Self exams for early detection of changes in the appearance of any moles, freckles and surface areas of the skin are essential for early detection of possible skin cancers. The American Cancer Society and the American Academy of Dermatology both stress the importance of watching for any changes in existing moles or freckles. This also includes monitoring any wounds that are slow to heal or textural inconsistencies in the surface of the skin that are not caused by known factors.1,2
In general the changes that should be noted in self exams include:
- Asymmetry – Moles are typically oval or circular in shape and are similar in shape in a symmetrical pattern. Moles that are not similar in shape from one half to the other should be closely monitored for any changes.
- Border – The border should be clearly defined and regular. Irregular, blurred or scalloped types of borders are often associated with skin cancer.
- Color – The color should be consistent throughout the mole or freckle. Multiple colors including tan, browns, blacks, blues, whites and reds should be noted when they occur immediately outside or within the border of the mole or freckle.
- Diameter – Typically most skin cancers are larger than 6mm, which is approximately the size of the eraser on the end of a standard pencil. However, size alone is not a determining factor if other changes are also present.
This creates the memory aid of ABCD with some mnemonics also including the letter E. E stands for evolution or change in any aspect of the mole or pigmentation. Any moles or skin pigment changes that are accompanied by itching, bleeding or slow healing wounds or lesions should immediately be checked by your doctor. In many cases the change will be in an existing mole; however it is possible that a mole may develop and then change if cancerous cells are present. 3
Who Should Do Self Exams
Skin cancer can occur in anyone at any time. There are different types of skin cancers that are more prone to occur in different groups of people from the elderly through to those of different ethnicities. In general the risk factors increase when the following factors are present:
- Number of moles – with large numbers of moles on the body, typically indicated as more than 50, there is an increased risk of developing skin cancers
- Sun exposure or tanning –both duration and intensity is significant and is similar for direct sunlight or artificial tanning in beds
- History of sun burns that blistered
- Prior melanoma, basil or squamous cell skin cancers
- Immune system complications – HIV/AIDS, transplants, autoimmune disorders, other cancers and some chronic health conditions
- Melanoma diagnosed in two or more family members
- Dysplastic Nevi – atypical moles found anywhere on the body that tend to be much larger and more irregular than other moles
According to the National Institutes of Health, the more of these factors that are present the greater the risk for developing any type of skin cancer. White males and females are at highest risk for developing melanoma, with rates of 30.9 and 19.7 per 100,000 respectively.4 Individuals of all ages should complete a self exam for skin cancer as part of their ongoing preventative health routine. Parents can complete examinations on children and kids can also be taught to complete self examinations as they age and become more capable.
When To Complete Skin Cancer Self Exams
Skin cancer self examinations only take a few minutes of your time, typically not more than 10 minutes in total. The initial first examination is usually the most intensive since you will record the location of the mole or pigmented area of the skin as well as the ABCDs of each mole. The following exams will only record any changes noted and will require less documentation and record keeping.
Skin self exams can be done on a set day every month to three months to help you develop a routine. If you have any risk factors a monthly exam is recommended by most dermatologists. Many people choose the first or last day of the month since this is easiest to remember. You can complete the examination at any time of the day at your convenience. Make sure that you have good lighting that will allow you to easily note any changes in the skin, moles or freckles on your body.
A full length mirror and a hand held mirror are essential and a chair can also help you in examining your legs and body in comfort. Since it is very difficult to examine your own scalp and back a family member can be a great asset to help with these more difficult areas. Be sure to examine the entire scalp, which can be done using a hair dryer on cool to move the hair, as well as the bottoms of the feet and between the toes.
Check all skin on the body including the areas around the genitals and buttocks, the armpits, under the breasts and under any body hair including beards and moustaches on men. Start at the top of the body and move in a systemic way down to the toes to ensure that you don’t miss any body areas and have a complete picture of your skin when you are finished. Use a body map to keep accurate data on the moles and variations that you note on your skin and report any changes to your dermatologist or doctor to aid in early detection and treatment of any form of skin cancer.
References
1 How To Examine Your Skin. Retrieved from American Academy of Dermatology: www.aad.org/skin-conditions/skin-cancer-detection/about-skin-self-exams
2 Skin Cancer: Basal and Squamous Cell. Retrieved from American Cancer Society: www.cancer.org/Cancer/SkinCancer-BasalandSquamousCell/DetailedGuide/skin-cancer-basal-and-squamous-cell-detection
3 Melanoma. (2009). Retrieved from MedlinePlus: www.nlm.nih.gov/medlineplus/ency/article/000850.htm
4 SEER Stat Fact Sheets: Melanoma of the Skin. (2011). Retrieved from National Cancer Institute: seer.cancer.gov/statfacts/html/melan.html5 Self Skin Examination. (2010). Retrieved from DermNet NZ: dermnetnz.org/procedures/self-skin-examination.html
______________________________________________________________
DISCLAIMER:
The content provided on this site is for informational purposes only. Our content is not medical advice you should seek a licensed physician or health professional regarding all health issues. SKIN-CANCER.ORG takes no responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, or application of medication which results from reading this site.
