Routine skin self-exams are one of the best ways to catch skin cancer early. The American Academy of Dermatology generally recommends a monthly self-exam. Do you know how to perform one at home?
“Some skin cancers can be very aggressive and even deadly,” explains Seth Bendo, MD, a dermatologist at OhioHealth. “The earlier you catch the skin cancer, the higher your chances of a cure.” Even melanoma — the most aggressive form of skin cancer — is highly treatable when found at an early stage.
Let’s review what you need to look for during your self-exam and when it could be time to seek a professional evaluation.
What do you need for a thorough self-check?
Skin self-exams can be anything from a more formal 10-minute exploration to a few short minutes after a shower. Ample lighting, a full-length mirror and hand mirror can help you view all areas of your body. Good lighting and a partner can also help with those hard-to-see spots like your back, scalp and feet.
“The places that get missed during a self-exam are the ones that are hard to see — your back, bottoms of your feet, between your toes, and even your groin and scalp,” says Dr. Bendo. Ensuring you check these often overlooked areas, as well as those that receive the most sun, like your face, neck, arms, chest, legs, and ears, is important for a thorough self-exam. Keeping up with consistent checks allows you to notice and document any changes over time.
Warning signs to watch for
One of the best tools to assess suspicious spots is the ABCDE rule, which is used specifically for identifying potential melanoma. Each letter stands for a different concerning feature of a skin mark:
- Asymmetry: One half doesn’t match the other.
- Border irregularity: Irregular, ragged or blurred edges.
- Color variation: “A nice even brown is generally very healthy,” says Dr. Bendo. “Once you start seeing two or three colors in a mole, that’s concerning.”
- Diameter: The mole is larger than 6mm (about the size of a pencil eraser). Dr. Bendo explains that there are healthy moles larger than 6mm. Therefore, while size alone might not indicate cancer, it does suggest that the mark should be evaluated.
- Evolving: Any change in size, shape, color or height could be a cause for concern.
“Most skin cancers are what we call non-melanoma skin cancers. These include basal cell carcinoma and squamous cell carcinoma. So, the ABCDE rule is good for melanoma, but it’s not going to help identify every cancer,” warns Dr. Bendo.
Because of this, another tool Dr. Bendo recommends using is the “ugly duckling rule.” The “ugly duckling rule” is the idea that if you have a skin growth that doesn’t look like your other skin features, that’s something you want to get evaluated by a professional. For example, a sore that doesn’t heal or a rash that lingers could also be a warning sign. These non-melanoma cancer spots tend to be redder in color.
“Some people think that they look like a little spot of eczema, but it never goes away. These spots can sometimes bleed spontaneously. You thought it should have healed weeks ago, and it’s just not healing. These can all be signs of one of these non-melanoma skin cancers,” says Dr. Bendo.
When to see a dermatologist and what to expect
While self-checks are essential, they are not a replacement for professional skin cancer screenings. Dr. Bendo recommended seeing a dermatologist if:
- You notice a new or changing spot.
- You notice a spot that is concerning based on the guidelines above.
- You have a family history of skin cancer.
- You have fair skin or a personal history of excessive sunburns, lots of moles or previous skin cancers.
People at higher risk may benefit from annual skin exams, while others might only need screenings every few years. “A dermatologist can help you determine the best schedule based on your personal risk factors,” Dr. Bendo explains.
During a professional skin exam, here’s what to expect: you’ll change into a gown and the dermatologist will perform a full-body visual inspection using a dermatoscope (a magnifying tool) to look at skin growths in more detail. “If something concerning is found, we usually recommend a biopsy where we numb the area and remove a piece of skin to send to a pathology lab,” says Dr. Bendo. Results typically come back within about a week.
If melanoma or another form of skin cancer is diagnosed, treatment could range from minor surgery to more advanced care depending on how deep or aggressive the cancer is.
How to reduce your risk of skin cancer
Besides performing regular skin checks, proactive prevention is key. “Protecting yourself from the sun is the biggest thing you can do,” urges Dr. Bendo. Steps you can take to prevent skin cancer include:
- Wearing sunscreen
- Avoiding midday sun, especially during the warmer months
- Wearing protective clothing like hats and sleeves
- Getting under shade when possible
- Avoiding indoor tanning beds
“If you can mow the lawn at 4 PM instead of noon, to avoid the midday sun, that actually makes a huge impact,” advises Dr. Bendo. “The midday hours like 10 AM to 4 PM pack a lot more UV, and if people can elect to be outside of the sun during the hours outside of that period, that makes an impact.” Skin cancer is the most common cancer in the United States, with millions of cases diagnosed each year. It’s also one of the most preventable cancers and highly treatable when found early. Performing regular skin self-exams, knowing what to look for and when to see a professional could save your life.
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