Dermatologists routinely perform thorough skin cancer screenings as a major part of their preventative care practice. Their specialized training enables them to accurately identify subtle visual characteristics of early-stage skin cancers that a general practitioner might overlook. This expertise in early detection significantly improves treatment outcomes for all forms of skin cancer.
The Total Body Skin Exam: The Professional Screening Process
The primary method dermatologists use for screening is the Total Body Skin Exam. During this examination, the patient is asked to disrobe completely and put on a medical gown, allowing the specialist full visual access to the skin surface. The dermatologist performs a systematic, head-to-toe inspection of the entire body to ensure nothing is missed.
This inspection includes areas that rarely see the sun or are difficult for a person to check themselves, such as the scalp, behind the ears, between the toes, the palms, the soles of the feet, and the genital area. Skin cancers, including melanoma, can appear anywhere on the body.
When a spot looks unusual, the dermatologist often uses a handheld device called a dermatoscope to examine the lesion in greater detail. This tool provides magnification and polarized light, allowing the physician to visualize structures and patterns beneath the skin’s surface. Dermoscopy helps differentiate between a benign mole and a suspicious lesion, guiding the decision on whether a biopsy is warranted.
What Happens After a Suspicious Spot is Found?
If the visual or dermatoscopic examination identifies a lesion with concerning features, the next step is typically a skin biopsy to obtain a definitive diagnosis. This is a quick in-office procedure performed under local anesthesia to numb the area. The type of biopsy depends on the lesion’s size, location, and the suspected type of cancer.
For superficial or raised lesions like basal cell or squamous cell carcinomas, a shave biopsy may be performed, which removes the top layers of the skin using a fine blade. If melanoma is suspected, a punch biopsy, which removes a small, cylindrical, full-thickness sample of tissue, or an excisional biopsy, which removes the entire lesion, is often preferred. The sample must be deep enough to determine the cancer’s depth, which is a significant factor in staging and treatment planning.
The tissue sample is then sent to a pathology lab for microscopic analysis, resulting in a pathology report that confirms the presence of cancer cells. If the diagnosis is confirmed, the dermatologist will formulate a treatment plan. Treatment options can range from surgical excision to remove the cancer to other therapies like radiation or topical medications, depending on the cancer type and stage.
Determining Screening Frequency and Risk Factors
The recommended frequency for professional skin cancer screenings varies significantly based on an individual’s personal risk profile. For the average adult with minimal risk factors, an annual Total Body Skin Exam is a common recommendation for establishing a baseline and ensuring early detection. This yearly check helps track any new or changing growths across the body.
Individuals with certain risk factors often require more frequent surveillance, sometimes every three to six months. Key risk factors include a personal history of any skin cancer, a family history of melanoma in a first-degree relative, or having a large number of moles, particularly atypical or dysplastic nevi.
A history of excessive sun exposure, including tanning bed use, and having fair skin that burns easily also influence screening frequency. Your dermatologist will assess these elements, along with your overall skin condition, to determine a personalized screening schedule that provides the best opportunity for catching skin changes early.
The Role of Self-Monitoring: Checking Your Own Skin
Between professional appointments, you play an important role in monitoring your skin for new or changing spots. Performing a thorough self-examination monthly allows you to become familiar with your skin’s unique pattern of moles and blemishes. Use a full-length mirror and a hand mirror to check hard-to-see areas like your back and the back of your legs.
The ABCDE method provides a simple guideline for identifying concerning lesions that should be brought to a dermatologist’s attention. This method looks for:
- Asymmetry where one half does not match the other.
- Irregular Borders.
- Color variation within the same lesion.
- Diameter, typically larger than a pencil eraser.
- Evolving or changing lesions.
Any mole or spot that is new, or changing in size, shape, or color, warrants an immediate professional evaluation.