Skin Cancer Screening

physician using dermatoscope to examine a mole

Take it from UChicago Medicine skin cancer specialists who complete thousands of skin cancer screenings every year: No one is immune to skin cancer. It affects more people than any other cancer. One out of every five Americans develops skin cancer during their lifetimes.

It’s true that some people have a higher risk of developing skin cancer, but anyone can get it, regardless of skin color or family medical history. After all, the most well-known cause of skin cancer is the sun, which shines over all of our heads.

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Fortunately skin cancer, including melanoma, is very treatable when caught in the early stages.

That’s what makes skin cancer screenings, both self-exams and professional exams, so important, say UChicago Medicine dermatologists. The sooner suspicious skin spots, moles, bumps and blemishes are identified, the greater likelihood that skin cancer can be diagnosed in the early stages.

Healthy skin practices, such as wearing sunscreen and avoiding tanning beds, are also critical habits to adopt. These practices can prevent skin cancer from developing in the first place.

Armed with both these defenses—screening and prevention—you and your loved ones can protect yourselves against this common cancer. Below are how-to details on both these safeguards.

What raises your risk of getting skin cancer?

The most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. While anyone can develop skin cancer, certain factors raise your risk, including the following:

A past personal history of skin cancer, either melanoma or non-melanoma
A family history of skin cancer, especially melanoma, in a first-degree blood relative (mother, father, sibling, child)
Having fair skin that burns easily
A history of excessive or chronic exposure to UV light, whether from the sun or indoor tanning beds or exposure to radiation
Having 50 or more moles or having moles that are abnormal in size, shape or color
Genetic mutations and a personal history of certain types of other cancers, including breast cancer, pancreatic cancer and others
New or changing dark spots on skin areas that don’t tend to get a lot of sun (such as palms of hands or soles of feet) or new or enlarging pigmented stripes on nails

What does screening for skin cancer entail? Who needs these screenings and how often?

Skin cancer screening encompasses two types of exams that complement each other.

First are self-exams that you conduct yourself, possibly with the help of a loved one or friend. UChicago Medicine dermatologists recommend that everyone look at their own skin for signs of cancer once a month.

It is especially important to perform monthly self-exams if you have a higher risk for developing skin cancer. (To learn if you are at higher risk, see the previous question, What raises your risk of getting skin cancer?)

The second type of exam is a professional skin cancer screening by a dermatologist. Anyone who identifies a suspicious-looking lesion, spot, mole or bump on their skin should immediately seek a professional exam, especially if the spot is growing rapidly or bleeding and not healing.

In addition, anyone at high risk for skin cancer (for example, has a lot of moles, has had extensive sun exposure) should get an initial skin cancer screening exam by a dermatologist. Depending on what is found during that initial exam, the dermatologist will provide a recommendation on how frequently you or your loved one should come back for screenings (for example, once a year, twice a year).

People who are at risk for melanoma due to a high number of moles or moles that are abnormal in size, shape or color may also benefit from mole mapping, which involves taking high resolution pictures of moles over time to identify any suspicious changes.

There is no universal recommended age for starting or stopping skin cancer screenings. Nor are there universal recommendations on how often you should get these screenings. It depends on your personal risk factors and history of skin cancer.

For example, a teenage boy who has a lot of moles and a parent or sibling who had melanoma should talk to a pediatric dermatologist about how often he should get regular screenings. In contrast, a woman who has a low risk for skin cancer may not see a dermatologist until she develops a bleeding bump that won’t heal at age 45. Then her dermatologist might recommend she come back once a year for a professional skin exam.

How can you best conduct a skin self-exam?

The American Academy of Dermatology Association provides helpful how-to information on examining your skin for signs of cancer.

We recommend that everyone conduct these self-exams once a month, looking at any skin spots, moles, bumps, etc. During these exams, you should look for any skin spots that:

Change in size, color or texture. Learn about the ABCDEs of melanoma.
Look different than similar spots on your skin
Itch
Bleed

You also want to look for scaly patches and non-healing sores, as well as new or expanding dark streaks under your nails or pigmented spots on your palms or soles of your feet.

Look at every inch of your skin from the top of your head to the bottom of your feet. To help see your entire body, stand in front of a full-length mirror. In addition, you can use a hand-mirror to check your scalp, neck, back and buttocks.

It can be helpful to ask a loved one or friend to check hard-to-see places. Then you can do the same for him or her.

Where should you go for a professional skin self-exam?

It’s best to seek a professional skin self-exam from a board-certified dermatologist. These physician specialists are trained to determine whether suspicious skin spots and moles may be cancerous.

Skin cancer screening appointments are available from UChicago Medicine dermatologists and can be scheduled by calling 1-888-824-0200 or by completing the appointment request form at the bottom of this page.

What can you expect during a professional skin self-exam?

The dermatologist will examine your entire skin surface, from head to toe, inspecting and looking for abnormal skin growths and signs of cancer.

The dermatologist may use a hand-held instrument, called a dermatoscope, to help identify pigment or pattern abnormalities within the lesion. The device uses polarized light to magnify the view of skin lesions and makes it easier to see pigment or blood vessel pattern changes in the skin.

What happens when a dermatologist identifies a suspicious growth on the skin?

When a suspicious growth is identified, the next step is typically a biopsy, which involves removing some of the growth for examination by a pathologist under a microscope. The biopsy is a quick outpatient procedure done under local/injectable anesthesia and can often be performed on the same day as the screening exam. A biopsy allows us to determine if the skin growth is benign, cancerous or precancerous and recommend the next steps for treatment.

Some skin cancers can be difficult to diagnose even under the microscope. Our UChicago Medicine team includes renowned specially trained dermatopathologists who focus exclusively on pathologic diagnoses of skin diseases, including skin cancers.

When skin cancer is found, we bring together our world-class team of skin cancer clinicians—including dermatologic oncologists, surgical oncologists and radiation-oncologists—to recommend a targeted treatment plan. Treatments vary, depending on the specific type and stage of cancer the patient has, as well as the patient’s wishes and values.

In many cases, the first-line treatment is surgery to remove the cancer. Other treatments, including radiation, immunotherapy and chemotherapy, may be helpful for patients with more advanced skin cancers. UChicago Medicine also offers clinical trials of promising new treatments for skin cancer.

How can you prevent skin cancer?

Children and adults of all ages can significantly reduce their risk of skin cancer with some healthy skin practices, including the following:

Plan outdoor activities for times of the day when the sun is less intense: before 10 a.m. and after 2 p.m. and seek shade. Remember to use caution near water, snow and sand as they reflect UV rays.
Before going outside, apply a broad-spectrum sunscreen of at least SPF 30 and reapply every two hours or after sweating or swimming. Learn about the science of sunscreen.
Protect as much of your skin as possible with clothing including sun-protective UPF (ultraviolet protection factor) clothing.
Wear a wide-brim hat.
Avoid tanning beds.

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If you have symptoms of an urgent nature, please call your doctor or go to the emergency room immediately.

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