By Hedy Setyadi, MD, FAAD, Board-Certified Dermatologist
Some of your friends may have shared with you about their experience going to a dermatologist for a skin cancer screening. Why do people undergo skin cancer screenings? What may the experience be like? Let’s discuss!
Who should have skin cancer screenings?
If you have any of the following characteristics, regular skin cancer screenings are recommended:
• History of skin cancer(s) or precancers
• Family history of melanoma
• History of tanning bed use
• History of atypical or dysplastic nevi/moles
• History of immunosuppression (e.g. transplant patients, being on immunosuppressive medications, etc.)
• For those who have multiple/numerous moles
• History of congenital nevi (which means moles that have been present since birth)
• For those who have a significant history of sun exposure or blistering sunburns, skin cancer screenings are also encouraged since they have a higher risk of skin cancers. Since we live in sunny Southwest Florida, this may be the case for most of us!
Why are skin cancer screenings recommended?
When diagnosed and treated early, skin cancers usually have a high cure rate. However, when left to fester or diagnosed at later stages, skin cancers may cause disfigurement, spread to other body areas (metastasize), or may even be fatal.
Whom should you see for skin cancer screenings?
Various skin diagnoses can have very slight differences in their appearance. Therefore they may be indistinguishable to those with less expertise in skin. Also, some skin conditions may herald internal conditions that may otherwise not be apparent. This is why it is important to see a skin expert— a board-certified dermatologist— for skin diagnosis and treatment.
How often should you have skin cancer screenings?
It depends on your skin history. For example, it can be annually, or can be more frequent for some people, depending on the details of their skin cancer or precancer history. I encourage you to discuss your particular case with your dermatologist.
What should you expect during skin cancer screenings?
In general, you would be offered a gown to change into. (You may think, “Oh no! Not the dreaded gown!”) This is commonly done for your comfort and to facilitate the examination. Your dermatologist would be happy to evaluate for suspicious lesions in all skin areas that you are comfortable with. Skin cancers can occur on areas that are not exposed to sunlight. Therefore it is recommended to have your head, body, and extremities to be examined all over (which would be called a “full body skin examination” or FBSE).
Some patients may feel nervous or vulnerable in having their skin examined. I like to remind these patients that it is normal to feel that way. I also reassure them that as dermatologists, we are professionals who perform this examination as an essential part of our occupation, multiple times every day.
Often patients may come in saying that they would like a skin or body “scan”. What they really mean is that they would like a skin cancer screening, and had incorrectly assumed that they would get a “scan” just like a CT (computed tomography) or MRI (magnetic resonance imaging). The “scanner” in this case is the dermatologist’s eyes and brain! Some patients would later on get a chuckle out of this inaccurate assumption.
Some dermatologists may also use a dermatoscope (also known as a dermoscope), which is a handheld device that helps in examining skin lesions.
If your dermatologist detects any lesion that may need testing or treatment, in general he/she would suggest procedure(s). For example, a biopsy to first diagnose the lesion, or treatment (such as liquid nitrogen or topical treatment for precancers), depending on your particular case.
If you go to a free skin cancer screening, which may be offered in the community or in clinics, not all areas of the body may be examined. Depending on your particular case, the dermatologist who screens you may advise you to return or see a local dermatologist for regular FBSEs.
What can you do to help you get the most out of your examination?
Here are a few tips for your appointment:
• Do not wear any makeup. This is important to enable a thorough examination of your face.
• Avoid having fingernail or toenail polish, or anything that may cover your nails such as artificial nails. Sometimes concerning lesions may be present under your nails, so you want to make sure your nails are ready to be examined.
• Avoid having hair extensions (or any hairstyle that may obscure the scalp) or significant amount of
• It is a good idea to remove your watch or jewelry as not to obscure the skin areas underneath.
• If possible, it is advised to remove your socks and shoes to enable examination of your feet.
• Do moisturize! Excessively dry skin may make a thorough examination more difficult.
Another important tip:
When you have a skin cancer screening, your dermatologist would like to make sure to have the opportunity to do their very best to find and evaluate for any concerning skin lesion. This takes time and concentration, as sometimes dangerous lesions can be very subtle. For your health and well-being, please support your dermatologist to be able to perform a methodical and thorough job in this important endeavor. If you happen to have other skin-related concerns such as hair loss, acne, eczema, or psoriasis, if necessary your dermatologist may suggest having you return to the office at another day to adequately and thoughtfully evaluate and address those concerns.
Or, at the time of your skin cancer screening appointment, you may happen to have a more urgent/acute skin problem, such as infection, rash, or flaring of a chronic skin condition. In this case, to ensure adequate time and attention for both the acute condition and the skin cancer screening, you and your dermatologist may end up taking care of the urgent problem first, and scheduling another appointment for the skin cancer screening.
I think you have now been well-educated for your skin cancer screening visit!
As a board-certified dermatologist, one of my missions is to educate everyone that I come across about the importance of sun protection and how to properly do so. Please make sure to check out another article that I wrote at the Charlotte Edition of the Health and Wellness Magazine. In the following article I reviewed healthy sun protection habits while debunking myths about skin health related to sun exposure.
Associates in Dermatology
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