In short. What skin cancer screening involves, how to examine your own skin properly, which lesions deserve a professional opinion, and how often to check.
Key points
- Change is the most important warning sign, and change is impossible to judge without a reference.
- Take dated photographs of your whole skin once a year, with someone helping for the back and scalp, and keep them.
- Close-up photographs of individual moles, taken with a ruler or a coin for scale, are even more useful.
No blood test or scan substitutes for looking at the skin. Screening means a total body skin examination by a trained clinician, and self-examination means the same thing done at home, less expertly but far more often. Both work on the same principle: find a lesion while it is small, because stage at diagnosis is what determines outcome.
What a professional examination involves
A full skin examination covers the whole body surface, including the scalp, behind the ears, the back, the buttocks, the soles and between the toes, and the nails. Dermoscopy is used on lesions that need a closer look. The clinician records what is found, photographs lesions that will be watched, and either diagnoses clinically, recommends observation at a set interval, or takes a sample. A short examination that skips the scalp or the feet is not a full examination.
Who benefits most
Screening has the greatest value in people at higher risk: those with fair skin that burns easily, a history of sunburns or tanning bed use, many or unusual moles, a previous skin cancer or a close relative with melanoma, long-term immunosuppression, or a condition that impairs DNA repair. For these groups, periodic professional review is worth having. For everyone else, knowing your own skin well enough to notice change is the more powerful tool, because melanoma is usually found by the person who has it or by a partner.
Photograph your baseline
Change is the most important warning sign, and change is impossible to judge without a reference. Take dated photographs of your whole skin once a year, with someone helping for the back and scalp, and keep them. Close-up photographs of individual moles, taken with a ruler or a coin for scale, are even more useful. When you attend a review, bring them. A lesion compared with a clear photograph from two years ago is a far easier decision than a lesion judged from memory.
How to examine your own skin
Use a well-lit room with a full-length mirror and a hand mirror, and ask someone to help with the areas you cannot see. Work systematically rather than by memory: scalp with a comb to part the hair, face and ears, neck, front and back of the trunk, arms and hands including the nails, buttocks and genital skin, legs, feet including the soles and the spaces between the toes. Learn the pattern of your own moles so that you notice a new one immediately.
How often
A monthly self-examination is reasonable for people at higher risk, and every two to three months for everyone else. Professional review annually, or more often if risk factors are significant or a previous melanoma was thicker, is a common schedule. Frequency is a clinical judgement rather than a fixed rule, and should be set with your clinician.
Seek review promptly if
- You find a new lesion, or a mole that has changed since your last check or photograph.
- A lesion itches, bleeds, crusts, or is tender without an obvious cause such as injury.
- You have had a melanoma or skin cancer before and notice any change in the treated area or nearby nodes.
Frequently asked questions
Why does a photograph of your own skin help at a review?
Change is the most important warning sign, and change is impossible to judge without a reference. Dated photographs of your whole skin, taken once a year, let a clinician compare a lesion with how it looked two years ago instead of relying on memory.
What should a full professional skin examination include?
The whole body surface: the scalp, behind the ears, the back, the buttocks, the soles, the spaces between the toes and the nails. Dermoscopy is used on lesions that need a closer look. A short examination that skips the scalp or the feet is not a full examination.
Who benefits most from periodic professional screening?
People at higher risk: those with fair skin that burns easily, a history of sunburns or tanning bed use, many or unusual moles, a previous skin cancer or a close relative with melanoma, long-term immunosuppression, or a condition that impairs DNA repair.
Risks & Limitations
- Incomplete excision, which may require a further operation to achieve clear margins.
- Recurrence of the skin cancer, and the need for surveillance for years afterwards.
- Scars are permanent. They mature and fade but never disappear.
- Problems with a graft or flap, including partial or complete loss, which may need further surgery.
- Numbness, altered sensation or nerve injury around the operated area.
- Melanoma carries a risk of spread that surgery cannot remove, even when the excision is complete.
- Pigment change, contour irregularity, or a scar that widens or thickens.
- Final assessment of the scar is made at 6–12 months, and surveillance continues longer.
When to Seek Care
- A lesion that changes in size, shape, colour or height, or that starts to bleed or itch.
- A new, rapidly growing nodule, or a sore that is not healing.
- A mole that becomes painful or bleeds.
- Swelling in a lymph node region — the neck, armpit or groin.
- A graft or flap that turns dark, cold or black, or a wound that opens or discharges.
- Fever above 38 °C, or spreading redness, warmth or pain around a wound.
References & Further Reading
- American Academy of Dermatology (AAD) — skin cancer diagnosis and treatment guidance
- American Cancer Society (ACS) — skin cancer types, staging and outlook
- Skin Cancer Foundation — prevention and skin self-examination resources
- American Society of Plastic Surgeons (ASPS) — reconstruction after skin cancer excision
- Cochrane Library — systematic reviews in skin cancer treatment and prevention
- Chinese Medical Association — clinical guidance for skin tumours and dermatologic surgery
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.