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Skincare Intelligence

Skin checks for every skin tone: palms, soles and nails too

Skin cancer can show up on palms, soles and nails, and on deeper skin it is often found later. How to check your whole body, and when to get seen.

Education, not a diagnosis. Only a clinician who examines your skin can say what you have. Every point below shows how strong the evidence is and links to its source.

Who it affects

  • Skin cancer can affect people of every skin tone.[1,2,3]Established
  • Melanoma is reported much more often in people with lighter skin, red or blond hair, blue or green eyes, freckles, many or unusual moles, a family history, or past sunburns.[2,4]Established
  • Skin cancer is less common on deeper skin, but there it is found at a later stage more often.[5,6,7]Established
  • A U.S. registry analysis reported that, from 2011 to 2015, 55.3% of melanomas in non-Hispanic Black Americans were found at an early, localized stage, compared with 78% in non-Hispanic White Americans. Five-year relative survival was 66.2% compared with 90.1%. These are group figures, not a prediction for any one person.[6]Established
  • U.S. studies have also reported later-stage diagnosis in Hispanic patients and in American Indian and Alaska Native patients, and longer waits for treatment in Asian American and Pacific Islander patients. Each of these groups is very diverse, and anyone can be affected.[8,9,10]Supported
  • Heritage labels can't tell you what your own skin will do. How your skin behaves, and your personal and family history, tell you more.[4,11]Mechanistic only

What it can look like

  • On deeper skin, skin cancer often shows up in places that get little sun: palms, soles, fingers, toes, under or around nails, the mouth, buttocks and genitals.[5,12,13]Established
  • Acral lentiginous melanoma, the type found on palms, soles and nails, occurs at broadly similar rates across U.S. groups. It makes up a bigger share of melanomas in people of color because other types are rarer. So palms, soles and nails are worth checking on everyone.[14]Established
  • This type is less strongly linked to sun exposure than other melanomas.[4]Established
  • In a nail, warning signs include a brown or black band or streak, dark color spreading onto the skin beside the nail, a nail that lifts or splits, or a bump under the nail. Nail melanoma is often found late.[12,15]Supported
  • Not every nail streak is cancer. Only a clinician can tell them apart.[15]Supported
  • In skin of color, squamous cell carcinoma more often starts on skin that sees little sun, such as the legs, feet and genital area, or in an old scar, burn or long-lasting sore.[16]Supported
  • Basal cell carcinoma on deeper skin is often pigmented. It can look like a shiny brown or black bump and be mistaken for a mole.[17,18]Thin

What helps

Check your whole body regularly

A self-check is a way to notice change. It is not a way to decide what a spot is.

  • Use a full-length mirror and a hand mirror in good light, and look at your whole body, front and back.[19]Supported
  • Include the places that are easy to skip: scalp, palms, soles, between the toes, fingernails and toenails, and buttocks.[5,19]Supported
  • Check the genitals and inside the mouth too, where skin cancer on deeper skin can appear.[5,13]Supported
  • The Skin Cancer Foundation suggests a self-exam every month, including palms, soles and nails.[3]Mechanistic only
  • Self-checks have not been shown to lower deaths from skin cancer. Their job is to help you notice change and get it looked at.[19]Thin

What to look for

  • A spot that is new, changing, bleeding or itching, or that looks different from your other spots.[12,19,20]Supported
  • A sore that doesn't heal.[5]Supported
  • A new or changing dark line in a nail, or darkening of the skin next to a nail.[15]Supported
  • A dark area under a nail that wasn't caused by an injury.[12]Supported
  • An old scar, burn or wound that changes, thickens, bleeds or breaks down.[16]Supported

ABCDE, and what it leaves out

  • The ABCDE guide lists signs of melanoma: Asymmetry, an irregular Border, varied Color, Diameter (size), and Evolving (changing).[20]Supported
  • It is a useful start, but it doesn't cover nails, palms and soles, or darker skin. Use it together with the nail signs and the places above.[5,15,20]Mechanistic only
  • Teaching images have shown mostly lighter skin, so skin cancer on deeper skin may not match the pictures people have seen.[21,22]Supported

Sun protection still counts

  • UV damages skin of every tone, and sun protection is advised for everyone.[1,3,23]Established
  • For lighter, burn-prone skin, freckles or many moles, guidance stresses extra care with shade, clothing and SPF 30 or higher.[2,4]Established
  • Sun protection doesn't replace checks. The melanoma type found on palms, soles and nails is less tied to sun.[4,14]Established

