What to expect during a skin exam

There are plenty of things that I'm supposed to do for my health that I skip (like that overdue vision exam), but a skin exam isn't one of them. As a melanoma survivor, these screenings are a routine part of my life.

So when friends ask about skin exams, I try to demystify what should be an important, annual appointment for everyone, especially those at increased risk for skin cancer. Here's what I tell them.

What does the actual skin exam entail? 
First, you'll change into one of those stylish one-size-fits-none gowns. You know the ones - they claim to preserve a sliver of modesty, but really do anything but. 

Before the skin exam, your doctor may ask if you have any concerns. Even if he or she doesn't ask, don't be shy. Point out any spots that worry you or changes you have noticed.

Your doctor will then do a head-to-toe skin exam, making note of any spots that need monitoring or closer examination. My screenings typically include an exam of my scalp, face, mouth, hands, feet, trunk and extremities, eyes and eyelids, ears, fingers, toes and toenails. Because of my melanoma history, my doctor also looks at my lymphatic regions. 

Your doctor may look at any unusual spots with a dermatoscope, which looks like a combination of a magnifying glass and flashlight. This allows your doctor to better examine moles that are hard to see with the naked eye. 

Do skin checks ever get more ... thorough? 
I'm often asked if a skin exam includes the genital areas. Some doctors do a full-body exam in every sense of the phrase. Others skip these areas altogether unless a patient specifically requests them.

If you've noted any concerning spots in this area, raise them. Don't let a few minutes of awkwardness mean the difference between catching skin cancer early, when it's most easily treated, and when it's advanced to a more troubling stage. 

My skin checks include examination of these areas, and I encourage friends to at least have someone examine those areas -- if not a dermatologist, then a gynecologist or other trusted health care provider. While skin cancer usually appears on parts of the body exposed to UV light, I'm proof that this isn't always the case. Melanoma and other skin cancers can and do arise where the sun doesn't shine.  

What if there's something suspicious on my skin? 
If your doctor finds a suspicious spot, he or she may make a note of it and monitor it over time. Often, your doctor will biopsy it that day. Biopsies at dermatologists' offices typically involve numbing the area around the spot with a local anesthetic, then scraping or shaving a small sample of the lesion. The sample is then sent for analysis. Sometimes a doctor will do a punch biopsy instead, which uses a circular blade akin to a hole puncher to remove deeper layers of skin for testing.  In either case, you will typically get your results within 7-10 days.  Your doctor also may want to photograph any unusual spots that don't yet warrant removal.  This will give your doctor something to compare your mole to the next time you have a skin exam. 

How long does a skin check take, and how often should I get one? 
I know: doctors' appointments can be disruptive and inconvenient. But a skin exam is quick and painless. A typical skin exam usually only takes 20 minutes, and most people don't need them more than once a year. If it's your first visit, it will take a bit longer, as your doctor likely will talk about skin cancer risk factors and ask about your medical history. Your doctor also will discuss about when you need another skin exam, based on your personal history and the results of this skin exam.

I'll be honest: I almost cancelled my first skin exam. It was my birthday week, and that seemed like a good enough reason to skip it. I also was feeling guilty about the tan I'd just gotten on vacation.

I'm glad I ended up keeping that appointment. It saved my life. 

Rachel Cruz volunteers with myCancerConnection, MD Anderson's one-on-one support program. To connect with other cancer patients and caregivers through myCancerConnection, please call 800-345-6324 or visit myCancerConnection online.

Melanoma is one of the cancers MD Anderson is focusing on as part of our Moon Shots Program to dramatically reduce cancer deaths. Learn more about our Melanoma Moon Shot.