What to Expect From Your First Skin Check

This article is sponsored by Sun Doctors.

Please note: The information in this article is general in nature. Please always consult a GP or other medical practitioner for advice that is specific to your health needs.

Ahhh the skin check, that routine check-up we keep telling ourselves we’ll do, yet never get around to doing it.

In Australia, due to our abysmal skin cancer rates, getting our skin checked regularly is a must. But if you’re anxious about getting one done, that makes sense. It’s a fairly exposing procedure, but it is an important one. According to the Melanoma Institute Australia, one person is diagnosed with melanoma every thirty minutes in Australia.

We spoke to doctors Luke Bookallil and Doctor Sarah Wahid, two practitioners at Sun Doctors Skin Cancer Clinics. There are over 31 locations around Australia, with 120 doctors specifically trained in identifying, treating and managing skin cancer. A referral from your local GP is not necessary to visit a SunDoctors clinic, and consultations are typically completed within 15 minutes.

If you’re anxious about getting a skin check, the docs tell us exactly what goes down in one so you can be prepared.

Hello, What can people expect if it’s their first time getting a skin check? What’s the process like?

Dr Wahid: The doctor will first talk to them and take a history, talk to them about how much time they spend outdoors, their hobbies, their occupation, assess their skin type, their family history — all of those questions.

And then once we have an idea of where the risk level is, we’ll tell them that this is the instrument that we use that magnifies your moles, we’re going to start with the face and work our way down. Then we get them to undress and just leave their undergarments on usually, you offer a gown if someone wants to wear that.

There is privacy and curtains they can draw while they’re changing. And then once they’re ready, we’ll just use a dermascope which magnifies the moles and will check all the areas except for, anything hidden by undergarments. And we tell them that if they know of any hidden spots around there, let us know and we’re happy to check.

When the skin check is done, we’ll let them know if there are any abnormal spots, any spots to monitor to watch out for changes. Sometimes we do photography because we have to digitally monitor changes in the moles that are a little bit suss, but not suss enough to take them out. And then we talk about sun protection, what they need to do, and how often they need to get their skin checked.

How often do you need a skin check?

Dr Bookallil: There’s no 100% right or wrong in any of this. Normally, for someone who hasn’t got a parent or sibling with skin cancer or melanoma, and doesn’t have more than 100 moles and atypical moles, then I’ll say they [should] come in every two years until 40 and then every year after 40. That’s a generalisation. Some people have got other illnesses and medications, which means they should come every six months or every year. Some people spend so much time in the sun working outside all the time you want to see every year. 

Dr Wahid: Occupation is a very important one. People who are working outdoors have the highest risk.

Are there spots people tend to miss?

Dr Wahid: That’s why it’s important to have a skin check because we look everywhere, like in between toes. I’ve had someone who had a basal cell cancer in between the buttocks area. Obviously, it never sees the sun and even I wouldn’t expect something there. Then there are basal cell cancers that just look like a sore or a pimple but if you’ve got a patch like that, that doesn’t go away for longer than about four weeks, then you need to get that checked as well.

During a comprehensive skin check, what are the doctors looking for?

Dr Wahid: When we’re checking, we’re looking for lots of clues that will tell us whether this could be cancerous or not. We are looking for pigment patterns of melanomas as well as features of other types of skin cancer, so lots of things. Plus the patient’s telling us whether it’s changing or sore or bleeding and all that. And then, based on that, we decide whether we biopsy it or remove it to send a sample to be tested in the lab. Or sometimes we know that’s definitely what needs to be removed.

So the moles might get removed?

Dr Bookallil: Generally speaking, most of our doctors are trained to take a biopsy on the day if it’s required. Any areas of concern are recorded and analysed, and if needed some things need to be excised, which basically means cut out to find out whether it’s a skin cancer or not, and that may need to then be organised for a later date.

At Sun Doctors, we strive to be as efficient as possible based on the patient’s requirements. Doctors often complete a biopsy within a matter of minutes. The majority of the appointment time is dedicated to the skin check, administering local anesthesia, discussing family history, providing preventive and management advice to the patient, carrying out the procedure, completing the necessary paperwork, and finally applying a bandaid – all designed to save the patient from a return visit.

What advice do you have for people?

Dr Wahid: Starting young is important, especially in the formative years, if you could with using sun protection and sunscreen. There’s been a few studies that show that it will reduce your melanoma rate by 40% later on. Use sunscreen like your wear your seatbelt — both can save your life. The best sunscreen is the one you actually use — it’s a personal preference. Often patients ask what’s the best sunscreen to use, but it’s anything with an SPF factor of 50. That’s the best, highest protection that we have in Australia. 

But use one that you like to use and you will actually use it. The amounts to use, are roughly half a teaspoon for the face, half a teaspoon for the neck, one teaspoon for each limb and one teaspoon for the front and the back. It’s a rough gauge of how much is adequate because often people don’t apply enough or don’t reapply if they’re going to be at the beach more than a couple of hours in to reapply, reapply after exercise, after swimming.

If you’re doing that be sensible, you can still enjoy some time in the sun, and get some vitamin D. But it has to be in the forefront of your mind that this is really important because melanoma is so common in Australia and is a completely preventable cause of death. Start young and just be sensible.

Dr Bookallil: Avoid any nasty sunburns, blistering sunburns – at any age – but certainly as a young person, that first 20 years of your life, that will reduce your chance of some of these melanomas and other skin cancers as well.

If we get it early in the top layer of the skin for melanoma, there’s a thing called melanoma in situ, which is in the top layer of the skin called the epidermis. And if we get the melanoma in that in that stage, then theoretically our cure is 100% because there are no blood vessels or lymphatic vessels, so there’s no way for it to spread. If we can do that, then that’s ideal. But even if it does get a little bit into the next layer of the skin called the dermis. It’s not very thick there so our chances there are also very good.

If you’ve been putting off booking your next skin check-up, now’s the time. Book in at SunDoctors online here, or visit your GP.