Dr. L.P Bhaskar Bhuvan, Medical Oncology, HCG Cancer Center – Vizag
The belief that “Melanoma only affects white skin” is profoundly ingrained—and sadly misplaced. Indians have long believed that our melanin-rich skin protects us from major sun damage. But the truth is that Melanoma does not discriminate. It’s just less visible on darker skin and goes undetected, until it’s too late to correct.
Melanoma is the most dangerous type of skin cancer. It occurs when pigment-producing cells, known as melanocytes, begin to expand uncontrolled. These cells are responsible for our skin’s colour. While melanin does provide some natural defence, it is not without limitations. When Indians do develop Melanoma, it often stays undetected until cancer is advanced.
Skin awareness involves indications to watch out for, and proactive protection.
Why Indian Skin Is Not Immune.
Yes, Indian skin has higher melanin, which helps filter ultraviolet (UV) radiation, to some extent. But melanin isn’t a magical shield. It simply delays the observable damage, without entirely eliminating the risk. And the delay leads to a false sense of security.
Melanoma in darker skin types frequently arises in locations that are not normally exposed to sunlight, such as the soles of the feet, under the nails, between the toes, or even on the palms. These are areas that we rarely investigate attentively. This is why Melanoma in Indian patients is often missed in its early, treatable stage.
Furthermore, when signs such as bleeding, crusting, or itching appear, the cancer may have already spread. Early detection, as with most malignancies, is essential. But this only happens when you know what to look for.
Skin changes that should raise red flags
Melanoma typically begins as a new mole or a change in an existing one. The problem is that Indians naturally have more moles, freckles, and pigmentation patches. So, how do you know which ones warrant your attention?
Use the ABCDE rule as a guide.
- A: Asymmetry refers to when one half of a mole differs from the other.
- B: Border with irregular, fuzzy, or jagged edges.
- Colour: Browns, blacks, reds, and whites.
- Diameter: Spots larger than 6 mm (about the size of a pencil eraser).
- Ache-Pain in the lesion/Mole
- Evolving: refers to any change in size, shape, colour, or elevation, as well as new symptoms such as bleeding, or itching.
For Indian skin, pigmentation or darkening of the soles, palms, or nails, including a dark stripe under the nail that is unrelated to trauma, should never be overlooked.
How Lifestyle and Environment Contribute
Prolonged sun exposure, particularly at midday, contributes significantly to skin cell mutations. Outdoor occupations, such as farming, construction, and even driving, expose huge portions of skin to UV radiation on a daily basis.
The rising use of tanning beds (yes, it is a growing trend in urban India), a lack of sunscreen use, and a general underestimation of skin health entail the perfect formula for skin cancer.
Chronic skin inflammation, existing scars, or long-standing sores (from burns or infections) can all lead to skin cancer, including Melanoma. That is why it is critical to observe any patch of skin that changes, heals slowly, or feels strange, over time.
Protective Measures that Work
Making sun protection a routine is the first and simplest approach to minimising the chances of developing Melanoma. The perception, in India that sunscreen is a cosmetic product, rather than a health necessity, needs to change.
Choose a broad-spectrum sunscreen with an SPF of 30 or greater, and apply it every morning, even if you spend the most of the day indoors. If you’re sweating or exposed to the sun, reapply every 2-3 hours. When you’re spending time outside, wear clothing, wide-brimmed hats, and sunglasses, to protect yourself from the sun.
Check your skin on a monthly basis. Examine your entire body, including between the toes, under the arms, behind the ears, and beneath the nails. If you detect anything out of the ordinary, consult a Dermatologist right away.
Bottom Line: Early action saves lives.
Busting the myth that dark skin implies immunity to skin cancer will encourage awareness and proactive vigilance to changes in the skin. Because darker skin tends to conceal changes on its surface, Indians should, ideally, do regular skin checks, ensure sun protection, and be consistently aware of unusual changes, such as dark spots, a dark patch beneath the nail, any area of skin that appears unusual, or evolving moles. Early detection of Melanoma and timely intervention by a medical team will significantly improve the chances of successful treatment and present a life-saving advantage.