What to avoid

  • Assuming skin cancer only affects lighter skin. Anyone can get it.[1,2]Established
  • Skipping palms, soles, nails and between the toes when you check.[14,19]Supported
  • Relying on ABCDE alone, especially for nails, palms and soles.[15,20]Mechanistic only
  • Waiting to see whether a new nail streak fades by itself.[15]Supported
  • Letting a photo app decide what a spot is. Dermatology AI performed worse on images of dark skin in testing.[24]Supported
  • Ignoring a sore in an old scar or burn that won't heal.[16]Supported

When to see a clinician

  • A spot is new, changing, bleeding or itching, or looks unlike your other spots. Contact a clinician promptly.[12,19]Supported
  • A nail has a new or changing brown or black line, color spreading onto the skin beside it, or it lifts or splits without an injury. See a dermatologist promptly.[12,15]Supported
  • A sore hasn't healed, or an old scar, burn or wound changes, thickens, bleeds or breaks down.[5,16]Supported
  • A new dark spot appears on a palm, sole, finger or toe, or in the mouth or genital area.[5,12]Supported
  • In the UK, your GP is the usual first stop. GPs can send photos to a specialist and refer you urgently if cancer is suspected.[12]Supported
  • When booking, mention a changing mole or other urgent concern so it can be seen sooner.[25]Mechanistic only

Questions to ask a provider

  • Can you check my palms, soles, nails and between my toes as part of the exam?
  • I've taken dated photos of this spot. Would they help?
  • Is this nail streak something to watch, or to look at more closely now?
  • Given my history, how often should my skin be checked?

Label claims to question

“Types V and VI rarely or never burn”
The Fitzpatrick scale was built to dose UV treatment. Critics say these labels are inaccurate and can falsely reassure people with deeper skin about sun and skin cancer.[7,26]
“AI mole checker”
Dermatology AI models performed noticeably worse on a diverse, biopsy-confirmed image set, especially on dark skin. An app cannot examine your palms, soles and nails or replace a clinician's check.[24]

Where the evidence is thin

  • Why melanoma survival is lower in some groups is not settled. One U.S. analysis found similar stage at diagnosis for acral melanoma but still higher mortality in Black patients; another found income and stage explained part of the gap.
  • Whether regular self-checks lower deaths from skin cancer was not shown in the sources reviewed.
  • The Skin Cancer Foundation's survival and stage figures are not linked to original studies on its page, so this guide uses a U.S. registry analysis instead.
  • The figure for how often basal cell carcinoma is pigmented on deeper skin comes from older work quoted in a two-case report.
  • Data are sparse for South and Southeast Asian, Middle Eastern and North African, Pacific Islander, non-U.S. Indigenous and mixed-heritage people. Small studies from Lebanon and Hawaiʻi call for more research on acral melanoma.
  • The DermNet page on squamous cell carcinoma in skin of colour dates from 2017.

Keep going

Sources

Retrieved and read for this guide; reviewed 2026-09-13. A source listed here says what it establishes and what it does not — a citation is not an endorsement.

