This tool does not diagnose skin cancer or replace medical care. Always consult a qualified healthcare provider.

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Educational Resource

Understanding Skin Cancer in Darker Skin

Skin cancer affects all skin tones. Learning where and what to look for in Fitzpatrick IV–VI skin can lead to earlier detection and better outcomes.

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~1 in 1,000
Lifetime melanoma risk for Black Americans
Other skin cancers add to this — and survival rates are lower due to later diagnosis
Acral
Most common skin cancer subtype in darker skin
Found on palms, soles, and under nails
Stage III/IV
Common stage at diagnosis in darker skin
Earlier detection dramatically improves survival

The ABCDEs of Skin Cancer Detection

Afor Asymmetry

Benign: Symmetrical

Warning: Asymmetrical

Bfor Border

Benign: Smooth borders

Warning: Uneven borders

Cfor Color

Benign: Single color

Warning: Multiple colors

Dfor Diameter
< 6mm

Benign: Smaller than 6mm

> 6mm

Warning: Larger than 6mm

Efor Evolution

Benign: Stable over time

Warning: Changes over time

A

Asymmetry

One half of the spot doesn't match the other. In darker skin, this may be subtle—compare both sides carefully.

B

Border

Edges are ragged, notched, or blurred. Acral skin cancers on palms/soles may have irregular pigment spreading beyond the main spot.

C

Color

Multiple shades within one spot: brown, black, blue, red, or white patches. In darker skin, look for unusually dark or multi-toned areas.

D

Diameter

Larger than 6mm (pencil eraser), though skin cancers can be smaller when first detected. Any growing spot deserves attention.

E

Evolution

Any change in size, shape, color, elevation, or new symptoms (bleeding, itching). This is often the most important warning sign.

Where to Look: High-Risk Areas

Self-examination of palms of hands for skin cancer screening

Palms of Hands

Look for dark spots, patches, or lines. Compare both palms. Even small new marks should be noted.

Common site for acral skin cancer
Self-examination of soles of feet for skin cancer screening

Soles of Feet

Check the entire sole including the arch and edges. Use a mirror for hard-to-see areas.

Most common acral skin cancer site

Fingernails & Toenails

Look for dark lines or bands running lengthwise. A single nail with a new dark streak is especially important.

Subungual melanoma risk

Between Toes & Fingers

Spread toes and fingers apart to check the web spaces. These hidden areas are easily overlooked.

Often discovered late

Mouth & Genital Area

Mucosal skin cancers can appear as dark patches inside the mouth, nose, or genital area.

Rare but serious

When to Seek Immediate Care

A spot that is bleeding without injury
Rapid growth of a new or existing spot
A sore or lesion that doesn't heal within 3–4 weeks
New dark streak under a single fingernail or toenail
Significant pain, tenderness, or itching in a spot
A spot changing in multiple ways (size, color, shape)

Important Reminder

This educational content is for informational purposes only and does not constitute medical advice. This tool does not diagnose skin cancer or replace medical care. Always consult a qualified healthcare provider for any skin concerns.