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How Often Should You Really Have a Skin Exam?

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Skin health matters. Every hour, one American dies of melanoma, the deadliest (and rarest) form of skin cancer. This year, experts expect to see 10,000 deaths from the disease. Not to mention, a new report from the Mayo Clinic shows that two types of skin cancer are increasing at startling rates among women. (That's why these sunscreens for working out are so vital, as are workout clothes that offer UPF protection.)

Fortunately, skin cancer screenings—it's as simple as going into your derm's office to have them check your body for any suspicious moles or changes that could signal cancer—are life-saving. But you might be surprised to learn that the U.S. Preventive Services Task Force actually doesn't suggest that everyone keep annual dates with their dermatologist.

Last summer, in an update to the recommendations, the group concluded that "there is not enough evidence to recommend for or against routine screening to find skin cancers early. This recommendation is for people who do not have a history of skin cancer and who do not have any suspicious moles or other spots."

So what's a lady to do? We caught up with top docs in the field to find out how often you should really have your skin checked.

Understanding the Task Force Recommendations
Recent studies may have failed to show the effectiveness of routine screenings for melanoma for everyone, but dermatologists do still recommend yearly screenings.

"Generally speaking, I recommend that everyone starts getting an annual body check in early adulthood," says Marc Glashofer, M.D., a skin cancer surgeon at the Dermatology Group in West Orange, New Jersey. "If you can vote, you should get your skin checked annually by a board-certified dermatologist."

In part, that's because the U.S. Task Force doesn't take into account non-melanoma skin cancers, including basal cell carcinoma and squamous cell carcinoma. The recommendations are instead based off of death rates from melanoma, explains Hooman Khorasani, M.D., the chief of the division of dermatologic and cosmetic surgery and an assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai.

Basal and squamous cell aren't as deadly as melanoma, but they're far more common. Every year, more than 3.3 million people in the U.S. are treated for these cancers. (Basal cell cancers can sometimes look pimple-like, like red bumps, and squamous cell cancers can appear scaly or sandpaper-y.)

Only a fraction of these cancers spread to other parts of the body, but catching them early can be the difference between easy (and near scar-free) removal and serious surgery that can have a significant impact on your life (like having to remove large sections of your nose), says Dr. Khorasani.

Understanding Your Risk Factors
In terms of skin cancer, the population at the highest risk is anyone with fair skin, often called Skin Type 1 and Skin Type 2 (here's how to determine your skin type). These people tend to have a hard time tanning and burn easily, and are Caucasian with blue eyes, light hair, and freckles. "No matter what, they should get annual skin checks," says Dr. Khorasani.

As for the rest of the population? Skin cancer risk is based on a slew of other risk factors, the biggest of which is a history of skin cancer yourself. Other risk factors: a history of severe sunburn, a history of using tanning beds, and a sibling or parent who has a history of skin cancer, Dr. Khorasani says. Research also suggests that having more than 11 moles on one arm could put you at an increased risk for skin cancer.

"If someone has a history of skin cancer or has a first-degree relative with a history of skin cancer, they should be coming for screenings every six to 12 months," says Dr. Glashofer.

In fact, a history of sunburns and tanning beds puts you at a higher risk of skin cancer than someone who simply has fair skin, says Dr. Khorasani, who adds that these people should also see their dermatologists once or twice a year.

Then, consider factors like your job or your general health. Studies show that pilots have more instances of skin cancer than the rest of the population. And Dr. Glashofer notes that gigs that keep you outdoors (gardening, athletics) can increase risk too, thanks to increased exposure to harmful UV rays.

People who are immune compromised, like transplant patients, are also at an increased risk because their immune systems aren't able to fight off mutations as effectively, notes Dr. Khorasani.

If you're totally low-risk with dark skin, no history of skin cancers, no past tanning bed trips, and don't want to see a derm? Keep up with self-checks and make sure to see a dermatologist if you notice any asymmetry (A), changes in border (B), changes in color (C), changes in diameter (D), or any evolving moles (E).

Do Your Own Checks
No matter how often you see a dermatologist, noticing skin cancer is not all up to your derm. "Fifty percent of melanomas are picked up by patients themselves or a family member," notes Dr. Khorasani. That's why every quarter, after you get out of the shower, Dr. Glashofer suggests doing a self-check of your skin and moles, keeping an eye out for any changes in the ABCDE's, itching, or bleeding. "Take ownership of your moles," he says. After all, your dermatologist usually only sees your skin once a year—you see it every single day.

And Don't Forget...
"Getting your skin checked is not a time to be modest," says Dr. Khorasani. "You can have skin cancer anywhere—even in places where the sun doesn't shine." So while it may be uncomfortable to strip down in front of your doc, it could also be the difference between catching a deadly disease early and not. If you don't feel comfortable with your doctor, it's important to switch derms and find one you're more at ease around, says Dr. Khorasani.

 

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