It doesn’t matter whether you’ve never had a sunburn or you go through multiple bottles of aloe vera each summer as part of your post-sun recovery, anyone can get skin cancer. Along with being adamant about applying sunscreen every day, scheduling a mole check with a dermatologist is an important step in preventing skin cancer. To fill you in on everything you need to know about the exam and why it’s essential to schedule one, we turned to New York dermatologist Dr. Dendy Engelman.
So, What Is a Mole Check?
A mole is a body skin examination performed by a dermatologist or other licensed practitioner. During this exam, the skin is inspected from head-to-toe in order to evaluate the health of the skin and of any skin lesions.
These examinations also go by skin checks, but ultimately they’re the same. “When a dermatologist performs a mole check, they’re also evaluating the entire integumentary system (skin, hair, nails) for abnormal growths,” explains Dr. Engelman. “Moles are pigmented skin lesions that can have malignant potential, but other skin lesions can also be malignant and not derived from moles like basal cell, squamous cell, and Merkel cell carcinoma.”
Why Are Checks Important, and How Often Should You Get One?
To put it plainly: yes. “They are so important because (as with all cancers) early detection is critical to better outcomes,” says Dr. Engelman. “This means if a mole is found that is atypical, it can be removed in order prevent the cancerous cells from multiplying, invading deeper into the skin, and metastasizing (spreading to other areas of the body). Cancerous lesions can lurk on the scalp, the palms, soles, and ever between the fingers and toes.”
Just like your annual physical, a mole screening should take place once a year. However, Dr, Engelman says that there are some exceptions to this rule. If you have over 100 pigmented lesions [moles], a personal or family history of skin cancer, history of blistering sunburns or fake tanning, your doctor may recommend bi-annual exams.
What Is the Doctor Looking For During an Exam?
“During an exam I am assessing skin type, degree of photodamage caused by UV radiation (sun damage), number and quality of skin lesions,” Dr. Engelman explains. “I inquire about personal and family history of skin cancers or atypical moles, sun safety practices, and history of sun exposure, including indoor tanning and sunburns.”
When it comes to pigmented lesions, doctors follow the ABCDE rule and are looking for the following: A: asymmetry, B: irregular borders, C: irregular colors, D: diameter greater than 6mm, and E: evolving (changing).
“Other types of skin cancer (meaning non-melanoma skin cancer), can have a wide variety of presentations,” says Dr. Engelman. “They can be pearly pink papules that look like a non-healing acne lesion or they can be scaly/flaky reddish spots that don't heal. Others can be erosions in the skin that look like an ulcer.” Since it takes years of training to be able to accurately identify healthy versus potentially dangerous skin lesions, it’s important to visit a dermatologist or medical practitioner for a mole check.
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What Does It Mean When a Doctor Orders a Biopsy?
Depending on the conditions of certain moles, your doctor may order a biopsy to inspect it further. “When a biopsy is needed it means that there is evidence clinically (and/or dermatoscopically) that a mole or other skin lesion doesn't look completely healthy,” explains Dr. Engelman. “If it's a pigmented lesion, then it has likely broken one or more of the ABCDE rules listed above. If it's a non-pigmented lesson, then it may be a translucent papules concerning for basal cell carcinoma or a scaly red lesion that may be a squamous cell carcinoma.”
How Should You Prepare for the Exam?
Before the appointment with your doctor, make sure to note any changes that have occurred with new or existing growths on the skin. In addition Dr. Engelman suggests arriving at the exam with knowledge of your family history of melanoma and non-melanoma skin cancers because they’re different and carry different genetic risks.