One of the most common reasons people visit a Dermatologist is for a Full Body Skin Examination, or a “Skin Check.”. A skin check is a chance for the dermatologist to assess your risk factors for developing skin cancer; address any lesions that might concern you; and examine your entire skin, from head to toe, to look for any concerning growths.
Skin cancer is the most common form of cancer in the United States; more than 3.5 million skin cancers are diagnosed yearly in this country. Basal Cell Carcinoma and Squamous Cell Carcinoma are more common types of skin cancer and are referred to as “non-melanoma skin cancer.” They do not tend to spread to the rest of the body, but they can be disfiguring if left to grow for many years. Melanoma is less common, but more dangerous in that it does tend to spread to the rest of the body and can cause death. Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for young people 15-29 years old.
What are the risk factors for skin cancer?
There are several risk factors for skin cancer. People with lighter pigmented skin are at higher risk, but having darker skin does not exclude you- case in point is Bob Marley, a Jamaican musician, who developed Melanoma on his toe. People with red hair are also at higher risk. A history of sunburns is especially concerning- a person’s risk for melanoma doubles if he or she has had more than five sunburns; and blistering sunburns increase the risk even further. Family history of skin cancer can also increase your risk. It is important to find out which type of skin cancer (melanoma or non-melanoma) as melanoma tends to be passed in families. Those with outdoor occupations and hobbies like construction workers, farmers, and golfers are also at high risk.
Tanning bed use is also important. One tanning bed session increases users’ risk of developing squamous cell carcinoma by 67 percent and basal cell carcinoma by 29 percent. Also, just one session increases a patient’s chances of developing melanoma by 20 percent, and each additional session during the same year boosts the risk almost another two percent.Of melanoma cases among 18-to-29-year-olds who had tanned indoors, 76 percent were attributable to tanning bed use.
What can you expect during a skin check?
Your provider will assess your risk factors for skin cancer by asking about your family history, your occupation, amount of tanning bed exposure, number of sunburns in your life, and amount of sun protection you use. You will most likely be asked to get into a gown (although some men prefer to simply remove their shirt). Your provider will also ask you if there are any specific lesions that concern you and focus on these first then he will examine your skin in a specific order- I usually go head to toe, but some providers may have another order that they prefer. It is best to let the provider do the check in order so that they don’t skip an area.
Some providers may use a special light, called a dermatoscope, to look at your moles more closely- this allows us to look a little deeper into the skin to see how the pigment is arranged and if there are any blood vessels in the lesion. However, don’t be alarmed if they do not use a special light- some moles need examination with one, but most do not.
It is best to come with no make-up on, so we can adequately examine the skin on your face. You may ask the nurse for face wash if you are coming straight from work or an outing and need to remove your make-up. It is also a good idea to take your socks off, since there is a type of Melanoma that grows specifically on the toes.
If your provider finds a suspicious lesion, she may circle it and plan for a biopsy. A biopsy involves numbing the lesion and taking a small sample. If the lesion comes back a skin cancer, there may be more that they have to do. Some lesions, like precancerous lesions, are amenable to freezing, and your provider may perform that procedure during your check as well.
What can you do at home?
Most importantly, your provider will discuss sun protection with you during your skin check. I recommend SPF 30 or higher sunscreen with “Broad Spectrum” written on the label; reapplication every two hours when outdoors is important. Broad-brimmed hats with no holes cover the ears, whereas baseball caps do not (the ears are a common place for skin cancer). A white T-shirt only gives you an SPF of 3, so if you spend a lot of time in the sun, consider investing in some clothes that contain SPF; companies like Coolibar and Bass Pro Shop sell all sorts of clothing items with sun protection within them. Also seek shade and avoid the outdoors between10AM and 4PM.
Monthly self-skin examinations (with a significant other if available) are also an important key to early detection. Married people with a diagnosis of melanoma have significantly lower death rates than singletons, most likely because a spouse is likely to detect a changing mole earlier. It is important to look everywhere! In women the most common place to get melanoma is the backs of the legs and in men it is the back. It is helpful for you and your spouse to have a good picture of what your moles look like at baseline so that when something changes you can come see us quickly.
Do you need a skin check?
If you have any concerning moles or growths, have any of the risk factors described above, have a family or personal history of skin cancer, or just want someone to look in the places you can’t see, you probably should give us a call for a full body skin examination. We look forward to seeing you soon!
-Carley Fowler, MD
** All statistics are from the Skin Cancer Foundation web site
