In recent years, people living with albinism on the African continent have had to face challenges, ranging from social and economic exclusion to attacks and killings that are fuelled by superstitious beliefs.
In addition, they face another, less obvious challenge – skin cancer.
Albinism is a genetic disease characterised by a lack of melanin, which gives colour to the skin, hair and eyes. People with albinism are extremely sensitive to sun exposure because melanin protects against ultraviolet rays. They thus have an increased risk of developing skin cancer and other skin disorders.
If you have darker skin, do not think you cannot get skin cancer, however. It can affect anyone and is one of the most common diseases that dermatologists deal with daily.n
Dr Mohlominyane Jeffrey Mokheseng, a senior dermatologist at Steve Biko Academic Hospital in Tshwane, says that early detection and awareness could help prevent serious skin cancer from developing.
“The overall rate of skin cancer occurrence in black South African patients with albinism is estimated to be 23% and the risk increases with age,” Mokheseng says.
Symptoms of skin cancer in people with albinism
Skin cancer among people with albinism shows as lesions on the skin that is most exposed to the sun. The lesions are initially red and crusty (pre-cancerous lesions) but may turn into non-healing ulcers and eventually tumours, which can cause disfigurement, he says.
He adds that the lesions are most commonly found on sun-exposed areas, especially the head and neck (56%), then the trunk (30%) and limbs (15%), as reported in a Tanzanian study.
If left untreated or discovered too late, the lesions spread throughout the body with horrible consequences that can lead to a painful death.
How to avoid skin cancer
While sunlight may be a vital source of life on Earth, it’s a threat to people with albinism because its UV radiation penetrates deep into the skin. “Avoidance of unnecessary sun exposure is encouraged,” Mokheseng advises. This can be done by seeking shade during the hottest part of the day, which is from 11am to 3pm; wearing long-sleeved clothing and wide-brimmed hats. “Synthetic material should be chosen over natural fibres,” Mokheseng says.
If you are a person with albinism and absolutely must be in the sun whether working, playing or swimming you must apply sunscreen at least 20 minutes before you go into the sun. Choose a lotion with SPF30+ or higher and reapply it every two hours.
You should also consider wearing sunglasses. Look for glasses that block 99–100% of radiation rays. Darker glasses don’t necessarily offer more protection against UV rays; they could simply be a fashion statement. Choose wraparound glasses or, if you use prescription glasses, make sure you add UV-protective to the lenses. Talk to your optometrist or doctor if you are unsure about the glasses that suit your needs.
What institutions can do to help
Mokheseng believes that awareness campaigns about skin cancer will encourage people with albinism to get medical help in time. He would also like to see the public and private health sectors playing a bigger role in finding solutions to the problem. “An average medical doctor must be able to spot premalignant skin conditions and refer the patient to a dermatologist,” he says.
He explains that if the lesion can be removed, this will be done by a plastic surgeon. The patient will then be sent to an oncologist for additional treatment, if needed. These specialists are available in the private and public health sectors.
Premalignant refers to tumours that have cells that are not yet cancerous, but can potentially become malignant. It’s common for people with albinism to have premalignant lesions. For this reason, Mokheseng advises people with albinism to visit a dermatologist for screening at least once a year, unless told to go more often.
How society can help
If we are to create a more caring and inclusive society, we all need to play our part to support people with albinism in tackling skin cancer and all other ills. Mokheseng believes the harmful myths about people with albinism, which so often lead to their ill-treatment and injury, need to be tackled head-on. “Health education, using platforms like newspapers, digital media and so on, can help in reducing these incidents,” he says.
For more information, visit your nearest clinic.