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Anyone who has an increased risk of developing melanoma must be particularly vigilant. Do any of these risk factors apply to you: light eyes, hair, and/or skin; freckles; many moles; personal or family history of melanoma or nonmelanoma skin cancer; sun sensitivity; inability to tan; repeated and intermittent sunburns; a very large mole present at birth, or dysplastic nevi?

The best advice is “Know your skin.” Each family member should become aware of all moles on his/her total skin surface to minimize the risk of melanoma progressing to life-threatening stages.

Anyone, especially someone with an increased risk of developing melanoma, should:

• Examine the skin completely each month, using a good light source (to illuminate the areas being examined), a full-length mirror and a hand-held mirror. Ask a family member or friend to help in examining hard-to-see parts of the body. A hair dryer is useful when checking the scalp. Also, examine the bottom of the feet and between the toes.
• Seek prompt medical attention if any of the warning signs of melanoma described earlier are found.
• Have a head-to-toe skin examination by a physician annually or more often. If moles are changing, as they may during adolescence, they should be checked at more frequent intervals. Inform your doctor about any moles that have suspicious signs, symptoms, or changes.

Suggestions for People with Dysplastic Nevi

If your doctor suspects dysplastic nevi, one or more moles may be biopsied — removed in a minor surgical procedure for microscopic examination. It is not necessary to remove all dysplastic nevi. However, if moles show significant change or signs of melanoma, or if new moles appear after age 40, they may be considered for removal by your physician.

When the diagnosis of dysplastic nevus is confirmed microscopically, it is advisable to:

• write down a complete family history of unusual moles, melanomas or other cancers. Discuss it with your doctor.
• have regular complete skin examinations at intervals suggested by your doctor, and advise family members to do the same.
• supplement regular medical checkups with monthly self examination of the skin.
• reduce sun exposure. Excessive exposure may stimulate formation of new moles or even cause melanomas.
• check with your doctor about having a set of full-body photographs taken, especially if family members have dysplastic nevi or melanoma and/or you have many moles. Changes can be more easily spotted in this way.
• have any unusual or changing skin growth examined promptly by your doctor.
• check with your physician to see if an eye examination is recommended, since moles and melanomas may also arise in the eyes.
• be concerned, but don’t worry excessively.

With regular self-examination, professional examination, and common sense, you greatly reduce your chances that a melanoma will grow to a threatening size before it can be detected and removed.

Preventing Skin Cancer

While skin cancers are almost always curable when detected and treated early, the surest line of defense is to prevent them in the first place. Here are some sun safety habits that should be part of everyone’s daily health care:

• Seek the shade, especially between 10 A.M. and 4 P.M.
• Do not burn.
• Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
• Use a broad-spectrum sunscreen with an SPF of 15 or higher every day.
• Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours.
• Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.
• Avoid tanning parlors and tanning devices.
• Examine your skin head-to-toe every month.
• See your doctor every year for a professional skin exam.

Photos courtesy of William A Crutcher, MD; Ashfaq A. Marghoob, MD; Harold Rabinovitz, MD; and MSKCC Dept of Dermatology

Medical Reviewers:
Alfred W. Kopf, MD
Arthur J. Sober, MD
Steven Q. Wang, MD

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