ASK THE EXPERT: How do I perform a skin self exam?

By Roger Ceilley, MD, FAAD

Dr. Ceilley is clinical professor, department of dermatology, University of Iowa, Iowa City, and is in private practice in West Des Moines. He is past president of both the American Academy of Dermatology and the American Society for Dermatologic Surgery. He has authored or coauthored over 100 scientific publications, books, and chapters.

Q. What should I look for when I perform a skin self-exam, and how do I perform one?

A. Skin self-exams aid in early detection of skin cancers. They should be performed once a month, in addition to an annual full-body skin exam by your physician. A skin self-exam involves systematically examining your entire body for skin changes that could be warning signs of the most common skin cancers (basal and squamous cell carcinomas and melanoma).

Basal cell carcinoma is rarely fatal, but like squamous cell carcinoma (SCC), can be disfiguring if not treated in a timely fashion. squamous cell carcinoma also causes about 2,500 deaths per year in the US. Warning signs for these skin cancers include:

  • A spot, sore, shiny bump or nodule, scaly lesion, or wart-like growth that continues to itch, hurt, crust, scab, erode, ooze, or bleed
  • An open sore or wound that does not heal within 2-3 weeks
  • A white, yellow, or waxy scar-like area, or a reddish patch or irritated area.

Melanoma is the deadliest form of skin cancer, killing an estimated 8,790 people in the US in 2011 alone. Melanomas are often mistaken for benign moles. However, moles and melanomas differ in significant ways. The ABCDEs, below, describe the characteristics that can help you identify potential melanomas.

The ABCDEs of Melanoma

  • A The mole is asymmetrical; the two sides do not match
  • B The mole is irregular in outline or border
  • C The mole changes color or appears pearly, translucent, tan, brown, black, or multicolored
  • D The mole is bigger than 6mm in diameter, or the size of a pencil eraser
  • E The mole evolves or changes in any way

Also be on the lookout for moles that appear after age 21. Any new skin growth, beauty mark, mole, brown spot, wound, or sore that doesn’t heal can be cause for concern; consult your physician if you have questions.

To perform a self-exam, you’ll need a bright light, full-length mirror, hand mirror, two chairs or stools, and a blow dryer.

1. In front of a full-length mirror, study your face, especially the nose, lips, mouth and ears — front and back.

2. Use a blow dryer to check your scalp, exposing each section to view.

3. Examine the palms, hands, fingers, fingernails, and fronts and backs of the forearms.

4. Check the upper arms, including underside and underarms.

5. Look at the neck, chest and torso; women should check underneath the breasts.

6. Next, turn your back to the full-length mirror and use the hand mirror to examine the reflection of the back of your neck, shoulders, and upper back.

7. Use both mirrors to view the lower back, buttocks, and backs of the legs.

8. Sit down, and prop your foot on another chair or stool. Using the hand mirror, examine your genitals. Look at the legs, especially ankles, tops and undersides of feet, and between the toes.

On your next self-exam, note any changes in your skin, such as increases in size, differences in shape, and the appearance of any new growths. If your skin shows any warning signs of skin cancer, consult your physician.

Published in the Winter 2009 Edition of Sun & Skin News