Two women look at a frame containing a real image of squamous cell carcinoma.

Advice for Skin Check Newbies

Dermatologist visits have been a consistent part of my life since 2007. Thanks, melanoma. I know the drill and what to expect when I arrive for my skin check every six months.

Not much has surprised me in the exam room over the last 15 years. I take my place on the table, can anticipate where my doctor will start her exam, and I’m never surprised when the cryoprobe makes an appearance. In fact, I'm shocked if it doesn’t. Biopsies also don’t come as a shock. It’s all so commonplace for me that I forget what it might be like for first-timers.

New patient surprises when it comes to skin checks

Recently, I talked with someone who just visited a dermatologist for the first time. She had never experienced a skin exam and was new to the whole cryotherapy process. Trips to the family doctor have an entirely different look and feel, and she wasn’t prepared for what a thorough skin check entailed. While I am really glad she took this first step toward taking care of her skin, I wish I had helped prepare her for the difference between a visit to her general practitioner and a visit to a dermatologist. If I had it to do over, I would tell her a few things.

Here's my advice for preparing for a skin check at the dermatologist:

Dress for the occasion

For a skin exam, you will be asked to remove all clothing except your underwear. I try to remember to wear tops that are easy on/easy off and bras without wide straps. This makes the chest and back easier for my doctor to examine. Pants are the same way. I want very few bells and whistles when it comes to getting ready for the exam and getting dressed when it’s over.

You’ll get some uber fashionable threads

I have always been handed a paper gown and a paper blanket for my lap. The paper gown needs to be worn in a certain direction. Just a little advice from someone who’s gotten it wrong: listen carefully to the nurse’s instructions. It’s easy to get caught up in the dread of undressing, and you can miss the preferred position of the gown: open to the front or to the back.

The doctor will look everywhere.

This means everywhere. From the scalp and behind the ears to the space between your toes, your skin will be thoroughly examined. Don’t be surprised if your doctor brings out a little light and gets up close and personal with spots that look a little concerning. Every spot they stop and ponder over won’t be skin cancer, but you’ll be glad they took their time and considered all possibilities.

You may hear the word “freeze”

Don’t freak out. That little canister your doctor is wielding packs a powerful punch, but it zaps those precancerous cells and may prevent some surgery or intense treatment down the road. Cryotherapy, or cryosurgery, stings briefly and leaves a sore that may blister up and scab over. It’s temporary. Most of the spots I have had frozen left tiny white scars. You might want to know this ahead of time. Some people prefer to have spots cut out rather than have the leftover white spots.

Biopsies are common

Again, don’t flip out. The word “biopsy” can come with some very negative connotations. I have come to understand it as another preventative measure and try not to expect the worst. Go into your first visit knowing that not every biopsy comes back with a frightening diagnosis. I have had at least one or two biopsies every six months for the last 15 years, and five have come back as cancerous.

It's just different!

The first visit to a dermatologist is nothing if not different. It can feel awkward, but it’s necessary. Once you know the routine, the next visit won’t come as such a blow to your sensibilities. Take a breath and rest assured that you are taking a step in the right direction: you’re taking care of you.

What advice would you give to someone before their first skin check?

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