How to Detect Skin Cancer, Even During COVID-19

It is important to protect yourself from the sun’s UV rays to lessen your risk of skin cancer and melanoma. It is also crucial to regularly check your skin for anything out of the ordinary and to alert your doctors to any changes, even during the COVID-19 pandemic.

How do I know if I should be concerned about skin cancer?

If you have many moles (more than 50), atypical moles, or a family history of melanoma, you should have an annual evaluation by a dermatologist. Other risk factors include:

• A family history of other types of skin cancer (basal cell carcinoma, squamous cell carcinoma)
• A personal history of excessive sun exposure with frequent sun burns
• Tanning bed usage
• Having fair skin that burns easily
• A tendency to freckle
• Being a Caucasian men over the age of 65 (this is a population of people who frequently have advanced melanomas at the time of diagnosis)

Primary care physicians don’t necessarily do skin exams as part of a routine physical, so individuals who are concerned about melanoma or other skin cancers should ask one’s primary care physicians to perform an examination, or be referred to a dermatologist.

How do I perform a self-exam for skin cancer?

Experts recommend monthly self-exams starting at age 18. These are particularly important during the COVID-19 pandemic, as many people have deferred or cancelled their non-urgent physician appointments. To conduct a self-exam, follow the ABCDEs (asymmetry, border, color, diameter, evolution) to determine if a mark on your body could be something more serious. If any spots seem unusual, consult your doctor as soon as possible.

The acronym ABCDE is a reference for the warning signs of skin cancer and melanoma and is recommended by the American Academy of Dermatology (AAD):

• A – Asymmetry, or when one half of the mark appears different than the other.
• B – Border, when the mark has an irregular, scalloped, or poorly defined border.
• C – Color, if the mark is varied from one area to the other. It might have shades of tan, brown, black, or be white, red, or blue.
• D – Diameter. Melanomas are usually bigger than 6mm, or the size of a pencil eraser. In some cases, they can appear smaller.
• E – Evolving, when a mole or mark looks different than others on your body, or different than it used to.

“Routine self-exams, especially while referring to a photo of what melanoma should look like, lead to thinner tumors and better prognosis,” says Jennifer Y. Lin, MD, a Dana-Farber dermatologist.

“Change is one of the most important things we want to hear about,” emphasizes Lin. “Get to know your skin. Check your skin routinely on a monthly basis – it is a cheap and effective safety measure you can do for yourself and your family.”

Importantly, if you have darker skin, you should pay attention to your hands and feet, although your risk of melanoma is much lower. Changing pigmentation in the nail, as well as a non-healing lesion in the hand and feet, are reasons to seek medical attention.

Should I still see my doctor or dermatologist during the COVID-19 pandemic?

Procedures may vary individually from doctor to dermatologist during this time, so communication with your various healthcare teams will be key. Together, you can come up with a plan that is medically appropriate for you. Remember that even during the COVID-19 pandemic, it is important to alert your doctor to any changes you notice in your skin. This is one of the best ways to detect skin cancer early.

If you are a Dana-Farber patient, please note that we continue to care for all of our patients throughout the pandemic. We are accepting new patients and providing second opinion consultations. We are also taking many precautions to ensure your health and safety when you come in for your appointment. If you have any questions, please contact your care team directly.