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Self-Check Skin Exams: How to Spot Signs of Skin Cancer

Guide to Early Detection and Skin Cancer Prevention

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Updated August 13, 2013

Spot Squamous cell carcinoma with a self-check skin exam

Squamous cell carcinoma

Photo © A.D.A.M.

One of the main reasons for the wonderfully high cure rate of nonmelanoma skin cancer is the ability to detect it in its early stages. However, early detection doesn’t happen in a vacuum: it relies on each person's taking an active role in her health care by learning how to check her body for potentially cancerous lesions. Unfortunately, research published in the Journal of the American Academy of Dermatology shows that only 8% of surveyed U.S. workers had a skin exam in the previous 12 months. That’s an abysmally low number, considering that finding a cancerous lesion early may just save your life.

Have you thought about performing a self-examination, but don’t know what to do? Fear not! Here are answers to five common questions about skin self-exams.

How often should I perform a self-exam?
Minimally, ask your general practitioner to perform a skin examination during annual physicals (it’s called a “total cutaneous examination,” or TCE, in medical parlance). Ophthalmologists, gynecologists, and even dentists can also check your skin during their respective examinations. In addition, you should perform a self-check at least several times per year. If you’re in a high-risk group — have a history of extended sun exposure and sunburn, fair skin color or freckles, a melanoma diagnosis in the family, or other risk factors — you should be especially vigilant by examining your skin monthly. However, people of all races, skin colors, and ages can get skin cancer, so it is important for everybody to examine their skin regularly.

How do I perform a self-exam?
Checking your skin is easy, quick, and decidedly low-tech. All you need is a full-length mirror, a handheld mirror, a comb, and a bright light. As you look at each part of your body, learn the pattern, location and size of blemishes on your skin so that you can quickly detect any changes that occur. The goal is simply to get to know your skin, so that you’ll be able to notice anything suspicious even before your doctor. Keep in mind that potentially cancerous growths may appear anywhere, even in areas not typically exposed to the sun, and that some skin cancers are not caused by the sun at all.

Here are the steps to follow:

1. After a shower or bath, examine your head and face, using both mirrors for hard-to-see areas. Use a comb to check your scalp under your hair. Don’t forget your ears, under your chin, and your neck.

2. Examine the tops and bottoms of your hands, including in between your fingers and your fingernails.

3. Examine your forearms, upper arms, underarms, chest and belly. Women will need to check the skin under their breasts.

4. Sit down and check your thighs, shins, tops and soles of your feet, toes, in between your toes, and toenails. (Don’t skimp on the foot exam: 60% of melanoma cases in African-Americans occur on the feet.)

5. With the hand-held mirror, check your calves and the backs of your thighs, lower back, buttocks and genital area, upper back, and back of your neck. (The legs and upper back are the areas most prone to melanoma, so be thorough.)

What exactly should I look for?
Generally speaking, you should look for changes over time in any marks on your skin. Here are some more specific warning signs:

  • new red or darker colored flaky patches or nodules
  • new firm, flesh-colored bumps
  • bleeding sores that don’t heal after 2 to 3 weeks
  • change in the size, shape, color, or feel of a mole (look for specific features that may be indicative of melanoma, the deadliest form of skin cancer, such as: a mole that is painful or itchy, larger than 6 millimeters across, irregularly shaped, multi-colored, or with an ragged border)

Photo galleries of basal cell carcinoma, squamous cell carcinoma, and melanoma are available that may help you decide if what you are seeing is a harmless mole, a pre-cancerous skin lesion (for example, an actinic keratosis), or something more serious that needs to be further analyzed by a professional.

What should I do if I see something suspicious?
If you’re in doubt about a new mole, bump or lesion that has appeared on your skin, contact your primary care physician or dermatologist as soon as possible. Your doctor will examine the area in question closely, possibly using a dermascope (a special skin microscope) or obtaining a biopsy (a sample of the skin). It is also important to remain calm, since the majority of moles and blemishes are not cancerous.

What if I can’t perform a self-exam or don’t have health insurance?
If you are unable to examine your skin or see a doctor, you’re in luck: free exams are available nationwide. The American Academy of Dermatology (AAD) offers a database of the free screening programs available: To find the time and location of a program in your area, just enter your city and state in the search form. The exam lasts only about 10 minutes and involves no blood work or other invasive procedures. Since 1985, AAD has conducted almost 2 million screenings and has detected over 180,000 suspicious lesions, so you’re in good hands. If no AAD program is in your area, the Skin Cancer Foundation sponsors a traveling 38-foot customized RV that stops periodically at participating Rite Aid stores and other locations in 50 cities nationwide. Just show up and a local board-certified dermatologist will conduct a full-body screening exam absolutely free.

Skin cancer is the most common form of cancer. Fortunately, it is also one of the most treatable — but only if you catch it early by making skin self-exams a part of your monthly routine.

Sources:

How to do a skin self-exam. National Cancer Institute August 2005. 15 July 2008.

Performing a skin self-exam. American Academy of Dermatology 2008. 15 July 2008.

Examining your skin. American Cancer Society June 2008. 15 July 2008.

Self-examination. Skin Cancer Foundation 2008. 15 July 2008.

LeBlanc WG, Vidal L, Kirsner RS, Lee DJ, Caban-Martinez AJ, McCollister KE, Arheart KL, Chung-Bridges K, Christ S, Clark J 3rd, Lewis JE, Davila EP, Rouhani P, Fleming LE. “Reported skin cancer screening of US adult workers.” Journal of the American Academy of Dermatology July 2008 59:55-63. 16 July 2008.

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