Skin Exams: What to Expect

Medically reviewed by Cynthia Cobb, APRN on August 15, 2017Written by James Roland

Why skin exams matter

A skin exam is meant to identify suspicious moles, growths, and other changes on your skin. The shape, size, border, color, and other characteristics of the suspicious growth can help your doctor diagnose an underlying medical condition.

Skin exams are the best way to find skin cancers early. And the sooner a skin cancer is identified, the easier it is to treat. It’s important that you do self-checks on a regular basis. Adults should also have regular skin exams done by their dermatologist.

What to expect during a skin exam

Home skin exams can be done any time. A handheld mirror and a full-length mirror may be helpful to see your neck, back, and buttocks.

Areas exposed to sun regularly are the most likely to develop growths. However, a suspicious mole can show up anywhere on the body. That’s why it’s important to have a dermatologist do a complete body check.

Although skin exams with another person may be uncomfortable for some, they’re crucial to early diagnosis of skin cancer. You may be given a hospital gown for modesty. You can opt out of having your buttocks or genital area examined, but if you have a spot or growth that’s suspicious, you may want to have your doctor check it. A thorough skin exam, also known as a total body skin exam (TBSE), should include an inspection from scalp to toes.

Be sure to tell your doctor about any areas of concern before or during the exam. You should also feel free to ask any questions about signs to watch out for, skin cancer prevention, or any other aspect of skin health.

The exam should only take about 15 to 20 minutes.

What happens if your doctor finds something suspicious

If your doctor sees something suspicious, they may use a dermatoscope to examine an area more closely. A dermatoscope is essentially a lighted magnifying glass.

If your doctor suspects that a spot may be cancerous, they’ll biopsy it. They’ll remove a small tissue sample from the suspicious growth and send it to a lab for analysis. There, a pathologist will study the tissue to determine whether it is or isn’t cancerous. This process usually takes about a week.

Sometimes, a suspicious mole or spot doesn’t need to be removed or biopsied. Instead, your doctor may take a photograph of it and place that picture in your file. At your next checkup, they can compare to see if there are any changes in the spot’s size or shape.

What comes next

If a biopsy shows the tissue is benign, there isn’t anything more to do until your next exam. If lab results reveal skin cancer, your treatment plan will depend on the type of cancer you have.

Smaller procedures

If you have basal cell carcinoma — the most common type of skin cancer — or squamous cell carcinoma, you have a few options. Small cancerous lesions may be removed with a procedure called curettage and electrodesiccation. It involves scraping off the growth and then desiccating or burning the area with a hot needle. This procedure has a 95 percent cure rate.

A larger lesion may require Mohs micrographic surgery. In this procedure, the layer of skin containing the cancerous growth is removed. The tissue is examined on site for any more signs of cancer. If any parts of the tissue contain cancer cells, another layer is removed and examined the same way until no cancer is found.

More invasive procedures

Mohs surgery may also be used to remove a melanoma, the most serious type of skin cancer. However, excision, which is a more invasive procedure, may be used if the cancerous growth is deeper than the very top layers of your skin.

If the melanoma has spread to other parts of the body, such as the lymph nodes, more dramatic treatment is necessary. You may need additional surgeries to remove cancerous growths elsewhere. Chemotherapy or radiation therapy may also be necessary.

Know your options

Regardless of your diagnosis, you and your doctor should discuss all your treatment options. Ask about the risks and benefits of each option. If the skin cancer is in an obvious place, such as your face, you can also talk with your doctor about aesthetic procedures after treatment or initial treatment options that may leave less scarring.

The key is to find and treat skin cancers as early as possible. Even a potentially life-threatening diagnosis such as melanoma has a nearly 100 percent cure rate if diagnosed while it’s still just in the top layer of skin.

How often to get screened

Your medical history and your skin cancer risk help determine how often you should have a TBSE. If you’re at high risk or if you’ve had a skin cancer of any kind, you should consider yearly screenings.

If you have any of the following, you’re considered to be at a higher risk of skin cancer:

  • red hair and freckles
  • more than 50 moles
  • a family history of skin cancer
  • a genetic disorder that makes you especially sensitive to the sun
  • precancerous conditions including actinic keratosis, dysplastic nevi, personal history of skin cancer, and basal or squamous cell cancer
  • too much sun exposure
  • frequent visits to a tanning salon
  • at least one blistering sunburn
  • prior treatments including radiation therapy, immunosuppressive treatment, or other cancer treatments

If you’ve had melanoma, you may need skin exams more frequently than once a year. Talk with your doctor about what is appropriate for you. Be sure to follow through on those checkups, even if you don’t see anything during a self-exam.

Skin cancers are usually easy to identify early on. But the only way to catch them early is with regular skin exams.

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