Who should perform a skin self-exam?
Everyone should perform a skin self-exam on a regular basis. No one is immune from skin cancer, and all skin types can be affected.
- However, there are risk factors that make some individuals more susceptible to skin cancer than others.
Identifying your risk factors will help you recognize the importance of performing a skin self-exam.
Why should I perform a skin self-exam?
Early detection and treatment are key to the prevention of advanced stages of skin cancer.
Malignant melanoma–the most deadly type of skin cancer–is the sixth leading cause of all cancer-related deaths in the US, particularly affecting caucasian men over 50 years of age.
The survival rate for malignant melanoma is dependent on the depth of the cancer at detection. A diagnosis of malignant melanoma at less than 1 millimeter in depth has a good survival rate (stage I). However, malignant melanoma beyond 1 millimeter in depth has a significant decreased survival rate (stages II and III). Once malignant melanoma spreads internally and metastasis (spread of cancer cells) occurs, treatment options are limited and cure rate is lowered (stage IV).
Early detection and treatment are key to prevention of advanced stages of skin cancer.
Figure 01
What should I look for?
Look for any mole, growth, or spot that is new, changing, or different and/or unusual.
The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. The most common is basal cell carcinoma and the most dangerous is malignant melanoma. There are significant variations in symptoms, shape, size, and color for these three common types of skin cancer. Skin cancer can appear as flat or raised and look pink, skin colored, black, or brown. It can look like a pimple, a growth, an open sore, or a scar. It may bleed, itch, or scale. Because of variations in presentation and symptoms, self-diagnosis is NOT recommended.
Instead of focusing on whether a mole, growth, or spot looks good or bad, focus on whether it is new, changing, or different and/or unusual from the surrounding ones.
When inspecting your skin for any moles, growths, or spots, look for these signs.
| New |  |
|---|---|
| Changing |
|
| Different and/or unusual |  |
If you notice any mole, growth, or spot that is new, changing, or different and/or unusual, speak with your dermatologist as soon as possible.
Typically, individuals over 35 years of age are less likely to develop new moles.
Therefore, a new mole in an adult is suspicious and should be checked by a dermatologist.
You can help your dermatologist with early skin cancer detection by identifying a new, changing, or different and/or unusual mole, growth, or spot. You will be able to recognize if it is new, changing, or different and/or unusual only if you check your skin regularly.
When inspecting a single mole, only if you know it is a mole, it is helpful to apply the ABCDE rules to determine wether or not it is suspicious.
| Normal | Suspicious | |
|---|---|---|
| Asymmetry |  |
 |
| Border |  |
 |
| Color |  |
 |
| Diameter |  |
 |
| Evolving |
|
|
Asymmetry:Â malignant melanoma has one half not matching the other half in size, shape, color, or thickness
Border irregularity:Â malignant melanoma has irregular edges that are notched, ragged, or scalloped
Color:Â malignant melanoma has a variety of colors within the same lesion, including shades of dark black and dark brown mixed with lighter tones; sometimes it may be red, pink, white, or skin colored
Diameter:Â malignant melanoma is larger than some surrounding moles, often greater than 6 millimeters or the size of a pencil eraser; however, malignant melanoma is less than 6 millimeters when it first appears
Evolving: malignant melanoma continues to grow and change, while other benign moles remain the same.
How should I perform a skin self-exam?
Always check your skin the same way every time—look everywhere.
Skin cancer can develop under the nails and on the palms or soles, armpits, groin area, and scalp. The most common site for malignant melanoma is on the back. Most of the time, it will be on sun-exposed areas, but not always. Using two mirrors—a handheld mirror and a full-length mirror—in a well-lit room, thoroughly check your skin. Always check your skin the same way, using a systematic approach, and do not overlook any areas.
Figure 02.
Use two mirrors
Use a handheld mirror and a full-length mirror for front and back viewing.
Look everywhere
Remember to look behind ears and between toes.
Use a systematic approach
Report any mole, growth, or spot if it is: new, changing, different and/or unusual.
When should I perform a skin self-exam?
Perform a weekly skin self-exam on the same day of the week.
Check same day, every week
It takes approximately 2 minutes to perform a complete skin self-exam. The more you do it, the more you will know your skin, which will help you recognize any new, changing, different, or unusual spots.
