Protecting Yourself From Skin Cancer

What type of cancer affects more people than all other forms of cancer, combined? The answer is as plain as a red spot on your nose or a mole on your back.

More than 3 million people in the U.S. are diagnosed with skin cancer each year, making it the most common type of cancer. Skin cancer occurs so often that one in five Americans will get it in their lifetime.

Vermonters are at greater risk of getting skin cancer than residents of many other states. In fact, Vermont is ranked fourth highest in incidence rates of skin cancer, with 37.1 cases per 100,000 population. Why is the number of skin cancer cases so high here, while other states like Texas and Florida are much lower? The large number of Vermonters with fair skin (a skin cancer risk factor) is a big reason. Also, Vermonters spend a lot of time outdoors in all seasons. As we work and recreate outside, we’re exposed to ultraviolet light from the sun, which can cause skin cancer. UV exposure continues year-round and can be quite harsh in winter as the light is reflected off the snow.

The good news is that the survival rate for skin cancer is very high — if it’s detected and treated early. The key is finding skin cancer and removing it before it can spread to the lymph nodes and other parts of the body.

To help you protect yourself from skin cancer, this article discusses how to do skin self-exams. We’ll also cover what happens when you visit a doctor for skin cancer screening and tell you the easiest way to find an in-network dermatologist.

Self-Exam Process

You are the front line in the battle against skin cancer. After all, you know your body best! Get in the habit of checking your body regularly for signs of skin cancer (we’ll tell you what to look for later in the article). A self-exam should be done at least once a month. You’ll need a:

• Well-lit room
• Full-length mirror or large wall mirror
• Handheld mirror

While you can do the self-exam yourself, it helps to have someone you trust involved to check areas that are hard for you to see, like your back or scalp.

While facing a mirror, check your:

• Face, ears, neck, chest, and belly. Don’t forget to look under breasts.
• Underarm areas, both sides of your arms, the tops and palms of your hands, between your fingers, and under your fingernails (you may need to remove color nail polish first).

Next, sit down and check your:

• Thigh fronts, shins, tops of your feet, between your toes, and your toenails (remove any color nail polish first).
• Using a hand mirror, look at the bottoms of your feet, your calves, and the back of your thighs.

Stand up and use the hand mirror to view:

• Buttocks, genital area, lower and upper back, and the back of your neck and ears. (For some of these areas, it may be easier to use a combination of wall and hand mirrors.)
• Use a comb or hair dryer to part your hair to check your scalp.

Be sure to check your entire body during the self-exam. While skin cancer tends to develop more often in places that have been frequently exposed to the sun, such as the face, neck, and arms, it can occur on any part of the body.

You can set a reminder on your phone or computer’s calendar to let you know when you’re due for a skin check. For more information on how to perform a self-exam, watch a video from the American Academy of Dermatology (AAD).

What to Look For

When doing a self-exam, check for suspicious spots, including ones that look like:

• A smooth, shiny, pale, or waxy lump
• Firm, red lump that may bleed or develop a crust
• Flat, red spot that’s rough, dry, or scaly

Also look carefully at any moles (small dark spots). Note ones that:

• Are asymmetrical — they have two sides that look different from each other
• Have borders that are blurry, scalloped, or jagged
• Have more than one color
• Are larger than 6 millimeters, about the size of a pencil eraser
• Seem to be changing over time

Skin cancer can also look like:

• Sores that bleed or don’t heal
• Wart-like growths
• Brown or black streaks under fingernails or toenails

For examples of what various skin cancers look like, view the American Cancer Society’s skin cancer image gallery.

If you find a suspicious spot, don’t panic. There are many types of skin lesions that turn out to be benign (non-cancerous). What’s important is to make note of them and have a medical professional look at them (more on that below). 

Keep a record of any moles, spots, or suspicious areas. You can use the AAD’s downloadable body mole map form. You may find it helpful to take pictures of suspect areas, putting a ruler in the shot to document size. You can use the photos later for comparison to see if there have been any changes.

If you prefer to use your phone, there are many apps available to assist with tracking and monitoring moles and skin lesions. However, please disregard any claims that an app can determine if a suspect area is skin cancer — only a medical professional can do that.

Seeing a Dermatologist

If you find a spot on your skin that differs from others, or has changed appearance, itches, or bleeds, you should make an appointment to see either your primary care provider or a dermatologist — a doctor that specializes in skin diseases.

Your primary care provider can look at any suspicious areas and discuss them with you. If they feel you should see a dermatologist, they can refer you to one (which may help expedite getting an appointment). However, referrals are not required under our health plans and you can contact a dermatologist directly.

To find an in-network dermatologist, use our Find a Doctor tool. In the role/specialty menu, select dermatology. To see the closest doctors first, search by distance. You can check the “accepting new patients” box to see only doctors who are taking newcomers.

Bring your body mole map form and any photos you’ve taken with you to the appointment. The doctor will examine areas of concern and determine if they could be skin cancer. The doctor may opt to use liquid nitrogen to freeze skin lesions (a treatment called cryotherapy). The treated area will become red afterwards and it may also blister or form a scab. In about 7 to 10 days the area will heal and there probably won't be any scar.

The dermatologist may choose to do a biopsy, removing a small sample of skin to be examined under a microscope by a pathologist to determine if it is cancerous. They will use a local anesthetic to numb the skin, so you won’t feel any pain. There may be a scar after the biopsy, but these tend to fade over time.

If you are at increased risk for skin cancer, you may want to get annual screenings by a dermatologist. Factors for increased risk include:

• Exposure to ultraviolet light, such as being outside in the sun a lot or tanning bed use
• Having a fair complexion
• A large number of moles or atypical moles (those with irregular borders, different colors, or asymmetrical shapes)
• Family history of melanoma

During a screening exam, you’ll be asked to get undressed and wear a hospital-style gown. The dermatologist will check you from head to toe looking for signs of precancers, as well as basal cell and squamous cell carcinomas — the two most common forms of skin cancer. They will also look for abnormal moles, which may indicate melanoma. 

Depending on the exam’s findings, the doctor may want to monitor certain areas to see if they change over time or do treatments to remove skin lesions. For suspicious moles and other areas, they may want to do a biopsy to determine if they are cancerous.

Early Detection is Important

We hope you’ll use the information in this article to take an active role in looking for potential skin cancers. Treatments can be very successful, if skin cancer is found early. That’s why it’s important for you and everyone in your family to get into the habit of doing self-exams regularly. For additional information on preventing skin cancer, check out our blog on tips for keeping your skin healthy.