By guest dermatologist David Fieleke, MD, FAAD
Board Certified-Dermatologist and Mohs Surgeon at Cornerstone Dermatology & Surgery Group
What to Expect During a Skin Cancer Screening With Your Dermatologist
The first question that runs through many people’s heads when scheduling an appointment for a full-body skin exam is usually “Do I have to take off all my clothing?”
The simplest answer? Yes.
As dermatologists, your health and safety are of the utmost importance to us, which means we need to check the entirety of your skin.
Just know that if you’re feeling a little bit anxious about disrobing for your skin cancer screening at your dermatologist’s office, you’re not alone. I hope that by detailing a skin cancer screening visit from start to finish, I’ll give you peace of mind as you prepare for your appointment.
Why Is Skin Cancer Screening Important?
The skin is the largest organ in the body, and more people are diagnosed with skin cancer every year in the U.S. than all other cancers combined. One in five Americans will develop some form of skin cancer before the age of 70.
But the great news is that when detected early, skin cancer is highly treatable. When detected early, the five-year survival rate for melanoma, the most aggressive form of skin cancer, is 99 percent.
Preparing for Your Skin Cancer Screening
To provide your dermatologist with the best access to information during your skin cancer screening appointment, here are a few ways you can prepare:
Perform a skin self-exam at home. If you’ve noticed any spots that are new, changing or unusual, be sure to bring these up with your dermatology provider.
Bring a summary of your medical history and all medication you currently take. Some health conditions or medications can affect the way things appear on the skin or could predispose you to certain types of skin cancers.
Remove nail polish to allow your dermatologist to fully examine your fingers, nails and nail beds, since skin cancers can form in these locations.
Wear your hair loose, or in a hairstyle that can easily be taken down so your dermatologist can examine your scalp.
Skip the makeup, or if you’re coming from somewhere and cannot come-clean faced, arrive early to your appointment and remove all makeup in the patient bathroom. The face is one of the most common locations for skin cancer to form, and your dermatology provider cannot adequately perform an exam when you’re wearing makeup.
Wear clothing that’s easy to change out of and move out of the way. Your dermatology provider will ask you to change into a gown with either no garments underneath or garments that can be easily moved aside to provide you with a full exam.
During Your Skin Cancer Screening
The skin cancer screening itself will most likely take around 10 minutes, but I advise patients to plan for around an hour for their full appointment.
A clinical assistant will escort you to a private patient room and provide you with a gown. It is my goal to visualize all of your skin, so we don’t want anything in our way, whether it’s clothing, makeup or nail polish!
Depending on your dermatology provider, you may wear undergarments that are easy to move out of the way so your provider can fully visualize your skin. Some patients feel more comfortable wearing a two-piece swimsuit underneath, and that’s fine with me as long as it’s something I’m able to shift around and see under during the exam. SwimZip has some great options!
During your skin cancer screening, your dermatologist will inspect you from head to toe. You may notice your dermatologist using a tool that looks like a lighted magnifying glass. This specialized tool is called a dermatoscope, and provides magnification as well as polarized light, which will help your dermatologist identify and evaluate lesions.
During the exam, your dermatologist may take clinical photos of moles or lesions to monitor them for growth and any future changes.
If a mole or lesion is of concern to your provider, they will review this information with you. They may take a biopsy of your mole/lesion during this visit, or may ask you to schedule a followup appointment for your biopsy.
Prior to a biopsy, your dermatologist will deliver a shot of numbing medicine, which can sting a little. After that, it’s a quick and painless procedure!
The size, location and suspected diagnosis will help determine the type of biopsy.
A shave biopsy involves shaving the surface of the lesion with a flexible blade. A punch biopsy looks like a small cookie cutter, and removes a deeper portion of the lesion, if needed.
After Your Skin Cancer Screening
Following your skin cancer screening, your dermatologist will discuss any concerns with you and will recommend a time range for your followup appointment. This could be six months to a year, based upon your health history, risk factors and your dermatology provider’s visual exam.
If a biopsy was taken during your visit, expect to receive a followup call from your dermatologist’s office within two weeks to discuss the results and next steps.
We always hope for a report of ‘benign’ … but there are many excellent treatment options in the event of skin cancer.
If you have a cancer diagnosis on sensitive or visible areas such as the face, neck, ears or hands, your dermatologist might recommend Mohs micrographic surgery. This procedure offers the highest cure rate of any treatment for non-melanoma skin cancer – up to 99 percent for basal cell and squamous cell carcinoma. This procedure is performed on an outpatient basis and under local anesthesia.
If you have any questions about a skin cancer screening or Mohs surgery, don’t hesitate to reach out to us at Cornerstone Dermatology & Surgery Group!