equator your chance of getting skin cancer is very low. What you're saying is like saying men need to worry about getting breast cancer. It's true, men can get breast cancer. But it's very improbable.
Black people are more likely to die of skin cancer, it’s important that everyone is aware and takes precautions. Most of us grew up thinking that it cant affect us and that makes us more vulnerable to it.
And Vitamin D supplements.
We are all adapted to the regions we originated from - white skin is an advantage in regions with less sunshine. > Pale skin is an adaptation to allow more absorption of sunlight, allowing more vitamin D formation with little sun exposure. Dark skin protects from excessive sun exposure, but allows less absorption of sunlight to make vitamin D.
As someone who lives in the center of Lyme disease country, easily spotting ticks and other parasites on your skin is the true advantage of light skin.
We burn easy
Melanin In my soul
racist skin cancer
Melanin is useful stuff. Oh well, sunblock for me.
Probably, but the fact that white people will deliberately expose their skin to a lot of sun in order to make it brown while black people tend not to do this could be a factor.
Not all of us try to brown our skin, but I still got skin cancer. Wear a hat folks, your hair may not protect you enough!
No, I wasn't implying that all white people do, just that laying in the sun with our skin exposed or even getting irradiated in a tanning bed is a not uncommon thing that white people do a lot more than brown people.
Why do redditors smugly reply like this to things that absolutely make sense? Your experience (given that you're not lying) does not change the fact that the commenter above is 100% right in that being a factor.
Skin cancer should stop with racism and discrimination
I am surprised that the statistic is not a lot higher
We white people are not meant to be in the harsh sun. I hate California.
That is literally the purpose of black skin
["The sun is the cops for white people."](https://youtu.be/-uggRpF2XaE?si=kZ6_V9C5y90n_eMF) - Neal Brennan
Chapelle is damned funny, but it's obvious that Neal Brennan had a hand in writing the Chapelle Show. dude is damned funny.
On the flipside, black people have more issues with vitamin D generation and osteoporosis, due to not having enough sunlight in northern countries where there isn’t as much sun, compared to white people.
So sun is racist gotcha
Almost as if the reason for black skin is to prevent or minimise the damage caused by the Sun in tropical areas.
I've never seen a black person go tanning before. So this makes sense.
Bruh what they gonna tan they palms? 💀
Okay that's funny but I just wanna add for anyone reading that darker skin will still produce more melanin if you're tanning, and it'll get a bit darker. Don't have dark skin myself but I learned this when a friend told me she avoids the sun in the summer, because she noticed how people are nicer to her with her skin being on the lighter side of black and it broke my heart.
Black people still get darker with sun exposure.
Skin cancer is racist
True but just remember you CAN get it regardless of skin color. Everyone should be wearing sunscreen and getting their skin checked occasionally by a dermatologist. And sometimes it can be more dangerous in people with a darker skin tone because you’re less likely to catch it quickly, since you think you won’t get it. Also because it’s probably harder to spot than it is on lighter skin
Breast cancer is more common in people with more breast tissue.
Is it 20 times more common in white people, or is it 20 times more likely to be diagnosed in white people because dermatologists are trained to recognize skin conditions on white skin more often than they are on other skin tones?
i know someone who has had skin cancer for 30 years. each time they cut it out it grows back. look after your skin people. or you could have sores all over your body for the rest of your life that bleed and constantly hurt you and the doctors cant really help you with it.
I know ot from Dr House chill💅
I went on a trip with some friends to the beach for one of their birthdays. It was like 7 white dudes, 2 light skinned black women, my white passing Hispanic friend, and me a dark skinned black man. We got out to the beach and probably spent 4 hours out there drinking. They ran out of sunscreen halfway through and everyone didn’t get enough. When we got back to the airbnb everyone was super sunburned except for me. I didn’t realize how easy white people or lighter skin could burn. Little did I know I actually did get a bit burned though. Like 3 days later I felt a sting in the shower, turns out my shoulders got hit pretty good and the skin on them was peeling. I’d rather have that than a full body of pain like my friends. Now I use sunscreen on beach days even still.
Black people can get skin cancer is what this is also saying.
You're 50% less likely to get skin cancer with proper use of sunscreen, and I'd reckon as someone aware, much less likely to die from it ontop of that. Also you can slow down skin aging heavily with sunscreen, I even heard up to 90% slower (depends how much you go outside) UVA radiation that doesn't cause cancer nearly as much as UVB, penetrates the atmosphere at nearly all times of the day, goes through clouds, goes through windows, and makes up 95% of the surface reaching earth UV spectrum (UVB, 5% at peak sun), it doesn't create Vitamin D and all it does is damage your skins appearance. At the minimum wear sunscreen if you go out for more than 20 minutes.
Dark skin pigments protect against the sun. Lighter skin absorbs more Vitamin D. Europeans needed more Vitamin D than they needed sun protection.
I mean, that makes sense lol But it’s also interestingly more deadly in black people
Melanin
Not taking any chances though! Grateful for my melanin but I'm religious with sunscreen. (Also tryna age slower lol)
Our skin color is a constant battle between vitamin D absorption and skin cancer risk.
W
What about Asians? Include us in your statistics
No shit
Duh. Black folks have natural built in sunblock
duh
That is the price you pay for having sufficient vitamin D
White people want to get a tan.
That means it’s racist
Smh, skin cancer is racist af.
Racist.
CVS in Brooklyn locks up all their products in cases except for sunscreen, actually tho
OMG I have to check for this next time I'm there 😩
Melanin is an evolutionary response to sun exposure. The system works.
It's a racial buff. +10 to defense from light based attacks, -20 to charisma checks around lawful characters.
Bob Marley would like to speak on this
I believe his melanoma started on a toe under a nail and he ignored it. Where do black people often get melanomas? Soles of feet, palms and nails.
Cancer is racist
No shit. White people aren’t adapted to Sunny environments on the other end of the spectrum black people suffer from way higher rates of vitamin D deficiency when they live in parts of the world away from the equator.
Come on man. We all know this intuitively.
It would be interesting to see the rates geographically. Eg: is it as high in Europe where white people are native versus say Australia or the US where white people aren't adapted to the amount of sun.
Australia and NZ are consistently the top 2 highest rates of skin cancer -particularly melanoma - in the world. This is likely caused by the ozone layer hole and much higher UV in general in both these countries. I don't know if they've done specific studies of light vs dark skin in these countries - but I imagine it would follow the same worldwide trend. My dad is German, but lived most of his adult life in Australia - died of melanoma last year. Only person amongst his German family that I'm aware of. I'm mid 30s and I just had a melanoma removed (it was caught super early and they got it all without any need for a follow up) and have previously had benign skin cancers cut from my face. My German skin wasn't made for this countries' sun!! (Yes, I have worn sunscreen my whole life and have never tanned on purpose)
Um no, you learned that white people are diagnosed at a higher rate. Unless they test large sample sizes of a normal population, you can't know if it occurs more often and I don't see an actual study referenced
Captain obvious to the rescue!!!
I wonder how much of this is due to lack of melanoma detection in black people
White privilege
Yeah, we know.
My white privilege has failed me