Health
Did you know skin cancer is the most common cancer in the U.S. and in the world?1 According to the Skin Cancer Foundation, 1 in 5 Americans will develop skin cancer by the time they are 70.1
If it is found early, the 5-year survival rate for skin cancer is 99%.1 Scheduling an appointment with a dermatologist can help identify early issues and give you peace of mind.
Scheduling regular skin cancer screenings can drastically improve your chances of catching and treating skin cancer. In fact, the survival rate is extremely high if caught early — 99% for a 5-year survival rate.1 Regular checkups by a dermatologist are incredibly important — they can help catch any abnormalities, including early signs or symptoms of skin cancer before they become a serious problem.
Schedule a TBSE (Total Body Skin Exam) to get ahead of any potential skin cancer issues. A TBSE is an examination of all of your skin, from your scalp to your toes. If you’ve never had a skin cancer screening, the idea can be nerve-racking; knowing what to expect at a TBSE before you go can help reduce anxiety about your appointment.
“It can feel embarrassing for you to have all of your parts looked at,” says Tsippora Shainhouse, MD, FAAD, a board-certified dermatologist in Los Angeles. ”But it’s important to point out any new skin issues to your dermatologist. They look at unclothed bodies all day and are comfortable looking at all body parts with a professional eye. If you feel at all uncomfortable, speak up.”
“If it’s the first time you have seen a particular doctor or dermatologist, make them aware of your skin history,” says Lisa Bickerstaffe, head of communications at the British Skin Foundation“ And make sure you let them know if there’s a family history of skin cancer.” If you’ve had a previous biopsy, bring pathology records so the dermatologist is up to date on the site, diagnosis, treatment, and approximate date.
You’ll be asked to fully undress and put on a standard paper gown, open in the back. “If you don’t want your genital area examined, you may leave your underwear on,” advises Dr. Shainhouse. “Many dermatologists will not automatically do a genital exam. If yours doesn’t, and you have a spot or bump that concerns you, do ask them to look.”
The entire exam shouldn’t take more than a few minutes. “Your dermatologist should use their naked eye, as well as a magnifying tool, such as a dermatoscope — a tool that can help differentiate benign (harmless) from malignant (cancerous) lesions — to examine the surface features more closely,” says Dr. Shainhouse.
“I start with the neck and chest, work my way down each arm, examine the abdomen and breast area and then examine the sides and back of the trunk. I look at the groin area, then the front of each leg, and then examine the feet, between the toes and the toenails. I then ask the patient to stand up, and I examine the backs of the legs, the buttocks, and the waist area. I then examine the scalp by parting the hair all over. I examine the back of the neck and behind the ears, the sides and front of the neck, and finally, the entire face, including lips, tongue, ears, and eyelids.”
If you have any irritating, benign lesions, or surface pre-cancerous spots, they can be treated with liquid nitrogen (LN2). “LN2 is very cold and it’s used to frostbite the abnormal cells, so that they lyse (burst) and die and flake off,” explains Dr. Shainhouse. This process will be done on the spot: “The dermatologist will take a metal can with a tiny nozzle and spray the concerning spot for a few seconds; It will look white and icy. After letting it thaw for a few seconds, the process may be repeated, to make sure that the full-thickness of the cells are frozen,” she says. You’ll develop a blister or scaly spot within a few days, which will heal within a few weeks.
If your dermatologist identifies a mark that may be cancerous, they will order a biopsy. “This takes a few minutes to set up and perform, and you’ll only feel the initial injection for the local anesthetic,” says Dr. Shainhouse. “First, a photograph of the lesion is taken to document the appearance and the site. Then consent is signed that you permit the lesion to be biopsied and sent to the pathology lab to make a slide for further evaluation. The site is then injected with a small amount of lidocaine with epinephrine; it will feel numb within seconds.”
There are two types of biopsies: a shave and a punch. “For a shave biopsy, a small blade is used to shave off the lesion. Aluminum chloride or electrocautery is used to stop any bleeding. Ointment and a Band-Aid are placed on the site and the specimen is placed into a labeled jar,” says Dr. Shainhouse. “For a punch biopsy, a tool with a tiny cookie-cutter end is used to cut out the lesion in question. After cleaning and numbing the area, the area is ‘punched’ out, and one to two stitches are usually placed. These need to be taken out in seven to 14 days, depending on the site.”
It can take up to two weeks for the dermatologist’s office to receive results from the lab. Some offices require that you return in two to three weeks to discuss your biopsy results, which doesn’t necessarily mean that further treatment will be required or performed on that day. Others will call patients with any result, benign or malignant, while some will call only for malignant lesions. So be sure to clarify what to expect with your dermatologist.
If cells are cancerous and “an excision is necessary, you will need to schedule that,” says Dr. Shainhouse. “It’s fairly similar to the biopsy procedure, but will require stitches, which takes a bit longer, so you will be scheduled for a longer, 20- to 30-minute visit.”
Typically, dermatologists recommend scheduling a total body skin exam at least once a year if you have a first-degree relative who’s had skin cancer or you’ve had precancerous or cancerous spots yourself. But between appointments, you aren’t off the hook.
“The best way to detect skin cancer is to check your skin regularly, about once a month. You should examine the skin all over your body, from top to toe,” says Bickerstaffe. “Ask a friend or family member to look at areas you can’t see such as your scalp, ears, and back.”
What skin cancer symptoms should you be looking for? “Moles or patches of skin that are growing, changing shape, developing new colors, inflamed, bleeding, crusting, red around the edges, particularly itchy, or behaving unusually,” advises Bickerstaffe. “If in doubt, get it checked out straight away.”
Arm yourself with the right information and know what to expect when it comes to skin cancer screenings and regular checkups with a dermatologist. Find a doctor who you’re comfortable with and keep up with self-examinations too — you’ll go a long way in protecting your skin and overall health.
