My skin type (fair and freckly) puts me in the so-called “high-risk” group for developing skin cancer. On top of wearing hats and sunglasses whenever the slightest ray of sun shines, I am also quite vigilant with the sunscreen. Fortunately, the last years of my education in graduate school (and now medical school) have made sure my sun exposure was at a minimal level, thereby saving my delicate skin any unnecessary UV contact.
The skin check is a dermatologist’s best way of keeping tabs on your skin, your moles, and how your skin and moles change with time. It is a really easy and painless appointment with the doctor, but it’s one of the most important things you can do to catch skin cancer at its earliest stages. In between those quarterly, bi-yearly or yearly skin checks, you can do yourself and your doctor a favor by keeping tabs on your skin and moles, by checking them out thoroughly in the mirror (use a handheld mirror too if it helps) after you shower. So, now we ask ourselves the question; how does one do a proper self-skin-examination?
Initially, you need to know where ALL your moles and birthmarks are in every nook and cranny of your body, including the hard to reach places like your scalp, ear, back, and genital areas. If it’s hard to see something, get a relative or friend to help you with this task (I have a freckle-like spot on my head that I ask my parents to keep watch over as I can’t see it properly). Knowing where ALL your moles and birthmarks are may sound like a daunting task, but it can easily be accomplished with a sheet of paper by using a human-shaped outline (or as close as you can get) of both the front and back, and a pen to “mark the spot(s)”. Also, with each mole and spot you mark in the document, note the color, size, shape and elevation. This will help to determine your “normal.” After months of checking your skin, you will come to appreciate your “normal”. Now you are ready for your first self-skin check!
Every couple of weeks, make sure you are in a room with lots of light and that you are fully equipped with mirrors both full-length and handheld. Ensure that none of your previous spots have changed. If your moles have altered characteristics, note the changes. Also check for any spots on your body that are new (and perhaps look different from the moles you’ve had since birth in color, texture, and elevation). Look for any sores on your body that appear red and do not heal. Record everything you observe in the handy “skin-check” document with a date. You can even bring this document with you to your dermatologist appointments if necessary to remind you of anything suspicious you feel you need to discuss with your doctor. Patients have a very acute “spidey-sense” when it comes to their health and often if you feel something is “not quite right” with a mole, bring it to a doctor’s attention so you can either ease your concerns or catch something before it’s too late!
There are five easy parameters regarding moles you can remember to help with your skin personal check. These parameters are collectively called ABCDE: A for asymmetry, B for irregular border, C for color changes, D for diameter, E for enlarging, evolving or elevation. Though these considerations are not the most scientific methods of diagnosis (the only true diagnosis for skin cancer is biopsy followed by pathology studies), these are very good guidelines to help you and your doctor sample suspicious skin lesions.
Though a personal skin check is no substitute for a skin check done by a professional, it is important to keep tabs on your own skin health (as well as other aspects of health, mind and body). I am all for checking my moles, birthmarks, freckles and constellations in the mirror quickly (it really only takes a second to scan your body) whenever I step out of the shower, and if I see something that raises my “spidey-sense” I examine further. So get naked, stand in front of the mirror, and drink in all the moles and marks your body presents you with; someday you may be thankful you were the one who first realized that mole looked funny.
Margit Lai Wun Juhasz
Mount Sinai Medical Student