Skin Cancer Checks: Self-Exams and Professional Screenings

Skin cancer is the most common cancer in the United States, yet it's also one of the most preventable and treatable when caught early. Unlike many other cancers, skin changes are visible, making regular self-examinations a powerful tool for early detection.

Combining monthly self-checks with periodic professional screenings offers the best approach to catching skin cancer in its earliest, most treatable stages.

Why Skin Cancer Screening Matters

When melanoma is detected early and hasn't spread, the five-year survival rate exceeds 99%. However, when it spreads to other parts of the body, survival rates drop significantly. This dramatic difference makes early detection through screening critically important.

Non-melanoma skin cancers, including basal cell carcinoma and squamous cell carcinoma, are even more common than melanoma and also respond much better to treatment when found early.

The ABCDE Rule for Self-Examination

The ABCDE rule helps you identify potentially concerning moles or skin spots. When examining your skin, look for these warning signs:

A - Asymmetry

If you draw a line through the middle of a mole, the two halves should match. If they don't look like mirror images, that's asymmetry and warrants attention.

B - Border

Benign moles typically have smooth, even borders. Melanoma borders tend to be uneven, scalloped, or notched.

C - Color

Most benign moles are a single shade of brown. A variety of colors is a warning sign. Watch for moles with multiple colors or uneven color distribution, including shades of brown, tan, black, red, white, or blue.

D - Diameter

Melanomas are usually larger than 6 millimeters (about the size of a pencil eraser) when diagnosed, though they can be smaller. Any mole larger than this size should be evaluated by a dermatologist.

E - Evolving

Any change in size, shape, color, elevation, or another trait, or any new symptom such as bleeding, itching, or crusting, is a warning sign. This is perhaps the most important letter to remember, as changes in existing moles are often how skin cancers are detected.

How to Perform a Skin Self-Exam

Monthly skin self-exams are recommended for everyone, but they're especially important if you have risk factors such as fair skin, a history of sunburns, many moles, or a family history of melanoma.

What You'll Need

• A well-lit room with a full-length mirror
• A hand-held mirror to check hard-to-see areas
• A comb or blow dryer to help examine your scalp
• Optional: a camera or smartphone to document moles for comparison

Step-by-Step Examination

Face and scalp: Examine your face, ears, neck, chest, and scalp using a mirror. Part your hair or use a blow dryer to lift hair and check your entire scalp. You might ask a family member to help with this area.

Arms and hands: Raise your arms and look at both sides. Check your hands thoroughly, including palms, between fingers, and under fingernails.

Upper body: Standing in front of the full-length mirror, examine your chest and torso. Women should lift breasts to check the skin underneath.

Back and buttocks: Use the hand-held mirror to check your entire back, buttocks, and the backs of your legs. This is another area where a partner can be helpful.

Lower body: Sit down to examine your legs, including the tops and bottoms of your feet, between toes, and under toenails. Check your ankles and the backs of your calves.

Genital area: Use a mirror to check areas you can't easily see.

What Professional Skin Examinations Involve

During a professional skin cancer screening, a dermatologist examines your skin from head to toe, including areas you might miss during self-exams.

The Examination Process

You'll typically be given a gown and asked to remove your clothing. The dermatologist will systematically examine your entire body, often using a dermatoscope, which is a special magnifying tool that allows detailed viewing of skin lesions.

The doctor will look at all moles, freckles, and spots, noting any that appear concerning. If something looks suspicious, they may recommend a biopsy, where a small sample of skin is removed and sent to a lab for testing.

How Often to Get Professional Screening

Frequency recommendations vary based on your risk level. People at average risk might have a baseline exam with screenings every few years. Those at higher risk due to fair skin, many moles, previous skin cancer, or family history may need annual or even more frequent exams.

Who Should Get Professional Screening?

Anyone can develop skin cancer, but some people are at higher risk and should be especially vigilant about professional screenings:

• People with fair skin, light hair, and light eyes
• Those with a history of severe or frequent sunburns
• People with many moles (more than 50) or unusual moles
• Anyone with a personal or family history of skin cancer
• Those with a weakened immune system
• People who have used tanning beds
• Outdoor workers or people with significant sun exposure
• Anyone who notices changing or concerning spots

Other Warning Signs

Beyond the ABCDE rule, be alert to these additional warning signs:

• A sore that doesn't heal within a few weeks
• A spot that becomes painful, itchy, tender, or bleeds
• A growth that looks pearly, translucent, or shiny
• A red, scaly patch that crusts or bleeds
• A growth with a raised border and central indentation
• The "ugly duckling" sign - one mole that looks very different from your others

Don't Forget Less Common Areas

Skin cancer can develop anywhere on your body, including areas that rarely see sun. Don't skip checking between your toes, the bottoms of your feet, under your nails, your scalp, behind your ears, and even your genital area. Melanoma can develop in these locations, and because they're often overlooked, cancers here may be detected at later stages.

When to See a Dermatologist

Make an appointment with a dermatologist if you notice:

• Any new mole or spot that appears after age 30
• A mole that matches any of the ABCDE warning signs
• Any mole or spot that looks different from your other spots
• A sore that won't heal
• Any skin change that concerns you

Don't wait for your regular check-up if you notice something concerning. Early evaluation of suspicious spots can make a significant difference in outcomes.

Prevention Is Still Primary

While screening is important for early detection, prevention remains the best strategy against skin cancer. Protect your skin by seeking shade, wearing protective clothing and broad-brimmed hats, applying broad-spectrum sunscreen with SPF 30 or higher, and avoiding tanning beds.

Remember that sunscreen should be reapplied every two hours, or more often if swimming or sweating. Even on cloudy days, UV rays can damage your skin.