To help you make the most of your dermatologist’s appointment, The Skin Cancer Foundation asked Elizabeth Tanzi, MD, how to prepare for and what to expect during a routine full-body skin examination. Dr. Tanzi is co-director of laser surgery at the Washington Institute of Dermatologic Laser Surgery, Washington, DC, and assistant professor in the Department of Dermatology, Johns Hopkins Hospital Center, Baltimore.
Before the Exam
“Remove all nail polish from your fingernails and toenails!” As Dr. Tanzi explained, “We need to look at your nails and nail beds, since skin cancers can form there.” Perform a full-body skin self-exam, and make note of any new, changing, itching, or bleeding moles, growths, or other lesions. In the early stages of skin cancer development, “You’re the person who has the best chance of noticing small changes,” Dr. Tanzi observed.
At the Exam
The exam itself will likely be brief, said Dr. Tanzi: “An annual skin exam on a patient who’s never had atypical (dysplastic) moles takes about 10 minutes. [Atypical moles are benign, but look suspicious and could be a risk factor for skin cancer.] The more moles you have, the longer the exam.” Ask the dermatologist to examine closely any moles, growths, or lesions you noted during your skin self-exam. Your dermatologist may biopsy (remove a layer of skin for examination under a microscope) suspicious-looking growths. If you’ve never evaluated your skin, “Have the dermatologist show you how to do a proper skin self-exam. You should know where to look and what to look for.” In particular, Dr. Tanzi counsels patients not to ignore often overlooked areas like the scalp, between the toes, and the soles of the feet. Finally, ask questions. From spellings of unfamiliar terms to recommendations for further research, your doctor should be able to address your concerns. You may want to take notes for reference.
“Because patients are often uninformed about what they need to look for, they can be prey to misconceptions about what is a cause for concern,” Dr. Tanzi explained. “For example, a lot of patients ask me if their raised moles are dangerous. Mostly they’re nothing to worry about,” though they should be checked. “Additionally, I’m often asked if a mole should be removed because it itches. For instance, a patient will have a mole that gets chafed and irritated by clothing. In general, irritation does not lead to skin cancer. If it’s truly a benign nevus (mole) or lesion, then irritation from clothing over long periods of time is not going make it cancerous.”