You finally scheduled your annual skin exam.
Maybe you have a friend or family member recently diagnosed with skin cancer. Suddenly, you realize, “I’ve never had my skin checked!” or “I missed my last annual exam!”
Or you have a spot on your skin that looks suspicious, and you’re tired of worrying, so you might as well get a skin check.
Even if you haven’t been to the dermatologist in years (or ever), you’ve taken a vital step towards the health of your skin. As you get ready for your skin exam, here’s what you need to know.
Why You Need A Skin Exam
Annual skin checks are important — especially for patients with a personal or family history of skin issues. Patients with a history of melanoma may need to visit for skin checks as frequently as every three months. Patients with a history of squamous cell carcinoma or basal cell carcinoma typically need a full skin check twice a year.
With regular appointments, your doctor is able to monitor issues closely and begin treatment if they notice a change. Some skin cancers progress quickly — particularly squamous cell carcinoma which can develop over weeks. Melanoma doesn’t usually develop that quickly, but the changes may go unnoticed because it often develops within a mole you’ve had your entire life. When you visit the dermatologist for a skin exam, they look at each of your spots with a microscope. If they detect a change, they proceed with a biopsy and diagnosis.
Even if you haven’t previously received a skin cancer diagnosis, these checks are vitally important for patients with a history of tanning bed use, blistering sunburns, or a high number of moles. If you have 50+ moles on your body, you’re at a higher risk of undetected melanoma. With an annual once-over evaluation of the spots, we can catch problems before they develop into something more serious.
What to Bring To Your Skin Exam
Although you technically only need to bring yourself to your dermatologist skin exam, patient preparation never hurts. These items can help your dermatologist address your specific concerns, put your mind at ease, and make sure no spot goes unchecked.
1. List of Skin Issues
Patients with specific concerns should bring in a list of worrisome spots, so the doctor can address these specifically. As we check the body, we may see a spot we immediately recognize as benign and wouldn’t typically comment on. However, if the patient asks about it, we can put their anxiety at ease.
2. Marked Areas
Some patients also like to bring in a shadow figure with pen-marked areas of concern. Other patients use a permanent marker to circle the places they’ve noticed on their skin. Any of these methods suffice for pointing out suspicious spots to your dermatologist.
3. Past Pictures
Patients can also bring in past pictures to document how a spot has changed. While not everyone remembers to take routine body pictures, if there’s a spot of concern on the face, you can often look back at any picture of yourself from the last year to check for potential changes.
Patients with a high number of moles may have had professional full body photos for the purpose of mole mapping. If so, they can bring these to the appointment as a means for us to compare lesions and look for new or changing spots.
Within the clinic, we take pictures on the iPad as a means of mole mapping for the patient’s chart. We can then compare those photos to future visits, checking current constellations against the year previous. About 70% of melanoma spots develop as new lesions. The remaining percentage develops within current moles. When we use photos, we can better notice changes in the spots or identify spots not in previous photos. Rest assured, these photos are extremely protected within the patient’s medical chart.
What To Expect During Your Exam
Most skin checks begin with information gathering before the patient gets undressed. The nurse asks a few questions about the patient’s medical history and medications. Some medications put the patient at higher risk for skin cancer or other issues.
We then ask additional questions to assess the patient’s risk category regarding personal skin cancer, family health, and sun-exposure history.
The nurse leaves a gown and instructs the patient to undress to their comfort level.
When the patient is ready, the doctor comes in to examine the skin from head to toe. For patients who are concerned about a certain spot, we usually start with the area of concern. We can either reassure them it’s okay, or we can make a plan for the problem before proceeding with the rest of the exam.
Many doctors begin with the scalp, looking and feeling for lesions, precancerous, and cancerous spots. Skin cancers of all types can appear on the scalp — and some rough and scaly lesions can be better felt than seen.
We continue in this process, looking down the extremities at the hand and feet — even in between toes and on the bottoms of the feet. Doctors may examine the genital area, particularly if there is a spot of concern, but this isn’t required.
The full exam takes about ten minutes.
In some situations, we’ll recommend a procedure immediately following the exam.
If we find a lesion we suspect of skin cancer, we’ll suggest a same-day skin biopsy. We’ll numb the area, remove the lesion, and send it to the pathologist for evaluation. After the slides have been processed and diagnosed, the patient will be notified of their results within a week.
Precancerous spots can be removed during the initial appointment as well. These spots can be quickly frozen with liquid nitrogen. After freezing, the area will temporarily turn red. If a patient prefers to wait due to cosmetic reasons, they can schedule this for a different time.
We also offer same-day treatments for benign issues that are bothering the patient. Warts are often treated immediately with freezing.
Procedures requiring surgical prep, such as lipoma or cyst removals, need to be scheduled for a later date.
How To Keep Your Skin In-Check Between Appointments
Never underestimate the power of prevention. Implement good practices at home to prevent skin cancer in the future. Apply SPF 30 sunscreen daily. Seek shade and wear long sleeves and hats during time outside.
Also, keep an eye on the spots your doctor points out as potential problems. If you’re monitoring a specific spot, take a picture on your phone. Then, if you notice your spot has changed, schedule an appointment before your annual check.
Check your skin monthly. Use a mirror to check the places you can’t see and have a partner check your back. If there’s a concern, err on the side of caution and come in for an evaluation. If it looks like a problem to your dermatologist, a biopsy is an easy procedure that can be done immediately. The earlier we detect a problem, the easier it is to treat. If the spot looks fine to your doctor, we can calm your fears so you don’t spend time anxious about a spot that’s not problematic. We’d rather you come in for reassurance than lose sleep over something you don’t need to stress about.
Don’t let apprehension about skin cancer or self-consciousness about exam gowns stand in the way of your health. If you haven’t scheduled your yearly skin exam, give us a call today.
Dr. Winslow Blankenship is a board-certified dermatologist in Breckenridge and Vail, CO. She is an expert in medical dermatology and finds great reward in the management of acne, psoriasis, and other dermatologic conditions. She particularly enjoys that dermatology allows her to care for both adult and pediatric patients, having completed a significant portion of her residency training at Children’s National Medical Center in Washington, DC. In her spare time, Dr. Blankenship enjoys skiing with her husband and children.