A woman and a dermatologist talk to each other about a skin exam, with a speech bubble showing a magnifying glass between them.

Routine Skin Exams: Should They Be Recommended for the General Public?

Last updated: October 2022

It recently occurred to me that I have gone for a routine physical examination on a yearly basis my entire life, or forty-seven years. As a child, I saw a pediatrician, and when I reached adulthood, I saw a general practitioner or a specialist in internal medicine.

Skin cancer runs in my family, and I was a heavy tanner, but even with that being the case, no doctor ever recommended that I get a routine skin check by a dermatologist.

Only one friend

I did my own informal poll among my friends to see if that was the case for them as well. Of all the friends that I polled, only one of my friends reported that her general practitioner recommended she have a routine skin check as part of basic healthcare, and it was over thirty years ago.

It goes without saying that after a skin cancer diagnosis, it is recommended that a skin cancer survivor have routine skin checks, but what about routine skin checks for the general public as part of basic healthcare?

It seems to me like a routine skin check would be beneficial to everyone. At a minimum, what about those with a strong family history or a history of significant tanning?

Monitoring and diagnosis

If a routine skin exam is not recommended as part of general healthcare, how are skin cancer issues supposed to be diagnosed?

The two skin cancer issues I had were not and could not have been preliminarily diagnosed at home in a self-skin check. They did not fall within the Asymmetrical Border Color Diameter Rule for detecting skin cancer.

And I had to knock on a lot of medical doors to finally get a correct medical diagnosis. My 2018 skin issue started when a rather large and unusual growth appeared on my bottom lip. I saw two mid-level professionals (one was a nurse practitioner in a general practice, and the other was a physician’s assistant in a dermatology practice) because I was very concerned, and they had the first availability to see me.

First, a misdiagnosis

I was originally diagnosed with herpes by the nurse practitioner, and the P.A. in the dermatology practice said she did not know what was wrong with my lip.

The P.A. referred me to a plastic surgeon because, according to her, whatever was wrong with my lip, the growth needed to be removed, and a plastic surgeon would be able to remove it with less scarring to my face.

I was ultimately diagnosed with skin cancer by the plastic surgeon, and he performed a shave excision surgery. I later had three recurrences and three additional shave excision surgeries.

I do not fault the mid-level professionals who misdiagnosed or could not diagnose my skin issue. Rather, it says to me that skin cancer is not always evident and easily diagnosed, which is why I had to take all those steps to eventually learn I had skin cancer.

I was just relieved that I eventually got a correct diagnosis and proper treatment. Without a correct skin cancer diagnosis, there was no way for me to move forward and get the proper treatment.

Education and knowledge

Every time I go to the dermatologist for a skin check, I learn more about my skin. My dermatologist has taught me the proper way to care for my skin, the best types of sun block for me, and so many more beneficial things about my skin.

If the general public is not having a routine skin exam, presumably they are not meeting with a dermatologist about their skin and getting this invaluable information.

I consider myself a fairly educated person, but prior to my skin cancer diagnosis in 2018, I was extremely ignorant about proper skin care and the very real risk of skin cancer to me. Prior to my own diagnosis, I held the misguided belief that people who were diagnosed with skin cancer were unable to tan, fair-complected, blue eyes, and blonde or red hair.

I never thought that a person like me, a dark brunette with eyes so dark that they are almost black, was at any risk of getting skin cancer. Honestly, it never crossed my mind that it was a concern. Although I always burn now, as a young person, I was able to tan fairly easily.

I have been lucky enough to get the education I so desperately needed, and I would like to see that information more readily available to the general public.

Without a routine skin exam by a dermatologist, the general public does not get the interaction with a skin expert and the knowledge that comes from such an interaction.

Prevention

My surgeon told me that the earlier she catches skin cancer, the better the odds are of her successfully treating it. If an individual is having routine skin checks by a dermatologist, any issue will almost assuredly be detected faster than if the person is just doing self-skin checks at home, or worse yet, nothing at all.

The reason skin cancer survivors go for regular skin checks is to catch any issues early and hopefully prevent them from becoming bigger, perhaps life-threatening, issues.

Self-skin checks have their place, for sure, but I believe they should be used in tandem with skin checks by a dermatologist, not alone. An untrained eye is unlikely to catch the things a dermatologist has been trained so many years to spot.

In sum, from my perspective as a skin cancer survivor, I find it unsettling that routine skin exams with a dermatologist are not part of basic healthcare for the general public.

How do you feel about the fact that skin checks are generally recommended only when there is a skin issue? Do you agree with this thought process, or do you see the issue from another perspective?

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