What’s the Best Way to Detect Melanoma Early?

Skincareaus [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons

Mt. Pleasant Dermatology’s Dr. Caroline Wooten Discusses How to Find, Treat and Even Prevent this Serious Skin Cancer.

Dr. Wooten why is it so important to get a skin check and how often should one get checked?
Skin checks are the best way to find and diagnose skin cancers early. When skin cancers are identified early, the vast majority can be effectively treated with an in-office procedure with minimal discomfort.

Do you often find melanoma during these routine skin checks? What about other cancers?
Since January of 2017, our practice has diagnosed 117 melanomas. Other skin cancers, specifically basal cell carcinomas and squamous cell carcinomas occur and are found much more frequently. Fortunately, these skin cancers typically have an excellent prognosis provided they are identified and treated in a timely manner.

Who needs a skin check, everyone or just those above a certain age?
Most adults should have a skin check yearly. Those with a history of skin cancer or certain other skin conditions may need more frequent checks, such as every six months. Children and teenagers with any new, changing, or symptomatic lesions should be examined by a dermatologist as well.

Where do you find most Melanomas? Do they look different than other moles or freckles on the body?
The majority of melanomas are on sun exposed areas such as the head and neck or upper extremities. However, melanomas can occur ANYWHERE on the skin. They vary widely in appearance. Some are flat; others are raised. They can be brown, black, tan, gray, red or pink. You may have heard of the “ABCDE’s of Melanoma”: Asymmetry, Border irregularity, Color variability, Darkness/Diameter, Evolution (changing). These findings can indicate that a lesion might be dangerous.

It’s important, however, to remember that some “safe moles” will exhibit some of these characteristics, and some concerning lesions can’t be identified using these criteria alone. The trained eye of a board-certified dermatologist is really the best tool for identifying melanomas.

If a Melanoma is found, what’s the next step in having it safely removed?
Treatment depends on a number of factors, particularly the location and the depth of the lesion. Of the 117 melanomas we diagnosed in 2017 and 2018, 108 of them were superficial or “thin” melanomas (less than 1mm deep). That’s important, because, in general, these thin melanomas can be fully treated with excision by a dermatologist or surgeon. The vast majority of these procedures are performed in an office-based setting with local anesthesia (injected into the skin surrounding the lesion). The procedures are tolerated very well and the prognosis for these early melanomas is generally excellent.

How can one prevent getting melanoma? Any tips beyond just sunscreen?                                  

Sun protection is the key to preventing melanoma. Daily application of a zinc-based sunblock to exposed areas is extremely important. You can also help protect yourself by wearing sun-protective/”UPF” hats and clothing, avoiding the midday sun, and seeking the shade.

Beyond prevention, early detection is your best tool. In addition to your skin checks with your provider, look at your skin thoroughly once a month (enlist the help of a partner if needed for hard to see areas like your back). If you find any lesions that are new, changing size, shape or color, or becoming itchy or bleeding, you should contact your dermatologist.

Caroline Wooten, MD is a Board Certified Dermatologist and has been practicing at
Mt. Pleasant Dermatology since 2013.