The Importance of Regular Skin Screenings
The American Academy of Dermatology (AAD) makes available on its patient education website some surprising statistics when it comes to the prevalence of skin cancer throughout the United States. “Most notable is the fact that skin cancer is actually the most common form of cancer within the U.S. population,” explains Dr. Melanie Pickett, board-certified dermatologist at Sanova Dermatology. Estimates are that 20%, or one in five Americans, will experience skin cancer at some point in their lifetime.
On a positive note, the most deadly form of skin cancer (melanoma), has declined in the younger population (30 and younger). However, other age groups have experienced a rise in skin cancer cases in the past 30 years, especially those age 80 and older. With this significant rise within the older population, it’s clear that as one ages, it becomes even more important for individuals to perform regular skin self-exams, especially those who have a personal history of skin cancer or atypical moles, or a family history of any form of skin cancer.
What to Look For
“In order to accurately perform a skin self-check, it’s important to know what to look for during an exam,” emphasizes Dr. Pickett. The “ABCDE” rule was established as a guideline to help individuals screen for suspicious skin lesions. The ABCDE rule is as follows:
Asymmetry — The “A” in the ABCDE rule stands for asymmetry. Upon discovery of a freckle or mole, the best way to check for symmetry is to draw an imaginary line through its center. If each side looks very similar to the other, then it is said to be symmetrical. This is the case for most normal freckles and moles. If the two sides look very different from each other (e.g., only one side has a jagged edge) then its shape would be considered asymmetrical. “This doesn’t necessarily mean the mole or freckle is cancerous, but it does raise a red flag when physicians are looking for skin abnormalities,” Dr. Pickett explains.
Border — The “B’ in the ABCDE rule stands for border. When performing a self-check, look at the border of any spots, moles, freckles, or “beauty marks.” All of these should have a well-defined, round border. If a border is jagged or blurry, it could be a sign of precancerous or cancerous growth and should be evaluated by a physician.
Color — The “C” in the ABCDE rule stands for color. Normal moles, freckles, etc. consist of only one color or are largely uniform in color. “If a spot on the skin has multiple colors or is very dark in color, this could be a sign of an abnormal skin lesion and should be brought to the attention of a medical professional,” notes Dr. Pickett.
Diameter — The “D” in the ABCDE rule stands for diameter. Any spot on the skin that is larger than a pencil eraser (roughly 6mm) should raise suspicion of an atypical or cancerous skin lesion. While skin cancers can come in all sizes, a large spot (especially one that is growing!) should be evaluated in a timely manner.
Evolving — The “E” in the ABCDE rule stands for evolution. “If a spot on the skin seems to be evolving or changing, such as exhibiting enlargement, this could be a sign of a cancerous skin lesion,” warns Dr. Pickett. Skin cancers can exhibit both slow or rapid growth and any mole or freckle that seems to be changing over time should be further examined by a physician.
Performing a Thorough Self-Check
Once a person knows what to look for, they are ready to perform a skin self-exam. A skin self-exam should be done in front of a mirror in a well-lit room. Observe all areas of the front of the body, keeping in mind the ABCDE rule when noting any moles, spots, blemishes, etc. After checking the front of the body, with arms raised, observe both the left and right sides. Thoroughly check the underarm area, elbows, lower and upper arms, and the hands.
Sit in a chair and examine the legs (front and both sides) and the feet, including the soles (bottom of the feet) and between each toe. Stand up and use a hand mirror to check the back of the neck and the scalp. Part the hair if necessary in order to get a good look at the scalp area. Again, using a hand mirror, check the entire back, buttocks, and backs of both legs.
Following the ABCDE rule, if any spot on the skin is not symmetrical, if it has an uneven border or varies in color, if it is larger than 6mm, or if it appears to be enlarging or changing over time, it should be examined further by a physician.
How often should a self-check be performed? Most physicians recommend a monthly self-exam for their patients.
How a Visit to a Dermatologist Can Help
Finding something that looks suspicious can cause alarm, however, not every spot that meets the ABCDE rule is cancerous or even precancerous. This is why it is so important to see a dermatologist upon discovery of a suspicious lesion. A dermatologist is specially trained in disorders of the skin, and has the necessary expertise to determine if an area on the skin is normal, or if further testing or treatment is needed.
How often should an individual receive a skin exam from a dermatologist? Especially as one ages, it’s important to schedule at least an annual visit with a dermatologist for a skin cancer screening to evaluate for any suspicious lesions. Those who have had skin cancer previously, or those who have a history of atypical nevi may be recommended to schedule dermatology exams more frequently.
Prevention and Early Intervention
The best way to prevent a skin issue from becoming more serious or even deadly, is through prevention and early detection. Both adults and children of all skin types and colors should wear a broad-spectrum, water-resistant sunscreen with an SPF of 30 or more on any skin that receives sun exposure. When out in the sun, it’s a good idea to get in the habit of wearing a wide-brimmed hat, along with sunglasses that offer UV protection. The AAD also recommends that individuals completely abstain from using indoor tanning beds.
Avoiding excess sun exposure and committing to regular skin self-exams can go a long way in helping to prevent a minor issue from turning into a serious one. Upon discovery of an area that does look suspicious, prompt follow-up with a dermatologist can help determine whether there actually is an issue and if so, will also recommend the next steps for proper diagnosis and treatment
Are you do for due for your annual skins screening, have you never received one, or do you have a suspicious spot? Contact your preferred location and we will happily get you scheduled for a screening!
About Dr. Melanie Pickett
Dr. Melanie Pickett is a board-certified dermatologist that specializes in adult and pediatric dermatology, including general medical dermatology, skin cancer detection and treatment, and rheumatologic dermatology. She is experienced in the treatment of complex skin conditions and enjoys working with her patients to create an individualized treatment plan that is best for them.
She currently sees patients at both our Central Austin and North Austin locations!