Reducing scars: A case for change

It has long been understood that there are two key visual inputs to determining if a lesion is a potential melanoma or carcinoma. The first is looking for visual indicators that make a mole concerning at a point in time — the so-called “ugly duckling.”

The second is understanding how the lesion has changed over time. While some patients and dermatologists establish long-term relationships and can accurately track changes together, many dermatologists are missing this key evaluation tool when looking at lesions on a patient.

That’s where advanced mole-mapping technologies come into play. By giving both dermatologists and their patients the tools to quickly and easily map all the lesions on a patient’s body, mole-mapping empowers patients to perform regular skin self-exams and also work collaboratively with their dermatologists to monitor concerning spots for changes over time.

I spoke with Dr. Abel Jarell, a practicing Dermatologist, Dermatopathologist, and Clinical Trials Investigator who recently spoke on the subject of Pigmented Lesions for the AAD’s Dialogues in Dermatology podcast. I wanted to follow up on this discussion as some of the points he raised are very much in line with our thinking at SkinIO — that effective monitoring can reduce the number of unnecessary biopsies and save time and resources for higher risk patients and lesions.

Dr. Jarell shared with me that he uses photography throughout the day on virtually every patient he sees. Not only does he use photography in his office, he firmly believes that, “Patients who are tracking their own skin can save their own lives. I recommend patients take a photo every three months to allow for side-by-side comparisons.”

While this is not atypical advice in the dermatology field, it was helpful to hear his perspective that “while controversial, watching a lesion can be done very safely. Dermoscopy has become my best friend and I have avoided biopsies as a result.”

Dr. Jarell believes, and I agree, that the practice of dermatology is likely to change dramatically in the next decade. Better technology through photography, artificial intelligence, and monitoring for changes will lead to more information for dermatologists to accurately diagnose lesions with a reduced reliance on biopsies. This in turn will reduce the number of scars and the cost of medicine overall. The financial incentives in place today are not perfectly aligned with the best patient care, but by increasing access and embracing technology, forward-thinking dermatologists have an opportunity to lead their peers to better outcomes for patients.