Monday, January 13, 2014
The numbers on skin cancer are sobering — according to the Skin Cancer Foundation, over 3.5 million skin cancers are diagnosed in the United States every year. It’s the most common form of cancer in the United States, and the number of women under 40 who are diagnosed has more than doubled in the last 30 years. Melanoma (the most deadly form of skin cancer) is one of the leading causes of cancer death in women 25 to 29 years old, says Doris Day, MD, a clinical assistant professor of dermatology at New York University Medical Center.
When skin cancer is caught early enough, however, there is a 98 percent — or greater — chance that it can be cured, says Dr. Day. “Not catching it can be deadly.” The annual skin check is thus an exam that can literally save your life.
When the skin is being checked, there are some “hidden” areas that need particular attention from the trained eye of a dermatologist:
- Between the toes
- The scap
- Inside the ears
- Behind the ears
- The fingernails
- Between the butt cheeks
- The backs of the legs
- Beneath the underwear
- Beneath the pubic hair
People of color have more melanin in their skin, which functions as innate protection, Day says, but melanoma occurs in all skin types and every ethnicity. “I’ve seen it on the backs of the legs of women of color who’ve never had so much as a sunburn,” she says. Patients with darker skin, Day says, should be examined with particular attention to the following areas:
- Palms of the hands
- Soles of the feet
Regular self-checks of moles, birthmarks, freckles, and/or brown spots are also recommended, in addition to the yearly doctor's exam. People with numerous moles and freckles have a greater risk of melanoma, says Day, but not every mole or freckle has the potential to become a skin cancer. “This is another reason why it’s important to get checked. Your doctor can tell you the difference between moles. Sometimes a mole can be dysplastic, meaning that it’s not a typical benign mole, but it’s also not melanoma.”
For self-checks of spots, moles, birthmarks, and freckles, Day suggests following the ABCDE rules:
A — Asymmetry: Does one side of the mole match the other, or does the mole have an irregular, or asymmetrical, shape?
B — Border: Does the spot have a smooth edge or a ragged one? An irregular border can be a red flag.
C — Color variation: Is the color the same all over the mole, or are there patches of red, blue, or white?
D — Diameter: Be on the lookout for any spot larger across than the eraser head of a pencil.
E — Evolving: Does the spot/mole/birthmark always look the same, or has it changed in some way recently?
“Another thing to watch for is any spot that grows, gets darker, or starts itching or bleeding,” says Dr. Jessica Wu, assistant clinical professor of dermatology at USC Medical School and the author of Feed Your Face. “Dermatologists are trained to look for skin cancers, but we also often find other skin conditions during a yearly skin exam,” she says, “including fungal and bacterial skin infections, and benign growths like cysts and skin tags.”