Purpose of the Examination
The primary goal of a full skin examination is the early detection of skin cancer. Early diagnosis generally allows for simpler treatment before a lesion becomes a significant health problem. This examination is typically recommended for patients with specific risk factors — a personal or family history of skin cancer, a higher number of moles than average, or physical traits associated with elevated risk.
Common Types of Skin Cancer
| Type | Typical Appearance | Key Points |
|---|---|---|
| Basal Cell Carcinoma (BCC) | Pearly, raised area; often on sun-damaged skin | Most common. Rarely spreads to other organs, but can grow deep into local tissue if left untreated. |
| Squamous Cell Carcinoma (SCC) | Rough, scaly, or crusty patch; may arise from sun spots (actinic keratoses) | Higher risk of spreading than BCC. Early removal is important. |
| Melanoma | New or changing mole; can occur anywhere on the body, including areas never exposed to the sun | Least common but most serious. Can spread quickly. Early detection is critical. |
Detection: Beyond the ABCDE Rule
The ABCDE criteria — Asymmetry, Border, Colour, Diameter greater than 6 mm, and Evolving — are a useful starting point for patient self-monitoring, but they have real limitations. Many early skin cancers do not meet these criteria. To the naked eye, an early melanoma may look completely flat and unremarkable. A professional examination adds three things that self-examination cannot reliably provide:
- Identification of subtle changes not yet obvious to the patient
- Inspection of areas of the body that are difficult or impossible to see yourself
- Use of a dermatoscope — an instrument that illuminates the structures beneath the skin surface, providing far more information than a visual check alone
Between Appointments: What to Watch For
Do not wait for a scheduled examination if you notice a lesion that is new, growing, changing colour or shape, bleeding, or simply not healing. Come in promptly. When it comes to skin cancer, earlier is always better.
Privacy and Consent: Your Choices
You determine exactly what we examine. A consent form will be provided separately, and we will review your preferences together before the examination begins. Two specific areas require your explicit consent:
1. Buttocks and Lower Abdomen
Melanoma can occur on the buttocks, lower back, and lower abdomen — areas that are routinely covered by underwear and easy to overlook. If you prefer to keep your underwear on, we will ask your permission to briefly adjust the fabric to view the skin underneath. Alternatively, you may choose to omit this area entirely.
2. Inner Thigh
Examining the inner thigh requires adjusting the position of your legs. If you prefer, this area will be omitted and we will move directly to the lower legs and feet.
Draping and Chaperone
You will never be completely uncovered. We use a sectional approach — only the specific area currently being examined is exposed. A chaperone is available for every examination; please let us know if you would like one present.
How to Prepare
- Comfortable clothing: Wear loose-fitting clothes that are easy to remove and put back on.
- Clean skin: Please arrive with clean skin so all areas can be seen clearly.
- Questions or concerns: Bring a list of any spots or moles you've noticed changing or any skin concerns you have.
What Happens During the Exam
The examination typically takes 10-15 minutes. We'll examine your skin from head to toe, including areas that don't get sun exposure. We may use a dermatoscope (a magnifying instrument with special lighting) to get a closer look at certain spots. If we find anything concerning, we'll discuss next steps with you immediately.
References
- Vestergaard ME, Macaskill P, Holt PE, Menzies SW. Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting. Br J Dermatol. 2008;159(3):669–676.
- Argenziano G, Puig S, Zalaudek I, et al. Dermoscopy improves accuracy of primary care physicians to triage lesions suggestive of skin cancer. J Clin Oncol. 2006;24(12):1877–1882.
- Watts CG, Dieng M, Morton RL, Mann GJ, Menzies SW, Cust AE. Clinical practice guidelines for identification, screening and follow-up of individuals at high risk of primary cutaneous melanoma: a systematic review. Br J Dermatol. 2015;172(1):33–47.
- Canadian Cancer Society. Skin cancer: What is skin cancer? cancer.ca. Accessed December 2024.
- Skin Cancer Foundation. Early detection and self-exams. skincancer.org. Accessed December 2024.