TELEHEALTH

Why Skin Cancer Self-Exams Are More Important Than Ever

Dermatologists explain how to give yourself an at-home skin check.
Woman looking at her face in the mirror
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It's always felt appropriate that the month of May, when spring turns into summer and many of us start making beach plans and buying new bathing suits, is also Skin Cancer Awareness Month. This May is different, but even as we hunker down inside, many skin-care imperatives remain just that. Yes, you still have to wear sunscreen. And, as Skin Cancer Awareness Month reminds us, you still need a skin check.

The Skin Cancer Foundation recommends a head-to-toe skin self-examination once every month, and an in-person skin examination with a dermatologist once per year or more, if you have a higher risk of skin cancer.

As COVID-19 keeps non-emergency patients away from dermatologist offices, it's more important than ever to take responsibility for your own skin examination. While staying at home, we've been forced to take hair coloring, pedicures, and artificially plump lips into our own hands.

The skin self-exam isn't quite as glamorous as learning how to dye your hair pink, but it just might save your life. According to the American Academy of Dermatology, one in five Americans will develop skin cancer in their lifetime. Early detection is more than half the battle: When detected early, the five-year survival rate for melanoma is 99 percent.

"When skin cancers are caught and treated early they are highly curable," Marie Hayag, a board-certified dermatologist in New York City tells Allure. "You are the best person to notice an early change in your skin, so doing monthly skin self-exams are an important DIY and can be a lifesaver. Anyone can do a self-exam."

Ahead, we break down the two types of skin checks you should be getting right now — from yourself and from your dermatologist.

How to Conduct a Skin Self-Exam

"I say [to my patients], every time you have a little extra time, go in front of the mirror and look [at your skin]," says Orit Markowitz, a board-certified dermatologist and the director of pigmented lesions and skin cancers at Mount Sinai in New York City. "Like when you've just taken a shower and aren't yet dressed, that's a good time to take a peek and make sure there isn't something new [on your skin]."

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So: You're naked in front of the mirror. Now what? Scarlett Boulos, a Texas-based board-certified dermatologist and spokesperson for the Skin Cancer Foundation, recommends grabbing a hand mirror, two chairs or stools, and a blow-dryer to get yourself fully set up.

The goal is to look for anything "new, changing, or unusual" on your skin, says Boulos. More specifically, you can use the mnemonic device "ABCDE's of melanoma," says Hayag. Look for markings on the skin that are asymmetric; have uneven, scalloped, or notched Borders, appear black, brown, red, white, or blue in Color, is wider than six millimeters in Diameter, and has Evolved in color, shape, size, or with new symptoms like bleeding, itching, or crusting. She also advises looking for a sore that's been present for three weeks and doesn't seem to be healing, or spots that continuously bleed, itch, or scab.

Once you know what to look for, start by using one or both mirrors to examine your face, especially the nose, lips, mouth, and ears, says Boulos. From there, inspect the scalp, using the blow-dryer to expose each section of the scalp in turn. Next, check the hands: palms, back of the hands, between the fingers, and under the fingernails. Then examine the front and back of the forearms.

Using your full-length mirror, scan the sides of your upper arms and underarms, as well as the chest, neck, and torso. People with breasts should "lift them to view the skin underneath," says Boulos.

Then, use the hand mirror to inspect your back body: back of the neck, shoulders, upper back, the back of your upper arms, lower back, butt, backs of legs. "Lastly, to examine the rest of your lower body, sit down and prop each leg in turn on the other stool or chair," says Boulos. "Use the hand mirror to examine the genitals and finish checking the front and sides of both legs, thigh to shin, ankles, tops of feet, the soles, heels, and between toes and under toenails."

If you find any worrisome markings, reach out to a board-certified dermatologist immediately.

How to Get a Skin Check via Telemedicine

Even if you've been keeping up with your monthly self-exams, dermatologists still recommend seeing a physician for a professional check-in. "A self-check is an important early screening tool to recognize new lesions or changing lesions usually noticed by the patient," says Hayag. "But a dermatologic exam is important because we usually pick up on things that the normal person wouldn't pick up on their own."

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Even if stay-at-home regulations mean you can't visit the doctor right now, many dermatologists have made the switch to telemedicine.

"People are hunkering down and they don't realize [skin checks are] something that can be done virtually," says Markowitz. She's on a mission to change that. In-office visits, dermatologists often use a tool called a dermatoscope, which uses light and magnification to make exams easier.

Markowitz has been recommending a home version of the scope (she prefers the DermLite Hüd Home Dermatoscope, which attaches to your phone to take highly-magnified, office-quality photos of the skin. Each patient gets Markowitz's personalized guidelines on how to capture the images, and the patients then send the close-up photos to Markowitz, who evaluates them as part of a virtual visit.

"Even though it's a little portable tool, if it's used correctly, the image quality is enough for me to make a diagnosis quite accurately [from afar]," she says. As dermatologists settle into telemedical offerings, your doctor will likely offer specific instructions for virtual self-exam.

We may not be able to visit the doctor in person, but we can assist ourselves and our dermatologists by taking on self-exams — and Skin Cancer Awareness Month is the perfect time to try.


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