The importance of a skin cancer check
Q: I turn 50 this year and at my annual physical, my doctor suggested I visit a dermatologist to check for melanoma. I have never had any suspicious moles or spots on my skin, so I've not had a skin check with a dermatologist before. Is this really necessary?
A: It is important to be familiar with your skin so you can notice changes, but it's always a good idea to be evaluated by a dermatologist for a baseline skin check. While regular self-evaluation make it more likely that melanoma and other types of skin cancer will be caught early, having a trained expert look for subtle changes you may not see is always helpful. The earlier skin cancer is diagnosed, the better the chances are of curing it.
Melanoma is the most serious type of skin cancer. It develops in cells called melanocytes that produce melanin, the pigment that gives your skin its color. The exact cause of all melanomas isn't clear, but exposure to ultraviolet (UV) radiation increases your risk of developing the disease. This can come from sunlight, as well as from tanning lamps and tanning beds. Also, genetic factors and skin type can play a part in developing skin cancer.
The number of melanoma cases has increased dramatically over the past 30 years, especially among middle-age women. The increase may be linked to the rise of tanning bed use in the 1980s, when many women now in their 40s and 50s were in their teens.
Melanoma that goes unchecked and spreads can be difficult to treat. But when it's caught early, melanoma often is curable.
When checking your skin for possible concerns, keep in mind the ABCDEs of skin cancer:
"A" is for asymmetry: watch for moles or markings that are irregularly shaped, or where one half looks different from the other.
"B" is for border, where the borders of the mole are uneven, jagged or scalloped.
"C" is for color, with the color of the mole varying from one area to another. Variation of color within a mole is something to have checked.
"D" is for diameter. If you have a mole larger than about one-quarter of an inch in diameter, have it checked.
And "E" is for evolving: If a mole changes in size, shape or color, or if there's bleeding, itching or tenderness, it's important to have it evaluated promptly.
Although you indicate you do not have any skin concerns, it still would be valuable to visit a dermatologist to get a baseline skin check, especially if you have a family history of melanoma or have often used tanning beds. Although it is more common to develop new moles during childhood and early adulthood, older people may develop other pigmented spots—such as seborrheic keratosis—that could be mistaken for moles and cause concern.
A skin check by a dermatologist often only takes a few minutes, but it is a critical part of identifying skin cancer early. Other types of skin cancer that a dermatologist will look for include basal cell carcinoma and squamous cell carcinoma. These cancers tend to look like pink, red or scaly spots on your skin that do not go away on their own. They may also bleed and grow in size.
In the meantime, I would recommend that you get into the habit of checking your skin once a month, and be diligent about protecting your skin as much as possible.
Stay out of the sun during the middle of the day when UV light is the strongest, and when you're outdoors, wear protective clothing, including a hat, and use sunscreen no matter the season or weather. The sun protection factor, or SPF, of your sunscreen should be at least 30. Look for sunscreen that is broad spectrum, to cover both UVA and UVB rays. Sunscreen should be applied generously and frequently to get the full amount of protection.
Dr. Alison Bruce, Dermatology, Mayo Clinic, Jacksonville, Florida
©2020 Mayo Foundation for Medical Education and Research
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