Skin cancer develops right before our eyes—or those of our friends and family. Too often, however, we just don’t look for early signs of trouble.
“No one wants to think about developing a disfiguring, even deadly, disease like skin cancer, so many Americans live in a state of denial,” says Joshua Fox, M.D., a leading dermatologist and medical director of Advanced Dermatology of New York and New Jersey. “Most people know they are supposed to be checking their skin monthly for changes that might be cancer, but they aren’t exactly diligent about it. It’s something that gets put off for later, often indefinitely.”
Checking your skin regularly, and making an appointment to have your dermatologist do the same, is the best and only way to catch skin cancer before it spreads.
“For the past twenty-five years, we’ve told people to pay attention to the ABCDs of pigmented skin irregularities,” Dr. Fox continues. “Checking for asymmetry, border irregularity, color variation, and diameter more than 6 mm (about 1/4 inch) is still the key to identifying a problematic growth among a bunch of innocuous-looking freckles and moles.”
Here are Dr. Fox’s five rules to save your skin:
1. Make it a habit to check your skin at home.
Inspect yourself, head to toe, once a month. “Many cases of melanoma and other cancers develop on the scalp,” Dr. Fox says. “These cancers can be deadly, but unfortunately, most people don’t check the tops of their heads very often.”
Helpful Hint: Look over every inch of your birthday suit, even in areas where you’ll need a hand mirror to get a good look.Check the palms of your hands, your nails, and the soles of your feet, too.
2. Know what is normal.
In most cases, a normal mole is a uniform shade of brown, tan, or black, and can be flat or raised, round or oval. Some moles are present at birth and others develop later in life, especially in areas that get lots of sun. Once moles appear, they most often remain the same size, shape, and color. Others eventually fade and disappear. “Almost everybody has moles, and almost all moles are harmless,” Dr. Fox says. But people with lots of moles, more than 50, are at a higher risk for skin cancer.
Helpful Hint: Be on the lookout for flesh-colored, pearl-like bumps or pinkish or reddish patches of skin that flake, scale, or even bleed. They can be basal or squamous cell carcinomas.
3. Pay attention to changes in your skin.
Be on the lookout for new marks and check for changes in old ones. Also note whether skin around a freckle or mole becomes crusty, for example, or spots start to feel itchy or sore.
Helpful Hint: “Spots on the skin come in all shapes and sizes, and not every mark you see will be cancer,” Dr. Fox says. “But if you see something that really stands out, what dermatologists call an ‘ugly duckling’, be sure to tell your dermatologist in a timely manner.”
4. Schedule an annual skin check with your dermatologist.
Most people should see the dermatologist once a year. At this exam, the doctor will check your skin and discuss any changes that the two of you have found.
Helpful Hint: Anyone who’s had skin cancer already or who has other significant risk factors should make an appointment at least every six months.
5. Find a dermatologist who uses dermatoscopy technology.
Also known as epiluminescence microscopy (ELM), or surface microscopy, this is a relatively new method of screening that’s extremely effective at identifying cancers, helping the doctor distinguish malignant lesions from benign ones, says Dr. Farkas, who uses a dermatoscope in her practice at Advanced Dermatology. “The dermatoscope uses polarized light and a magnifying lens to let us ‘see’ the skin more clearly,” she explains. “It significantly increases the accuracy of the exam, meaning we can detect problems much more reliably than with the naked eye.”
Helpful Hint: Next week, Medical Update offers bonus coverage from dermatology specialist Dr. Babar Rao about VivaScopes with advanced laser technology that provides optical images of cells at and below the surface of living skin to detect and diagnose skin cancer—without a biopsy.