Melanoma in skin of color
Melanoma can occur in any skin tone. People with darker skin develop it less often, but when they do, it is more likely to be diagnosed at a later, more dangerous stage. Knowing where to look closes most of that gap.
The disparity
Five-year survival is lower for Black Americans diagnosed with melanoma than for any other racial or ethnic group in the United States. The biology isn't dramatically different — late diagnosis is. By the time a melanoma is found in someone with darker skin, it has more often already spread.
The fix isn't more sun. It's looking in the right places, often, and not waiting on a spot that's changing.
Sources: CDC — Skin Cancer · AAD — Skin cancer in people of color
Where to look that's easy to miss
In darker skin, melanoma most commonly appears in places that get little or no sun:
Palms of the hands
Look at your palms and the side of each finger. A new dark spot, a streak that wasn't there last month, or a patch of color that doesn't match the rest of your hand all warrant a dermatologist visit.
Soles of the feet
This is the single most common site of melanoma in people with darker skin (called acral lentiginous melanoma). Check both soles, between the toes, and the heels every month.
Under fingernails and toenails
A dark stripe running the length of a nail — particularly one nail, getting darker or wider over time — can be subungual melanoma. New stripes, multiple-color stripes, or a stripe extending onto the surrounding skin (Hutchinson's sign) need urgent evaluation.
Mucosal sites
The mouth, nasal passages, genitals, and anus can all develop melanoma. New persistent dark spots in these areas — or a sore that doesn't heal — are worth flagging to a clinician.
What to watch for
The ABCDE warning signs still apply, but on palms, soles, and under nails the most useful prompt is simpler:
Take phone photos with a coin or ruler in frame so next month you can compare. The self-exam tool on this site stores notes and photos only on your device — they never leave your phone.
What it can look like
This site doesn't host clinical photos. The American Academy of Dermatology maintains an authoritative reference page with example images of melanoma in skin of color, including acral and subungual presentations:
If you find something
- Don't wait. Make a dermatologist appointment in the next few weeks for a full-body skin exam. Mention the specific spot.
- If it's bleeding, ulcerating, or growing fast, call sooner.
- AAD Find a Dermatologist filters by ZIP. Many practices accept self-referrals; a full-body skin exam is often covered as preventive care.
- If you're uninsured or underinsured, HRSA's federal health center directory lists sliding-scale options.