Skin cancer screening/Mole check
How does skin cancer screening work?
Skin cancer screening is usually performed by your physician using a dermatoscope. Dermatoscope is a medical magnifying glass that allows your physician to visualize the size and shape of the mole that you are concerned of.
A dermatoscope can examine:
- Skin lumps
- Protruding bumps
- Pigment lesions
- Hair follicles
- Persistent rashes
- Dermatoscopy examination allows a magnify of your mole/lesion up to 20 times in comparison to naked eyes to have a clearer picture of a lesion.
- Patients may be able to see the lesions themselves through the dermatoscope and have a better understanding of their conditions
When should I get my mole checked? What are the concerning symptoms?
- You should consider getting a doctor review if you notice your moles
- Change of size or shape
- Change of mole skin surface texture- more scaly, flaky, crusty
- The mole turns more bumpy, or hard
- The mole has an ulcer that never heals, it gets weepy
- There is spreading of the mole color over the borders
What results can I expect?
- Your doctor will explain to you the findings of the mole under the scrutiny of dermatoscope.
- Individual skin care advice will be given
- Skin medicated cream will be given depending on the skin condition.
- Depends on individual cases, sometimes your doctor will arrange a skin biopsy procedure to remove the mole and review the tissue sample under the microscope.
How many sessions do I need?
1 session should suffice. Your doctor usually will take a personal history and family history for risk factors. 1 mole check usually takes 5-10 minutes, a full body mole check occasionally can take up to 30-45 minutes for screening.
No preparation needed, though old pictures of moles/skin lesions are useful to monitor progressive changes of the lesion
Dermatoscopy mole screening is a non-invasive method that is comfortable and is pain-free.
Moles that get bigger over time may not necessarily be bad. As we progress with age, some mole can get slightly bigger. However, a mole that changes shape or sizes should be checked out by your doctor.
Moles can present themselves as flat moles or sometimes slightly raised. Some flat moles can progressively become more raised over time. The skin surface should remain smooth and even. Nonetheless, as certain skin cancer can also be more ‘nodular’ and raised, worth checking with your doctor if the moles becoming bumpier.
Moles can turn darker shades. This can commonly be a resultant of increase in sunlight exposure. The ‘pigmentation’ of moles can be increased secondary to hormonal changes during pregnancy or puberty period.
Although most of the moles are black or brown in color, some moles can be black, blue or even red in color. The color should be uniformed throughout the mole. If you are concerned with the color of the mole, do check with your doctor.
Some moles can begin with a brown/black flat patch. The pigmentation from the mole comes from the melanin pigment produced by melanocytes that are stored beneath your skin layer. As one grows older, the melanocytes sometimes burrows deeper under the skin layer. As a result, the moles become lighter in color, or in some cases ‘loses’ its color. Moles that lose color may not necessarily be cancerous, though if you notice a change in color, it is still good practice to let your doctor physically check the lesion.
The ABCDE rule highlights the ‘red flags’ that we should watch out for in a mole.
A: Asymmetry (the shape of the mole is not symmetrical)
B: Border (irregular and ill-defined borders are usually bad signs)
C: Color (multiple shades of colors are bad signs)
D: Diameter (size of more than 6mm in diameter warrants a check with your doctor)
E: Evolution (a mole that changes over time should be checked!)
- The duration (since birth/puberty/adulthood)
- Changes through time in terms of color, shape, size, surface texture
- Any history of trauma
- Any family history of mole/skin issues
- Skin type- does it burn or tan easily?
It is a myth that one can develop skin cancer by scratching the mole away. Scratching the mole sometimes causes a breach of skin surface barrier, predisposing a person to skin infection and bleeding.
The pathophysiology of developing moles is not completely understood. There is an element of genetic predisposition, where you may notice your family members may also have more moles. We tend to notice a few new moles emerging throughout our life in particularly through adolescence and adulthood period suggesting a potential role of hormones in our body and sunlight exposure.