Guest blog written by John Zade, current research fellow under Hooman Khorasani, MD, the Chief of the Division of Dermatologic & Cosmetic Surgery at The Mount Sinai Hospital and Assistant Clinical Professor of Dermatology at the Icahn School of Medicine at Mount Sinai.
Moles on our skin, medically termed as nevi, are extremely common and almost all of us have a few on our body. Although most dark spots on your skin are completely harmless, it is important to be aware that some may become cancerous. These cancerous moles are known as melanoma; luckily there are a few distinguishing features of these spots that help us find them and treat them. In this blog I’m going to go into how you can spot melanoma on yourself and your loved ones and how often you should be getting your skin checked.
Melanoma is the second most common invasive cancer in young adults, aged 20-39, (Bleyer & Barr, 2009) and can be fatal, especially if it has spread to deeper parts of the skin and beyond. In the United States, approximately one person dies every hour due to melanoma (Erdei & Torres, 2010). There are different types, and it can occur almost anywhere on the body including under your finger nails, scalp, and on the soles of your feet. Fortunately, there are steps you can take to decrease your risk factors to melanoma and aid in catching it early so we can treat and cure it.
How can I decrease my risk of getting melanoma?
Part of decreasing your risk is making sure you are using sun protection and protective clothing. A positive family history of melanoma puts you at a slightly higher risk and should be discussed with your dermatologist.
Is melanoma still a risk if I have darker skin?
Yes! Although people with lighter skin are at an increased risk of melanoma, darker skin individuals still need to be checked regularly. It is especially important to check the soles of your feet and palms of your hands.
How early/often should I see a dermatologist to get checked?
Most dermatologists recommend that you begin getting skin checks in your college years. In regards to how often, it really depends on your medical history and family history. For a healthy adult, most dermatologists would recommend a skin check every year. Remember, go without make-up on and without nail polish. If you are at an increased risk for getting melanoma, then you may be advised to have more than one skin exam every year. This is something that you should discuss with your dermatologist during your initial skin exam.
How long does a typical skin exam take?
Most skin exams are relatively quick and should only take about 15 minutes. It could take longer if the dermatologist needs to take a biopsy or if you have multiple spots that need to be checked.
What should I expect from a skin biopsy?
As a dermatologist checks your skin for suspicious spots, he/she may decide to take a biopsy to make sure a lesion is not cancerous. Biopsies are performed using an injectable anesthetic and should not be painful. The tissue that was taken is then read under a microscope to make a definitive statement on whether the spot has cancer in it or not.
Can I check my own skin for melanoma?
Absolutely! It is actually recommended that you check your own skin for melanoma approximately once a month. Some spots on our bodies are hard to check so having a partner or mirror is helpful. There is even a body mole map through the American Academy of Dermatology that allows you to keep track of your moles and note any changes. Bring this in to your next skin check appointment and I promise you will be your dermatologist’s favorite patient!
What should I be looking for?
When looking for spots that may be melanoma, you should be looking for one or more of the ABCDEs. Let’s go through this little alphabet for melanoma:
A: Asymmetry– one half of the spot is different than the other
B: Border– an irregular border
C: Color– varying colors with shades of tan, brown or black
D: Diameter– larger than 6 mm (about the size of a pencil eraser) or rapidly growing in size
E: Evolving– rapid change in any of the ABCD categories
If you see any of these features in one of your brown spots, be sure to set up an appointment with your dermatologist right away. Use your body map to make a note of spots you think are suspicious.
How do I perform my own skin exam?
- Examine the front, back and sides of your body with the help of a partner or mirror.
- Examine the back of your neck and on your scalp by using a comb or your hands to part your hair.
- Examine your arms, including your palms and look for any dark spots under your finger nail.
- Scan your genital area and buttock using a mirror
- Look at the front and back of your legs, the spaces in between your toes, the soles of your feet, and under your toe nail.
What if my mole is unsightly but noncancerous?
Large moles that are in visible areas can be bothersome and affect a person’s self-esteem. If they are not cancerous, removal of these moles would be an elective procedure and thus out of pocket. At Mount Sinai we have an ongoing clinical trial where we can remove these kinds of moles at no charge, and we then analyze them for the advancement of dermatologic research. For more information on this you may contact Giselle Singer at 212-241-3288 or via email: giselle.singer@mssm.edu.
What else should I know about melanoma?
Being proactive about your skin health and making sure to protect yourself from the sun are both extremely important. When we are able to catch melanoma early it is completely curable. Take the #getnaked pledge and let’s make deaths from melanoma a thing of the past!
References
Bleyer, A., & Barr, R. (2009). Cancer in young adults 20 to 39 years of age: overview. Semin Oncol, 36(3), 194-206. doi:10.1053/j.seminoncol.2009.03.003
Erdei, E., & Torres, S. M. (2010). A new understanding in the epidemiology of melanoma. Expert Rev Anticancer Ther, 10(11), 1811-1823. doi:10.1586/era.10.170