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Skin Self-Exams: What to Look for When Checking for Skin Cancer

May 18, 2021

How closely do you look at your skin in the mirror? It may be time to start looking a little closer, experts suggest.

In support of Skin Cancer Awareness Month, we spoke with Dr. Sarah Beggs, dermatologist with Jefferson Health – New Jersey, about how to do monthly skin self-exams to help catch skin cancer in its tracks.

Skin cancer is incredibly common, impacting nearly one in every five Americans in their lifetime, typically after age 50. Skin self-exams are beneficial for everyone, says Dr. Beggs, but are especially important for those who may be at higher risk due to a personal or family history of skin cancer; a history of tanning; and/or a history of severe, blistering sunburns. 

While it’s recommended for those at higher risk to have professional exams done too, at least once a year, self-exams are key to noticing rapidly growing skin cancers that may pop up between annual skin exams, adds Dr. Beggs. “Unfortunately, the more deadly skin cancers can sometimes quickly appear and spread. It’s best to check your skin every month or so to make sure one of these cancers has not appeared.” 

Where to start: “Stand in front of a mirror, completely naked – maybe before your shower – and work your way down from your head to toes,” said Dr. Beggs. “Keep a small handheld mirror handy to view your back and other hard-to-reach areas where some skin cancers like to hide, such as the scalp; armpits; bottoms of the feet; and in between the butt cheeks.”

This should only take a few minutes. You don’t have to look at each spot/mole meticulously, you just want to familiarize yourself with the spots you do have, so you notice when something changes or something new appears, explains Dr. Beggs.

What to look for: Skin cancers – melanoma specifically – are often assessed using what’s known as the “ABCDE” rule:

  • A – Asymmetry – Normal moles, if cut in half, would look symmetrical. A concerning mole is oddly shaped or looks like there’s a chunk missing.
  • B – Border – The edges of a normal mole should be round and well-defined, not fuzzy, or uneven.
  • C – Color – Normal moles are light or dark brown. Any white, gray, blue, or jet-black moles are concerning.
  • D – Diameter – Most normal moles are less than 6 millimeters, or roughly the size of a pencil tip eraser. Anything larger should be checked (unless you’re prone to larger moles and it has not been of medical concern).
  • E – Evolution – Normal moles will stay the same. Anything that grows or changes in shape or color is worrisome.

Another tell-tale sign of melanoma is known as the “ugly duckling,” adds Dr. Beggs. “Most spots will have a matching pair (or more) elsewhere on your body. So, if something funny or abnormal looking has others that match nearby, it’s unlikely that it’s cancer.”

Basal cell carcinoma – the most common skin cancer – on the other hand, often presents with small wounds that don’t heal over the course of a few months. They may first appear to be a pimple-like lesion, but then they never go away and frequently bleed. Any wound that persists for a few months should be evaluated for a skin cancer.   

Liver spots and sun freckles: There are various other types of benign spots on our skin, which can cause confusion. Liver spots – or lentigines – are flat and tan or brown; they come with age, often on sun-exposed areas of skin. Seborrheic keratoses are another natural occurrence in older individuals (some are genetically predisposed), explains Dr. Beggs. These are crusty looking spots and appear like they are “stuck on” the skin. 

Sun freckles also become more prominent this time of year, as they’re caused by an overproduction of melanin (from sun exposure). However, if you’re using sunscreen appropriately, they shouldn’t appear so much.

The bottom line: Know your body; if something looks “off” to you, tell your doctor, urges Dr. Beggs. Keep in mind, while skin cancers are rarer among adolescents, young adults, and people with darker skin tones, they can and do happen; so, keep an eye out and make skin self-exams part of your routine.

For more information on Dermatology and other Primary & Specialty Care Services at Jefferson Health - New Jersey, click HERE or call 856-557-6023.