How to make the most of your skin cancer check

by | Dermatology, Sun Safety

A doctor examines a patient's skin.

Being prepared and knowing what to expect will help you get the best from your next skin cancer examination.

Simply living in Australia is one of the greatest risk factors for developing skin cancer. Australia has one of the highest rates of skin cancer in the world. Two in three Australians will be diagnosed with skin cancer by the age of 70. About 2,000 Australians die from skin cancer each year. Regular skin checks by a doctor are the only way to know whether that itchy mole or new freckle is cause for concern. 

What age should I book a skin cancer check?

Dr Emily Kirkpatrick, General Practitioner and Executive Medical Director of the Calvary-Medibank Joint Venture, believes no time is a bad time to book in to have your skin examined.

“It is never too late or early in life to have a skin check appointment,” she reveals.

Dr Kirkpatrick, who has a Master of Medicine (Skin Cancer) and is an accredited skin cancer doctor with the Skin Cancer College Australasia, says all GPs can perform skin checks but you may want to consider one with a special interest in the area.

“To ensure a comprehensive screening assessment, seeing a GP who has undertaken additional training in skin cancer screening is the best option,” she suggests. “This may be your usual GP, however, there are specialised skin cancer clinics, where GPs with additional training and experience can undertake a comprehensive check.”

How often do I need a skin cancer check?

“Annual skin checks are recommended by a trained doctor, with self-skin checks every three months,” Dr Kirkpatrick says. “If you are at higher risk of melanoma, due to a family or previous personal history of melanoma or a recent non-melanoma skin cancer, more frequent checks may be advised.” 

How long does a skin check take?

Whoever you choose to see, always ask the receptionist or use the online booking form to request an appropriate length appointment. 

“Appointment times vary depending on whether you need a whole-body skin check or a spot check,” Dr Kirkpatrick says. “Usually, a thorough skin check takes between 20 and 40 minutes, depending on your skin type and how many skin areas of concern you have. Book in for a whole-body screening check if you haven’t had one before.”

Seeing a doctor who does whole-body photography to record skin irregularities can take extra time too so ask if this is likely to happen when booking.

How do I prepare for a skin check?

“Before your skin check it’s best to remove all nail polish, make-up and tanning products, as these can alter the appearance of skin cancers and in some cases, serious skin cancers can be present on the nails,” Dr Kirkpatrick says. 

You’ll also need to shower before the appointment and wash your hair so the doctor can examine your scalp. 

What do I wear for a skin cancer check-up?

Clothes and shoes that are easy to take off and put on are a smart choice because you’ll need to undress.

“All areas of the skin should be examined as a skin cancer can grow in areas not exposed to the sun,” Dr Kirkpatrick says. “Underpants are usually worn during the examination however it’s important to discuss with your doctor any concerns you may have with the skin in your genital area.”

What happens at a skin check with a doctor?

Appointments usually begin with a discussion of your sun exposure history. The doctor will want to know about your history of sun exposure, where you grew up, any past sunburns, occupation (especially if you work outdoors) and whether you have any specific concerns about your skin. They will ask about any previous skin check results, personal and family history of cancer, your general health and whether you take any medicines (some increase sun sensitivity). 

Next, the doctor will ask you to undress and stand in a well-lit area of the office. Then they’ll start examining your skin using a magnifying tool to view any spots that stand out. They may ask you to sit to inspect your scalp, face and feet. Sometimes they’ll take photos of your skin as well. 

“Dedicated skin cancer clinics usually have access to whole body screening photography or skin lesion photography, which can be helpful for monitoring skin areas of concern,” Dr Kirkpatrick explains. “Moles can be recorded and tracked through repeated photography, which allows the doctor to monitor any changes to your moles.” 

Once they’ve checked your skin, the GP will ask you to dress and talk with you about their findings.

“The doctor will discuss your overall risk of skin cancer and whether there are any skin lesions that need treatment,” Dr Kirkpatrick says. 

What if I need a mole removed? 

Sometimes the GP may decide further investigation is necessary, and a biopsy or mole removal will happen at the same appointment. 

 “The doctor may advise that treatment be decided based upon a biopsy, where a small part of the skin is removed, or that the skin lesion is excised, so that the mole or skin lesion is entirely removed,” Dr Kirkpatrick explains. 

But if there’s not enough time, you may need to come back. 

“The urgency of this will be discussed between you and your doctor, based on the skin lesion requiring treatment, this may be within the next few days or a few weeks.” 

Does it hurt to have a mole removed?

“All procedures that remove skin lesions use local anaesthetic to numb the skin and minimal discomfort is experienced,” Dr Kirkpatrick says. “It is important that if you have moles removed or a procedure performed that you plan your day, as there is usually a five to seven-day window where the area will need to be kept dry to assist with healing.”

Any time a biopsy is taken or a mole is removed, the tissue is sent to a pathology lab for analysis.

“Depending on what procedure is performed, a specialist pathology doctor can examine the skin under the microscope,” Dr Kirkpatrick says. “This provides a diagnosis as to whether the spot is cancerous, which may result in no further treatment if all has been removed or further treatment; pre-cancerous, which means further treatment may be needed now or in the future; or benign, meaning no skin evidence of skin cancer. Testing the skin will help guide next steps in your treatment.” 

Once the lab sends the results back to the doctor, you’ll be recalled for another appointment.

“Usually, a follow-up appointment is required with your GP to review the area where the procedure was performed and to discuss results. It is important that a follow-up plan is developed at this time, including when your next skin check is performed.”

Sometimes additional treatment is required, and Dr Kirkpatrick says you could be referred to a specialist at this point. 

“Specialist dermatologists or plastic surgeons may become involved when there is a skin lesion on the face or other cosmetically sensitive area that requires more complex removal, or when there is the need for a specialised opinion due to complexity of the skin lesion at the time of examination or after a procedure.”

RESOURCES

For more information, visit

SunSmart website

Cancer Council

Dr Emily Kirkpatrick is a Fellow of the Royal Australian College of General Practitioners and Executive Medical Director of the Calvary-Medibank Joint Venture. She is an Accredited Skin Cancer Doctor with the Skin Cancer College Australasia and holds a Master of Medicine (Skin Cancer) from the University of Queensland.



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