screening

Your skin is your largest organ, but it doesn’t get the attention it deserves—especially when it comes to skin checks for cancer.

That should change, says Dr. Susan Massick, associate professor of dermatology at The Ohio State University Wexner Medical Center, because a skin cancer screening exam is one of the easiest you’ll ever have. “There is nothing to fear, dread, or be anxious about. There is no preparation needed beforehand, no bloodwork or imaging studies required during it, and no downtime afterward,” she says. Not only is a skin check straightforward and painless, but it can also give you peace of mind while being proactive about your skin health, she adds.

Here’s what dermatologists say you should know about skin cancer screenings.

Who should get a skin cancer screening?

Does everyone need to get an annual skin check with a dermatologist? Can you just do it at home yourself?

In 2023, the United States Preventative Services Task Force, a panel of national experts in disease prevention and evidence-based medicine, issued a recommendation statement saying that asymptomatic, low-risk adolescents and adults do not necessarily need routine annual skin exams. Instead, groups including the American Academy of Dermatology Association say that people should perform regular self-exams and consult with a dermatologist if they notice any changes.

But “those at higher risk—such as individuals with a personal or family history of skin cancer, numerous moles or atypical nevi, or a history of significant sun exposure—should have annual professional screenings,” says Dr. Shoshana Marmon, assistant professor in the department of dermatology at New York Medical College. (For children, screenings are generally unnecessary unless there’s a family history of melanoma or concerning changes in moles; however, parents should routinely monitor their children’s skin for any worrisome lesions, especially if they have fair skin, freckles, or a tendency to burn easily, she says.)

Having any of these qualities puts you at higher risk for skin cancer, meaning you should be checked yearly by a dermatologist, Massick says:

• Personal or family history of skin cancer

• High density of moles or atypical moles

• Prior history of chronic sun exposure, high-intensity sun exposure, sunburns (particularly blistering childhood sunburns), tanning bed use (for any duration)

• Changing skin lesions (in terms of color, size, shape, or texture) or symptomatic skin lesions (those that are painful, itchy, scabbing, ulcerated, prone to bleeding, or non-healing)

• Fair skin, light eyes or hair, skin that freckles or burns easily in the sun

A lot of people fall into these categories, and indeed, too many people skip these checks. If you have risk factors and significant sun damage, your dermatologist may suggest more frequent exams than once a year; typically, patients with a history of non-melanoma skin cancer get an in-office check every six months, and those with melanoma should get a skin check every three months for two years and then every six months thereafter, says Dr. Raman Madan, chief of dermatology at Northwell Health’s Glen Cove Hospital.

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Above all, you shouldn’t delay evaluation of a concerning change because you assume you are “too young” to develop skin cancer. “Early detection can make a life-saving difference, turning a potentially serious condition into something easily manageable,” says Marmon.

Self-screening skin checks are also key for everyone. “Like breast and testicular self-exams, we should all try to do our own skin self-exams on a monthly basis,” Massick says. (More on how to conduct those below.)

What to expect at the skin cancer screening exam

You’ve arrived for your skin cancer check. Now what?

First, you will be taken to a private exam room where you will answer questions regarding your general medical history as well as questions regarding your skin health (your and your family’s history of skin cancer, your sun exposure and sunburn history, and any new areas of concern).

“The purpose of the exam is to be able to check your skin from head to toe, because skin cancer is not limited just to sun-exposed areas,” says Massick. “You will change into a gown because it is important to look at your skin in its entirety during a skin exam.” It’s important that you feel comfortable throughout the entire exam, so feel free to ask to have a chaperone in the room.

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Your dermatologist will do a thorough check of your skin, including the obvious areas on your face, body, and extremities, but also areas you may not think about, like on your scalp, behind your ears, on your hands and feet, your fingernails and toenails, and between your fingers and toes. You may be standing for part of the exam or lying on an exam table, notes Massick. The exam itself is painless.

For better visualization, your dermatologist may use a magnifying tool such as a dermatoscope, she says, and if there is a concerning lesion where a skin biopsy test is recommended, your dermatologist will use a local numbing anesthetic so that the skin biopsy procedure will be pain-free as well.

What happens after the exam?

After a skin cancer screening, your dermatologist will typically provide immediate feedback, says Marmon. “If they find a concerning spot, they may recommend a biopsy, which can often be done that day or scheduled for later. In some cases, they may suggest short-term monitoring, with a follow-up visit in about three months to check for any changes in a particular lesion,” says Marmon. 

It can take about one to two weeks to get biopsy results, which your doctor’s office should share with you ASAP when they are received. “If there is any serious concern, I will usually ask for the biopsy to be rushed,” Madan says.

If no issues are identified, Marmon says you’ll simply receive advice on self-monitoring and future screenings. “It’s reassuring to know that most skin cancers are localized and highly treatable. Even melanoma, when detected early, can be effectively treated with a straightforward in-office excision.”

How to do an at-home skin self-exam

Here’s how adults should conduct a monthly self-exam, Massick says: 

How to prevent skin cancer

Dermatologists stress that prevention is key to your skin health. “There is no such thing as a healthy tan,” says Massick.

“Ultraviolet light (whether by natural sunlight or indoor tanning beds) will increase your risk for skin cancer, and simply protecting your skin from UV exposure, including regular use of daily sunscreen, will decrease your risk of skin cancer and photodamage to your skin that causes aging and wrinkling.”

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Here are some other best practices Massick says you can do to decrease your UV exposure:

• Avoid sun exposure when possible, especially between the hours of 10 a.m.-3 p.m.

• Wear sunscreen daily, and if you’re spending a lot of time in the sun, reapply it every two to three hours.

• Use SPF 25+ for daily use and SPF 50+ for more intense sun exposure.

• Look for mineral ingredients like titanium dioxide and zinc oxide, which are safe for anyone to use, effectively block the sun from your skin, and are friendlier to the environment.

• Seek shade when possible.

• Wear sun-protective UPF clothing and UV protective sunglasses.

• Maintain a healthy, nonsmoking lifestyle. A well-balanced diet, routine exercise, and adequate hydration will all help keep your skin healthy.