Guide to a Self Skin Check

As I check my patients skin for cancer, I am frequently asked the question, "what does skin cancer look like?" This of course is a difficult question because skin cancer and precancer come in many forms.   What I try to emphasize to all of my patients is the importance of “JUST LOOKING.”  There are definitely some categories of spots that should send off red flags and bring you to the dermatologist:

1. Spots that look very different than anything else on your skin, also known as the “ugly duckling sign”. This term is typically applied to moles that have a different color or color pattern than other moles on your skin. 
2. Spots that are very new. This is especially true after the age of 30 or 40 when you should not be getting new moles, so a new mole or new growth on the skin may be of concern.
3. Spots that you notice are changing. To moles, you can apply the ABCDE rule, or Asymmetric, irregular Border, changing Color, Diameter (greater than 6mm) and Evolving. The AAD Website is an excellent resource for this.
4. Spots that bleed.  A basal cell carcinoma (most common type of skin cancer), will either bleed or easily scab with minimal to no trauma (like wiping your face with a towel), but are often difficult to spot otherwise.  Melanoma can also bleed but this is typically at a later stage and would have been an ugly duckling for a while before bleeding.
5. Spots that are consistently dry/peeling and rough like sand paper despite use of moisturizer. This will most often occur on the face, lateral neck, hands, and arms.
6. Spots that are bright pink like a bug bite color or a small rash, but do not heal over time.
7. Spots that are growing rapidly and painful. 

While the list above does help identify many skin cancers and precancers, trying to memorize it and apply it to your own skin on a monthly basis would be daunting.  If you are in the habit of looking at your front and using either two mirrors to reflect or just one but twisting side to side, you can see most of the skin on your body.  By doing this monthly, you will start to get familiar with what is on your skin. You don’t have to actively try to memorize, just passively take it in and over time you will be very “used” to what is on your skin.  If a new spot develops, you will notice and consider being seen by a dermatologist to help make the diagnosis.  Make it easy on yourself and just take a quick look once/month. Try to have a loved one look at your head especially if you are tall. Skin cancer is one of the only cancers for which we can self check, so we should make it our practice to take responsibility for ourselves and “JUST LOOK!"

For more information, check out the American Academy of Dermatology’s website highlighting their “spot a skin cancer” program.