Melanoma awareness: When should you see a dermatologist?

While it is the least common of the main types of skin cancer, melanoma is the deadliest form of skin cancer. The sooner it is detected, the better.

Skin self-exams—in a well-lit room and in front of a full-length mirror as well as with a hand mirror for hard-to-see areas—are important and should be done at least once a month. It is best, however, to have your skin examined by a medical provider, especially if you see a blemish that’s concerning.

But how often should a primary care doctor or dermatologist examine your skin? Determining the appropriate checkup frequency starts with assessing your risk of melanoma.

Know the risk factors

First, know that having a risk factor, or even multiple risk factors, doesn’t automatically mean you will get melanoma at some point. Many people with risk factors never get it, and some who do may have few or no known risk factors, says the American Cancer Society. Nonetheless, you should be familiar with the main risk factors that can lead to a diagnosis, which include:

• unprotected or excessive ultraviolet (UV) light exposure
• lesions or moles (if you have many moles, you are more likely to develop melanoma)
• family history (one or more first-degree relatives)
• skin cancer history (if you’ve had melanoma before, you’re at a higher risk of developing it again)
• a weakened immune system
• fair skin, freckling and light hair

When you should see a specialist

Generally, if you’re at increased risk for melanoma—especially if you have lesions or moles—you should be examined by a dermatologist “at least once a year, if not twice a year,” says Arun A. Mavanur, M.D., a surgical oncologist at the Alvin & Lois Lapidus Cancer Institute at LifeBridge Health.

“If there are any lesions that are suspicious and need to be monitored closely, then the dermatologist may want to see you more frequently,” Mavanur says. “But a routine dermatologic surveillance related to melanoma is usually every six to twelve months.” These examinations are not just to keep an eye on the lesion(s) or mole(s) in question, but also to check the rest of your skin and determine if (and what kind of) a biopsy is needed.

If you have no moles or lesions and use sunscreen regularly, then your primary care doctor can examine your skin during your usual checkups and refer you to a dermatologist if a curious spot appears. Skin self-exams also are fine, though “there are some parts of the body you just won’t be able to see” with the naked eye, such as behind the legs and ears, Mavanur says. This is where a hand mirror is helpful.

You can more easily spot lesions or moles on common sun-exposed areas around the upper body, like your face, hands and forearms. But you’ll need a hand mirror—and maybe assistance from a significant other, close friend or family member—in scouring those hard-to-see areas like the back of your neck and scalp, your back and buttocks, and behind your thighs. You can also ask your doctor to examine these areas during your regular checkups.

“Melanoma can occur practically anywhere on the body,” Mavanur says.

What to look for

Take the time to learn the pattern of the moles, blemishes or other marks on your skin so that you’ll notice if changes occur. During a self-exam, you should be checking your face, ears, neck, chest and belly (women should check the skin underneath their breasts). Also check your underarm areas, both sides of your arms and your hands (including between your fingers and under your fingernails). In addition, make sure to scan your shins, your feet, in between your toes and under your toenails. Don’t forget your legs, particularly your calves and behind your thighs.

Look for:

• a sore that bleeds or doesn’t heal after a few weeks
• a mole, wart-like growth, bump or spot that’s new or changing in size, shape and color (can appear brown, black or multicolored)
• a spot, sore or patch that continuously itches, crusts or bleeds

If you see these kinds of things, tell your primary care doctor and seek an appointment with a dermatologist immediately. “Melanoma can happen at any age. It tends to be more common as one gets older because of sun damage to the skin over time,” Mavanur says.

The age at which someone should begin consulting a dermatologist “really depends on the individual’s situation,” Mavanur says.

“For example, some people are exposed to the sun more often and incur sun-induced damage earlier than others, so those people should probably see a dermatologist sooner,” he says. “For someone with an average risk, probably in your mid-40s would be a good time to start, because that’s when you start accumulating enough skin damage over time that you should see a dermatologist on a routine basis.”

For information on services offered by LifeBridge Health, including specialty care and community events, visit lifebridgehealth.org or call 410-601-WELL.