How Often Should You Really Have a Skin Cancer Screening?
Skin health matters. Every hour, one American dies of melanoma, the deadliest (and rarest) form of skin cancer, and more than 9,500 people are diagnosed with skin cancer every day, according to the Skin Cancer Foundation. Not to mention, a 2017 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.
According to the latest 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."
But is it better to play it safe than sorry? We caught up with top docs in the field to find out how often you should really get a skin cancer screening.
TL;DR — If you have any risk factors (such as a history of skin cancer yourself or in your family, sunburns, or regular increased sun exposure), you should be getting a skin cancer screening every 6 to 12 months. If you're low-risk, you can go for yearly checks or go every couple of years. No matter what, you should keep an eye out by giving yourself skin checks using the ABCDE method: asymmetry (A), changes in border (B), changes in color (C), changes in diameter (D), or any evolving moles (E).
Understanding the Skin Cancer Screening 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.
Know 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, says Dr. Khorasani. 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. Ditto if you have a history of sunburns or using tanning beds, both of which put you at a higher risk of skin cancer than someone who simply has fair skin, says Dr. Khorasani.
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. (That's another key perk of indoor gardening.)
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.
Do Your Own Skin Cancer Screenings
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 for a skin cancer screening? 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). (Related: These Skin Cancer Pictures Can Help You Spot a Suspicious Mole)
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. (Up next: How My Skin Cancer Diagnosis Inspired Me to Lead Charity Hiking Trips)
And it's worth mentioning: "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.
If You Do Have a Weird Spot...
If you need intervention after your skin cancer screening, it doesn’t have to require a scalpel. Orit Markowitz, M.D., a dermatologist in New York, zaps precancerous cells and the most common skin cancers, like basal cell and squamous cell, with a laser. “You come into the office, and I eradicate them then and there. You won’t even need a Band-Aid,” she says. The non-ablative lasers she uses are targeted and require little downtime, unlike more intense lasers that can leave behind scar tissue. “This is key because I want to scan the skin at a later date to confirm that all the cancerous cells are gone,” she says.
The protocol for late-stage non-melanoma skin cancers is a combination of lasers, pills, and topical creams. For melanoma, however, surgery is still the standard; a Mohs surgeon will cut the cancerous area from the skin. Says Dr. Markowitz: “I hope surgery becomes more and more rare and that my tailored approach, using imaging devices and lasers, will be the standard of care in the not-so-distant future.”