Skin cancer screening and mole checks

What the exam is

A full-skin examination with a dermatoscope, which shows the structure underneath the surface rather than just the color on top. Anything that needs watching is photographed so that next year's exam is a comparison and not a memory.

The clinic uses digital mole mapping for patients who need systematic follow-up: many moles, a family history, or a previous skin cancer.

The ABCDEs, and the one that matters most

• A — Asymmetry.
• B — Border that is irregular or poorly defined.
• C — Color that varies within the same lesion.
• D — Diameter over 6 mm.
• E — Evolving. It changed, it bleeds, it itches, it doesn't heal.

E is the one that matters. An ugly mole that has looked the same for twenty years is less concerning than an ordinary one that changed in six months.

The one nobody recognizes

Most people picture skin cancer as a dark mole. The most common one isn't. Basal cell carcinoma usually looks like a pearly or shiny bump that bleeds easily, scabs over and opens again.

A sore on the face that hasn't healed in a month is not a pimple. It grows slowly and almost never spreads — which is why the prognosis is good — but it destroys what's around it, and on a nose or an eyelid every month of waiting means a larger reconstruction.

If something needs to come off

Biopsy and excision are done in the office under local anesthesia, and tissue is sent for pathology. Diagnosis comes from the pathology report, not from the eye — which is also why nothing can be ruled out from a photograph.

For patients traveling, say so when booking: in many cases the exam and the procedure happen the same day.

Who should be screened yearly

• A personal or family history of skin cancer or melanoma.
• Many moles, or large moles present since birth.
• Fair skin that burns rather than tans.
• Bad sunburns in childhood.
• Years of outdoor work or outdoor sport.