Skin Exam

What is a skin exam?

Every month or two, it is a good idea to check your skin for new growths or other changes. With skin exams you can look for changes in your skin that might be cancerous. Everyone is at risk for skin cancer from current or past exposure to sunlight. If it is caught and treated early, most skin cancer can be cured.

What changes are harmful?

Most changes in the skin are harmless and not cancerous. But some changes may be signs of disease. The type of skin cancer called melanoma is a very serious type of skin cancer because it can spread to other parts of the body.

Moles are small areas of darkened skin. Normally, they have a smooth, even border and are a single color. They may be beige, pink, or dark brown. Think of the letters, A, B, C, and D to remember the guidelines to find moles that may be harmful and should be checked by your healthcare provider:

• Asymmetry: The shape of one half of the mole does not match the other.
• Border: The edges are often ragged, notched, blurred, or irregular. The pigment may spread into the surrounding skin.
• Color: The color is uneven. Shades of black, brown, and tan may be present. Even white, grey, red, pink, or blue may be seen.
• Diameter: There is a change in size. Melanomas are usually bigger than the eraser of a pencil (1/4 inch or 5 millimeters).

If you have a mole that has any of these ABCD signs, see your healthcare provider.

Who should do skin exams?

Everyone should check their skin at least every couple of months. People with fair skin that freckles easily have a higher risk of skin cancer and may need to do a skin exam monthly. You can ask your healthcare provider how often you should examine your skin.

In addition to doing routine skin self-exams, you should have your skin checked regularly by your healthcare provider. Your provider can do a skin exam during visits for regular checkups.

See your provider if you have a mole that concerns you. Also see your provider if you have a lot of moles, for example, 50 or more.

How should I do a skin exam?

Here is how you can do a skin self-exam:

• After a bath or shower, stand in front of a full-length mirror in a well-lighted room. Use a hand-held mirror to look at hard-to-see areas.
• Begin with the face and scalp and work downward, checking the head, neck, shoulders, back, chest, and so on. Be sure to check the front, back, and sides of the arms and legs. Also, check the groin, palms, fingernails, soles of the feet, toenails, and skin between the toes. Look for any changes or new growths.
• Be sure to check the hard-to-see parts of your body, such as the scalp and neck. A friend or relative may be able to help inspect these areas. Use a comb or a blow dryer to help move hair so you can see the scalp and neck better.
• Pay attention to where your moles are and how they look. By checking your skin regularly, you will learn how your moles look. Watch for any changes, particularly a new black mole or a change in outline, shape, size, color, or feel of an existing mole. Also, note any new, unusual, or "ugly-looking" moles. If your healthcare provider has taken photos of your skin, compare these pictures with the way your skin looks now.
• At times of hormone changes in women, such as adolescence, pregnancy, and menopause, it is common for moles to change. If you notice changes, have your provider check them for you.
• It may be helpful to record the dates of your skin exams and to write notes about the way your skin looks. If you find anything unusual, see your healthcare provider right away. Remember, the earlier a melanoma is found, the better the chance for a cure.

When should I see my healthcare provider?

See your healthcare provider if you have any lumps, moles, or sores that grow in size, change color or shape, bleed, are painful, or do not heal. Sometimes your provider may want to remove a mole so that the tissue can be examined under a microscope. The removal of a mole, sometimes called a biopsy, is usually done in your provider's office. You will first be given a local anesthetic to numb the skin. It generally takes only a few minutes. Depending on how big or how deep a mole is, you may need stitches, and there will be a small scar after your skin heals.

Because most moles do not develop into melanoma, removing all of them is not necessary. Your provider will recommend when a mole needs to be removed. Usually, the moles that need to be removed are ones that:

• look like melanoma
• are changing
• are new and look abnormal.

If you have already had skin cancer, you should be sure to have regular exams so that your provider can check your skin. Your provider will look at the treated areas and other places where cancer may develop.