Patients often do not have concern about a specific skin issue, but would like to have surveillance of their skin by the most qualified experts. There are many reasons for having routine skin examinations by a dermatologist, but the goal is to catch skin cancers early so they can be treated the most efficiently with the least amount of scarring. In addition, pre-canceous lesions can be treated at routine visits thereby preventing progression. Although this is not an exhaustive list, a few of the most common reasons for scheduling a routine examination of your skin are listed here:
- personal history of any skin cancer
- personal history of pre-cancerous lesions (actinic keratoses)
- a weak immune system (organ transplant patients or patients with lymphoma)
- family history of melanoma
- extensive outdoor work or lifestyle
- living a significant part of life at altitude or in very sunny climates
- pale or fair skin
- prior tanning bed use or excess sun exposure
- moles that are asymmetric, have irregular borders or colors, are large or changing
- exposure to radiation (particularly acne treatment as a child)
- exposure to certain substances, such as arsenic (can be found in well-water)
If you have an examination scheduled, it’s best to either come to your appointment without anything on your skin, including foundation or makeup. This can be removed at your appointment, but you should a lot time to replace any makeup afterward, if necessary. Before you come see us, take a glance at your skin in a full length mirror and make note of any areas that stand out or cause you concern. Dr. Swann recommends that patients routinely do self-examination once per month after bathing in front of a full-length mirror. Even without knowing much about skin disease, patients are very good at finding changes in their skin.
Our paperwork will question you about your history of sun exposure, sunburns, etc. and if any specific spots have been bothering you. Then we’ll have you change into an exam gown. Skin cancers can occur where the sun doesn't shine. We can examine you with your underwear on, but would prefer you to have you remove your socks. If you prefer a limited exam (just the waist up, most intense sun damaged skin or only certain moles) we can accommodate.
During the exam, we may use alcohol on the skin and sometimes use magnification or special lighting. Your physician or physician assistant will be dictating their findings out loud to a medical assistants who makes sure that everything is documented in your medical record. The medical assistant may document some areas with photos during the exam. Routine skin checks might seem cursory to a patient, but even if a skin check seems quick, we take our examinations very seriously and spend time on areas of concern. These may be subtle to most patients, but this is our interest and passion.
Dr. Swann and our staff realize that sometimes after your skin check, you worry something has been missed and it is important for us to relieve any concerns or take appropriate action on areas that may be a concern to us. When we come to a spot that you are worried about, don't hesitate to point the area out it out us so that your concerns can be addressed.
During the examination, we may identify an area that requires treatment. After discussing the diagnosis and treatment with you, they will generally take care of the minor procedures right then and there. The two most common treatments are:
- Cryotherapy – A quick spray of liquid nitrogen is used to remove lesions that sit on the surface of the skin (for example, pre-cancerous actinic keratoses.
- Skin biopsy – A small sample of a suspicious lesion is removed under local anesthetic. It is then sent to a lab to be examined under a microscope to determine if further treatment is needed.
Many people have lots of spots on their skin that are not worrisome (for example, skin tags, sunspots and benign moles). Although these can be treated if they are causing discomfort, or if there is a cosmetic concern, our team gives their initial attention to any spots that have the potential to be cancerous. If you have something on your skin that bothers you cosmetically, let the doctor know and they can talk to you about treatment options. Simple cosmetic concerns can often be treated at the time of your skin exam if there is time and you will be given a price to cover these non-medical, cosmetic concerns. Payment for cosmetic-related procedures are expected in full at the time of service. We do offer Care Credit and can take credit cards should are expected.
To schedule a skin check with someone on our team, call 417-888-0858.