  1. [1]Sunscreen FAQs · American Academy of Dermatology, 2025Establishes: Recommends broad-spectrum, SPF 30+, water-resistant sunscreen, about 1 ounce for the body, reapplied roughly every 2 hours. Anyone can get skin cancer regardless of skin tone. Tinted iron-oxide sunscreens help with visible-light darkening in darker skin.Does not establish: Any product ranking.
  2. [2]Sunscreen and sun safety · NHS, 2026Establishes: Advises SPF 30+ with at least 4-star UVA protection, and shade between 11am and 3pm. People at higher risk include those with pale skin, red or fair hair, freckles or many moles. People of all skin tones can get skin cancer.Does not establish: Advice outside the UK context.
  3. [3]Skin Cancer in Skin of Color · Skin Cancer Foundation, 2026Establishes: Reports five-year melanoma survival of 70% in Black patients vs 94% in White patients, and late-stage diagnosis in 52% vs 16%. Advises monthly self-exams including palms, soles and nails, and states that UV damages skin of all tones.Does not establish: Primary citations for its statistics — treat them as secondary and prefer culp-2019-melanoma-black-americans.
  4. [4]Risk Factors for Melanoma Skin Cancer · American Cancer Society, 2026Establishes: Melanoma risk is much higher with lighter skin, red or blond hair, blue or green eyes, freckling, many or atypical moles, a family history, and UV exposure or sunburn. Acral lentiginous melanoma is less strongly linked to sun exposure.Does not establish: Individual risk estimates.
  5. [5]Finding skin cancer in darker skin tones · American Academy of Dermatology, 2025Establishes: In darker skin, skin cancer often appears on the palms, soles, fingers, toes, nails, mouth, buttocks, anus or genitals, and is often advanced at diagnosis. Warning signs include changing spots, dark streaks in nails, and sores that don't heal.Does not establish: Statistics — it gives none.
  6. [6]Melanoma Among Non-Hispanic Black Americans · Culp, Lunsford. Preventing Chronic Disease (CDC), PMC, 2019Establishes: US registry analysis for 2011–2015: melanoma incidence about 1.0 per 100,000 in non-Hispanic Black Americans. 55.3% of melanomas were localized at diagnosis vs 78% in non-Hispanic White patients; five-year relative survival was 66.2% vs 90.1%. Acral lentiginous melanoma was the most common specified subtype, and 48.2% of cases were on the lower limbs.Does not establish: What causes the gap — it does not separate the causes. Not an individual estimate.
  7. [7]Skin cancers in skin types IV–VI: Does the Fitzpatrick scale give a false sense of security? · Goon, Banfield, Bello, Levell. Skin Health and Disease (PMC), 2021Establishes: Fitzpatrick devised the scale in 1975 to choose UVA doses for PUVA treatment of psoriasis, originally in lighter-skinned patients; it describes burn and tan response, not skin colour. The authors argue its 'never/rarely burns' labels for types V–VI are inaccurate and can falsely reassure, and that skin cancers in darker skin are often found late.Does not establish: New incidence data or a validated replacement scale — it offers neither.
  8. [8]Melanoma Disparities in Hispanic Populations: Socioeconomic Challenges and Cultural Barriers · Zieneldien, Ma, Kim, Cohen. Journal of Skin Cancer (PMC), 2025Establishes: Hispanic patients more often present with stage III/IV melanoma and have higher rates of acral lentiginous melanoma than non-Hispanic White patients. Reported barriers include insurance, language, and outdoor work with little sunscreen use.Does not establish: Anything true of every Hispanic or Latino person — it is a narrative review of a highly diverse group.
  9. [9]Disparities in Cutaneous Melanoma Diagnosis and Survival Among American Indian and Alaskan Native Patients: A Systematic Review and Meta-Analysis · Li et al. Journal of Surgical Oncology (PMC), 2025Establishes: Across 20 studies, AI/AN patients had higher mortality (pooled aHR 1.43) and higher odds of late-stage diagnosis (aOR 1.75) than White patients. Pooled incidence was 5.35 per 100,000, with very high heterogeneity. Barriers include geography and insurance.Does not establish: Precise estimates or findings outside the US — samples were small and heterogeneous.
  10. [10]Asian American and Pacific Islander patients with melanoma have increased odds of treatment delays · Fane, Wei, Tripathi, Bordeaux. J Am Acad Dermatol (Europe PMC, PMID 37224968), 2023 · read at abstract levelEstablishes: National Cancer Database study: AAPI patients had about 1.5 times the odds of a 61–90-day delay to treatment and about 2 times the odds of a delay over 90 days, compared with non-Hispanic White patients. Uninsured patients waited longer.Does not establish: Differences between the very diverse groups it combines.
  11. [11]Rethinking the use of population descriptors in dermatology trials and beyond: disentangling race and ethnicity from skin color · Harvey, Lester, Jaleel, Takeshita, McMichael et al. Archives of Dermatological Research (Europe PMC, PMID 40252110), 2025 · read at abstract levelEstablishes: Consensus statement from a Skin of Color Society summit. Race and ethnicity categories do not accurately reflect biological differences. Recommends specific descriptors such as skin color, used alongside social factors, and objective color tools.Does not establish: A consumer self-report questionnaire — it specifies none.
  12. [12]Symptoms of melanoma skin cancer · NHS, 2026Establishes: Melanoma can appear on the soles, palms and genitals. Check for a dark area under a nail that was not caused by an injury. See a GP about a mole that changes. GPs may use teledermatology (sending photos to a specialist) and urgent referral.Does not establish: Urgency thresholds for the public.
