Skin Cancer Screening

Skin cancer screening is used to look for signs of skin cancer before it causes symptoms or spreads to other parts of the body. Unlike some cancers, there is no single routine screening schedule recommended for every person at average risk. Instead, how often your skin should be examined by a healthcare professional may depend on your individual risk factors. Being familiar with your skin and reporting new or changing spots can also help skin cancer be detected earlier.

What is a skin cancer screening?

During a skin cancer screening, a healthcare professional examines your skin for unusual growths, moles, lesions, or other changes that could potentially be cancer. A dermatologist may perform a full-body skin examination, which can include areas that are easy to overlook, such as:

• The scalp

• Behind the ears

• Between the fingers and toes

• The palms of the hands

• The soles of the feet

• Under the nails

• The back

• The buttocks and genital area

The examination is usually quick and painless.

Who should be screened for skin cancer?

There is currently not enough evidence to recommend routine clinician skin cancer screening for every adolescent and adult at average risk who does not have symptoms. However, regular skin examinations may be appropriate for people at increased risk of skin cancer. You may need more frequent professional skin examinations if you have:

• A personal history of melanoma or another skin cancer

• A strong family history of melanoma

• A large number of moles

• Atypical or unusual moles

• Fair skin that burns easily

• A history of frequent or severe sunburns

• Significant lifetime UV exposure

• A history of indoor tanning

• A weakened immune system

• Certain inherited conditions associated with skin cancer

• Other factors that place you at increased risk

Talk with your healthcare provider or dermatologist about your individual risk and whether routine professional skin examinations are appropriate for you.

Check your skin for changes

There is no universally recommended schedule for skin self-exams for people at average risk. However, becoming familiar with your skin can make it easier to notice something new or changing. When checking your skin, look at your entire body, including areas that may not receive much sunlight. A mirror can help you examine difficult-to-see areas. You can also ask a partner or family member to help check areas such as your scalp or back. Pay attention to:

• New moles or growths

• Moles that change in size, shape, or color

• Spots that look different from your other moles

• Sores that do not heal

• Growths that bleed, crust, itch, or become painful

• Scaly or rough patches

• Firm or shiny bumps

• New dark areas underneath a fingernail or toenail

If you notice something unusual, contact a healthcare provider rather than waiting for your next routine examination.

Know the ABCDEs of melanoma

The ABCDE rule can help you recognize some of the warning signs of melanoma.

• A – Asymmetry: One half of the mole does not match the other half.

• B – Border: The edges are irregular, blurred, notched, or poorly defined.

• C – Color: The color is uneven or includes different shades of brown, black, tan, red, white, or blue.

• D – Diameter: The spot is larger than about 6 millimeters, roughly the size of a pencil eraser. However, melanomas can be smaller.

• E – Evolving: The mole or spot changes in size, shape, color, elevation, or another characteristic over time.

Not every melanoma follows the ABCDE pattern. A spot that looks different from everything else on your skin, the "ugly duckling" sign, can also be an important warning sign.

What do other skin cancers look like?

Melanoma is not the only type of skin cancer.

Basal cell carcinoma may appear as:

• A shiny or pearly bump

• A pink or red growth

• A flat, scar-like area

• A sore that repeatedly heals and returns

• A growth that bleeds easily

Squamous cell carcinoma may appear as:

• A firm red bump

• A rough or scaly patch

• A crusted growth

• A sore that does not heal

• A wart-like growth

Skin cancers can look different from person to person. Any persistent, new, changing, or unusual skin lesion should be evaluated by a healthcare professional.

Skin cancer in people with darker skin

Skin cancer can occur in people of every skin tone. In people with darker skin, melanoma may be more likely to develop in areas that are not regularly exposed to the sun, including:

• The palms of the hands

• The soles of the feet

• Under the fingernails or toenails

A type called acral lentiginous melanoma commonly develops in these locations and is not necessarily related to UV exposure. Everyone should pay attention to new or changing areas of the skin, regardless of skin tone.

What happens if your doctor finds a suspicious spot?

If a healthcare provider finds an area that could be skin cancer, they may recommend a skin biopsy. During a biopsy, some or all of the suspicious tissue is removed and sent to a laboratory, where a pathologist examines the cells under a microscope. A biopsy is the only way to know for certain whether a suspicious skin lesion is cancer. If cancer is found, additional information from the biopsy can help determine the type of skin cancer and guide the next steps in your care.

When should you see a dermatologist?

You do not need to wait for a scheduled skin cancer screening if you notice something concerning. Make an appointment with a healthcare provider or dermatologist if you notice:

• A new or rapidly growing spot

• A mole that is changing

• A spot that looks noticeably different from your other moles

• A sore that does not heal

• A lesion that repeatedly bleeds, crusts, or scabs

• A persistent itchy, tender, or painful spot

• A new dark streak or discoloration beneath a nail

Most skin changes are not cancer, but having a suspicious area evaluated promptly can help identify skin cancer at an earlier stage.

The bottom line

There is no universal skin cancer screening schedule for everyone at average risk. People at increased risk may benefit from regular full-body skin examinations by a dermatologist. No matter your risk level, becoming familiar with your skin can help you recognize new or changing areas. If you notice a suspicious spot, changing mole, or sore that does not heal, do not wait for your next routine examination. Talk with a healthcare professional or dermatologist about having it evaluated.