In Medical Dermatology, Skin Cancer

Skin cancer is the most common form of cancer in the U.S., with one in five Americans developing it during their lifetime. Wearing sunscreen is not the only protection you need against skin cancer. A yearly skin cancer screening by your dermatologist is critical to early detection, preventing skin cancer from spreading and even becoming fatal.

Seeing your doctor for a skin cancer screening can be a bit intimidating if you don’t know what to expect. A skin exam is a simple process and nothing to be afraid of. We’ve broken down what to expect before, during and after your skin cancer screening so that you can be fully prepared.

How to prepare

It is wise to self-check your skin throughout the year to know if you need to see a dermatologist sooner than your yearly exam. When you see your dermatologist, be prepared to share any spots on your skin that you have concerns about or that have changed since your last exam. Make a list of skin- or skin cancer-related questions your dermatologist can answer during your appointment.

What to expect

During your skin cancer screening, you will be asked to take your clothes off and change into a hospital gown. Your doctor will perform a full head to toe exam on your skin. Unless they notice anything unusual, this should only take about 20 minutes.

Your doctor will start by looking at every inch of your body – from your face, chest, back, arms and legs. They will also inspect less-visible spots such as your scalp, between your toes and the soles of your feet. If you have a history of melanoma, they may also look at your lymphatic regions.

While you are with the doctor, speak up about any questions or concerns you have. Be sure to explain if you have noticed any changes in growths or moles.

What your doctor is looking for

During the screening, your doctor is looking for the “ABCDEs” of each mole or spot. These may be sign of cancer:

  • Asymmetry: Not the same shape on each side
  • Border irregularity: Ragged or blurred edges
  • Color: Different shades of tan, brown or black
  • Diameter: Larger than 1/4 inch
  • Evolving: Changing over time

If they find something

If your doctor notices any unusual spots, he or she may take a closer look with a dermatoscope, which looks like a combination of a flashlight and magnifying glass. Your doctor may simply take note of the spot and possibly photograph it to monitor it over time.

Should your doctor find a suspicious spot and want to know more about it immediately, she or he will take a biopsy. It is not unusual for the doctor to take a biopsy that same day. A dermatology biopsy typically involves numbing spot and the surrounding area, then shaving or scraping a small sample to send to the lab for analysis.

Your doctor might instead do a punch biopsy on the spot. Using a circular blade, like a hole puncher, the doctor removes deeper layers of the skin for testing. Both types of biopsy results should be available within 7 to 10 days.

Guidelines for skin cancer screening

Expert opinion varies as to the frequency with which individuals should see their dermatologist for a skin cancer screening. If you notice any suspicious mole or spot on your skin, best be safe and see your doctor. Those with high risk factors – such as fair skin, propensity for sunburns, prior incidence of skin cancer and family history of skin cancer – should have skin cancer checks every year.

Through regular skin self-exams, you will come to know your own skin and be able to notice changes in freckles, moles or other spots. A skin self-exam is best done with a full-length mirror in a well-lit room. Use a hand-held mirror for areas that are hard to see, such as the back of your thighs. Ask a family member or friend for help with checking areas such as your scalp and back.

Carefully examine your skin to learn where your moles, blemishes, freckles and other marks are and what they look like. Each time you do a self-exam, note any moles or growths that:

  • Are new
  • Have changed over time
  • Itch
  • Bleed

During your self-exam, if any growth or mole seems odd or different to you, take photos and reference back to see if it has changed over time. Show these photos to your dermatologist for closer inspection.

Where to get a skin cancer screening

Columbia Skin Clinic’s board-certified dermatologists are trained to screen, diagnose and treat all disorders of the skin, including skin cancer. With three convenient Midlands locations, it has never been easier to visit the dermatologist, and it just might save your life.

Physician Assistant Laura WinnUsing ultraviolet light to treat skin cancer and other skin conditions