  13. [13]Sun Advice for Skin of Colour · British Association of Dermatologists (Patient Hub), 2018Establishes: Darker skin can burn, though rarely in UK conditions. Advises checking palms, soles, nails, genitals and mucous membranes, and shade, clothing and SPF 30+ with UVA protection; mineral or iron-oxide sunscreens may help with hyperpigmentation. Advises a 10 microgram vitamin D supplement year-round and short summer sun exposure.Does not establish: Individualized advice, or conditions outside UK latitudes.
  14. [14]Acral lentiginous melanoma incidence by sex, race, ethnicity, and stage in the United States, 2010–2019 · Holman et al. (CDC). Preventive Medicine (Europe PMC, PMID 37659614), 2023 · read at abstract levelEstablishes: ALM incidence is similar across US groups (roughly 1.5–2.8 per million). It makes up 0.8% of melanomas in non-Hispanic White people but up to 19.1% in some groups of color, because other melanoma types are rarer in those groups.Does not establish: Outcomes — it reports none.
  15. [15]How to check your nails for melanoma · American Academy of Dermatology, 2021Establishes: Signs include a brown or black band in the nail, darkened skin next to the nail, a nail lifting or splitting, and a bump under the nail. Nail melanoma is more common in older adults and darker skin tones, but anyone can get it, and it is often diagnosed late.Does not establish: How to tell a harmless streak from melanoma — not every streak is melanoma, and the page does not help tell them apart.
  16. [16]Cutaneous squamous cell carcinoma in skin of colour · DermNet (NZ). Ramji; ed. Oakley, 2017Establishes: In skin of colour, SCC more often arises on non-sun-exposed sites (legs, feet, anogenital area) and in scars, burns or chronic ulcers. SCC in chronically scarred or inflamed skin is reported to metastasise in 20–40% of cases, vs 1–4% for SCC in sun-damaged skin.Does not establish: Guideline status — it was written in 2017 by a student author with editorial review.
  17. [17]Two Cases of Pigmented Basal Cell Carcinoma in African American Patients · Ruml et al. Cureus (PMC), 2024Establishes: Two cases with a literature summary. Cites earlier work reporting that more than 50% of BCCs in African American patients are pigmented (vs 5–6% in White patients), and that these can be mistaken for melanoma, moles or seborrheic keratosis.Does not establish: Prevalence data of its own — the figure is cited from earlier work, and two cases show only that this can happen.
  18. [18]Basal Cell Carcinoma, Squamous Cell Carcinoma, and Cutaneous Melanoma in Skin of Color Patients · Hogue, Harvey. Dermatologic Clinics (Europe PMC, PMID 31466591), 2019 · read at abstract levelEstablishes: Documents diagnostic and outcome disparities in skin cancer among patients with skin of color, and knowledge gaps caused by under-representation in research.Does not establish: Any figures — the abstract gives none.
  19. [19]Find skin cancer: How to perform a skin self-exam · American Academy of Dermatology, 2023Establishes: A self-exam covers the whole body using mirrors, including fingernails, palms, soles, between the toes, scalp and buttocks. See a dermatologist for any spot that is different from the others or changing.Does not establish: That self-exams lower deaths from skin cancer — it does not show this.
  20. [20]What to look for: ABCDEs of melanoma · American Academy of Dermatology, 2026Establishes: Asymmetry, irregular border, varied colour, diameter, and evolution as the features that should prompt an appointment — as should any spot that is new, different from the others, or changing, itching or bleeding.
  21. [21]Representations of race and skin tone in medical textbook imagery · Louie, Wilkes. Social Science & Medicine (Europe PMC, PMID 29501717), 2018 · read at abstract levelEstablishes: Content analysis of 4,146 textbook images: racial proportions roughly matched the US population, but skin tones shown were 74.5% light, 21% medium and 4.5% dark.Does not establish: Clinical consequences.
  22. [22]Disparities in dermatology educational resources · Ebede, Papier. J Am Acad Dermatol (Europe PMC, PMID 17010750), 2006 · read at abstract levelEstablishes: Found insufficient representation of dark skin in dermatology educational images.Does not establish: Figures — the summary read gave none.
  23. [23]Sun Protection · Skin of Color Society, 2026Establishes: Directly corrects the myth that any skin tone can skip sunscreen, addressing darker skin specifically. Advises broad-spectrum SPF30+, protective clothing, and limiting midday sun.Does not establish: Visible light in any detail.
  24. [24]Disparities in dermatology AI performance on a diverse, curated clinical image set · Daneshjou et al. Science Advances (DOI 10.1126/sciadv.abq6147); preprint arXiv:2203.08807, 2022Establishes: On the pathology-confirmed Diverse Dermatology Images set, leading dermatology AI models lost 27–36% ROC-AUC, performing worse on dark skin tones and uncommon diseases. Dermatologists also did worse on these images. Fine-tuning on diverse data narrowed the gap.Does not establish: Consumer apps in general.
  25. [25]How to select a dermatologist · American Academy of Dermatology, 2022Establishes: Look for FAAD / board certification and check insurance; cosmetic care is usually not covered. Mention urgent concerns, such as a changing mole, when booking. Bring a list of medications and questions.Does not establish: Questions about experience with skin of color — it lists none.
  26. [26]Integrating skin color assessments into clinical practice and research: A review of current approaches · Harvey, Alexis, Okeke et al. J Am Acad Dermatol (Europe PMC, PMID 38342247), 2024 · read at abstract levelEstablishes: Identified 17 skin classification systems. Fitzpatrick is the most widely used but has significant limitations, and current instruments have notable deficiencies.Does not establish: An endorsement of any single tool for consumer use.
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