Checking in with your doctor is one of the best ways to catch disease in its earliest stages and even prevent disease altogether. This is especially true when it comes to melanoma and other skin cancers. If you put off seeing a dermatologist, it may be too late, said Susan Touma, MD, a board-certified dermatologist with Huntington Dermatology Inc.
“Sometimes patients think they’re wasting my time, or they convince themselves that they’re worrying over nothing,” Dr. Touma said. “I can’t stress this enough: It is never, ever a waste of my time. And even if it’s nothing, it’s so much better to be safe than sorry. If you’re at all worried about the health of your skin, call your dermatologist today. Don’t wait.”
Not knowing what to expect at a dermatologist’s office can keep people from making that potentially life-saving appointment, she said. Nervous about your first full-body skin exam? We find out from Dr. Touma exactly what to expect when you visit a dermatologist for the first time.
What is a full-body skin exam?
Dr. Touma: A full-body skin exam is where a dermatologist inspects your skin for skin cancer and other abnormalities. We also assess common skin conditions like psoriasis, acne and eczema.
Can’t I see my regular doctor for that?
Dr. Touma: Nothing can replace a thorough skin exam with an experienced dermatologist. This is our specialty. It’s what we do all day long. If you’re concerned about your heart, you see a cardiologist. If you’re concerned about your eyes, you see an ophthalmologist. It’s very important that you do the same for your skin.
Does it matter what I wear to the exam?
Dr. Touma: You’ll be given a gown and asked to take off everything but your undergarments. The gown and undergarments can be moved in ways to keep areas of your body covered during the exam and to protect your privacy. Be sure to remove your socks and shoes, as skin cancer can develop on the soles of your feet and between your toes. I always do a careful check of the scalp and hairline, so wear your hair loose. You might even want to remove your nail polish and makeup. The exam is very thorough.
When you say “thorough”…?
Dr. Touma: Everyone wants to know if a full-body skin exam includes the genital areas. You can develop skin cancer anywhere – even on areas not exposed to the sun. However, most dermatologists can perform a thorough exam while your undergarments and gown remain on. If you have concerns about those areas, please mention them at your appointment. Don’t let the fear of awkwardness keep you from catching skin cancer early, while it’s still treatable.
Do you use any tools during the exam?
Dr. Touma: The only tool we use during a skin exam is a dermatoscope, which is basically a magnifying glass. The dermatoscope allows us to see the architecture of a lesion and assess its symmetry, color and vasculature – all things that can indicate whether or not the lesion is malignant.
How long does the exam take?
Dr. Touma: It depends on the number of moles and lesions you have, but on average a full-body skin exam takes about 15 minutes.
What else does the appointment entail?
Dr. Touma: We’ll start by going over the importance of self-exams and what you should look for when checking your moles at home. Then we’ll talk through any skin concerns you have, and I’ll examine those areas first before moving on with the rest of the exam. I’ll check your entire body for moles and other lesions, using the dermatoscope when I need a closer look. I always finish exams by asking if there’s an area I might have missed. It’s important to find a dermatologist who doesn’t make you feel rushed. You should have plenty of time to ask questions, and you should never leave feeling like something was missed.
What if you find something during the exam?
Dr. Touma: If a lesion appears suspicious, I’ll do a biopsy right then and there. I’ll start by photographing and measuring the lesion, then I’ll use a local numbing medication before removing the lesion. It’s a two-minute procedure, and it takes about a week to get the results back.
Where does the biopsy go?
Dr. Touma: A properly performed biopsy is one of the most important reasons to see a board-certified dermatologist. When a lesion is removed, it needs to be done completely and sent to a pathologist with specialized training in dermatopathology. Don’t be afraid to ask your dermatologist where your biopsy will be sent and what type of pathologist will be analyzing the lesion. A Huntington Dermatology Inc., a dermatopathology lab performs all of our biopsies.
If I see a dermatologist every year for a full-body skin exam, do I still need to do self-exams at home?
Dr. Touma: A mole that is benign today could become malignant in six months. Between annual exams, it’s very important to watch for changes in your skin. Get to know your moles. If you notice anything new or different, don’t wait for your scheduled appointment. Give your dermatologist a call.
How do I know if I need a full-body skin exam?
Dr. Touma: You don’t have to think you have skin cancer to schedule a skin exam. In fact, the very best time to visit a dermatologist may be before you have any skin cancer symptoms at all. We recommend that most patients have a full-body skin exam once a year beginning at age 35. Depending on your skin cancer risk, you may need to come in earlier or more frequently than that.
How can I convince my family member to schedule an appointment?
Dr. Touma: It seems like the men in our lives are especially hard to convince to come in for a skin exam. Men often start their visits with me by saying, “My wife made me come.” (I’m always quick to remind them that married men live longer than single men!) But the statistics speak for themselves: The majority of people diagnosed with melanoma are white men over the age of 55, and men ages 15-39 are 55 percent more likely to die of melanoma than women in the same age group.
My skin doesn’t burn easily. Do I need to worry about skin cancer?
Dr. Touma: Anyone can develop skin cancer, regardless of age, gender or race. The best way to keep from becoming a skin cancer statistic is to keep up with the health of your skin.
I had a lot of sunburns when I was younger, but I’m careful now. Am I still at risk for developing skin cancer?
Dr. Touma: Unfortunately, yes. We can’t erase our past. Damage from the sun accumulates over time, and the skin remembers every exposure it ever had. If you’ve spent a lot of time in the sun, if you’ve used the tanning bed even just once, if you had multiple sunburns when you were younger – those are all reasons to schedule a skin exam every year.
Do I need to do anything to prepare for a full-body skin exam?
Dr. Touma: Taking just a few minutes to prepare for your appointment can help make sure your exam is efficient and effective. Look around our website to learn more about areas you’d like to discuss, and check with your family members if you’re not sure about their history with skin cancer. Family history is extremely important. Not only do we inherit our skin type from our family, but we also inherit the genetic makeup that determines our risk for skin cancer. If you have a family history of any type of cancer, let your dermatologist know.
Who will perform the exam?
Dr. Touma: At Huntington Dermatology, I perform exams, and my father Dr. Nazem Abraham, who founded Huntington Dermatology Inc. in 1970, performs exams. Our physician assistant Darci Barger also performs exams. She’s been with us for eight years and sees both adults and children. I’d trust her with my life. When you schedule an appointment, you can opt for the earliest available appointment or wait to see the specialist you prefer. Our goal is to be accessible and available.
How do I schedule an appointment?
Dr. Touma: Just call. At many dermatology practices, you could wait six weeks or longer for a preventative, routine appointment. But with everything we know about skin cancer, those routine appointments can mean the difference between life and death. At Huntington Dermatology, most of our patients are seen within one to three days of calling our office.
To schedule a full-body skin exam at Huntington Dermatology Inc., call 304.523.5100.