Total Body Skin Examinations
I remember the first few times that I went to the dermatologist for regular skin checks in the late 1980s. It was a memorable experience because of how brief it was. I was in shorts and a t-shirt and the doctor asked me to remove my shirt as I was examined. The dermatologist had me stand up and looked around my torso, arms, and legs. After a short examination, this medical professional said that I “looked good”. I was a little cocky back then and thought to myself, "I know that I look good, but do I have any more of those melanomas?"
Full body skin examinations have changed since back then
Much has changed since then and it’s important to know what to expect from a more thorough examination. I recently moved to Long Island and have a new dermatologist. He has been in practice for quite a few years and has a hands-on approach. One thing I have realized over the years is that skin cancer presents itself in many ways that you might not think it would. Skin cancer sometimes has a different texture from adjacent healthy skin, making cancerous spots easier to detect through touch. Of course, this type of hands-on approach may take some getting used to and requires trust.
My dermatologist's style of full body skin examinations
My dermatologist uses a magnifying glass with a light. It looks a little funny watching him scan my body from millimeters away. He looks like a detective searching for fingerprints and clues. This whole experience was also a little weird for me at first, but I have gotten used to the idea that his job is to find and remove the bad things that can hurt me. This takes trust as well.
The skin check is very thorough
All this leads me to my main point: he checks everything. I mean everything, with my consent, of course. He checks my scalp and even between my toes and the areas where the sun doesn’t shine. At first, I wondered if this was really necessary. How much did I really tan those parts? Then, I recalled using tanning booths years ago, when my entire body was exposed to harmful UV radiation. Ugh!
What does the research say?
Checking everything makes intuitive sense to me, but does research back this up? A recent study from the International Journal of Women’s Dermatology found that total body skin examinations (TBSE) are more effective in finding malignancies that may have gone undiagnosed with a less thorough, less focused examination sparing these patients “significant morbidity and mortality.”1 I am all about being spared significant disease and living a long, full life.
Here are some things that I have found useful regarding TBSEs (total body skin examinations)
- Find a dermatologist that you are comfortable with. To make sure you're choosing a good one, get a first-hand recommendation or at least look at some online reviews.
- Go with your instinct. If it doesn’t feel right, find a situation that does.
- Ask for a TBSE. It’s your examination and for your benefit. You are your best advocate.
- Bring a trusted friend or family member, if you need to.
- Ask another person to be in the room, if you need to.
- Make sure to schedule enough time for a lengthy exam. Do not let yourself get rushed out.
- Take a shower before you go. I cannot stress this enough.
Any other recommendations?
How well have your skin cancer diagnoses been explained to you?