Routinely examine your whole body for changes in your skin and report concerns to a parent or healthcare provider.
Anyone can develop melanoma. Everyone should periodically perform a complete body check to look for symptoms of the disease. Early detection and treatment of melanoma will usually result in a high cure rate. If you know your own skin – its imperfections, freckles, and moles – you will notice changes.
The recommended frequency of self-exams and exams performed by doctors will depend on your risk of getting the disease. Catherine Poole of the Melanoma International Foundation, and Dr. Dupont Guerry at the University of Pennsylvania recommend monthly self-exams for people with a personal or family history of melanoma or dysplastic nevi, as well as frequent exams (quarterly for people at very high risk) by a dermatologist or other specially trained physician. The Skin Cancer Foundation goes further and recommends that children be taught early to perform self-exams so it’s a habit by the time they are teens.
Men in particular should be encouraged to give themselves body checks, asking someone to help them if needed. A number of studies show that although women are more often diagnosed with melanoma, the fatality rate is higher among men because of late diagnosis resulting from a failure to seek medical care.
In Australia a decline in the number of deaths from melanoma has been directly related to an educational campaign including how to perform a body check.
Here is how you do it.
- Keep a notebook to keep track of numbers of moles, sizes and locations. If possible, take photographs, particularly if you have more than fifty moles or if you have dyspastic nevi.
- Keep copies of the ABCDEs of Melanoma and the Measurement Guide both published by the American Academy of Dermatology, The Skin Cancer Foundation and the National Cancer Institute, and found at the bottom of this newsletter. Compare your moles to the illustrations. Date your notes and be diligent in recording exact numbers of moles and exact sizes.
- Follow these directions to check your whole body. The exam will take about ten minutes.
- Take notes. Start with your face (especially the nose), arms and hands (including fingernails and between fingers). Raise your arms and use a mirro to examine the backs of you upper arms (including underarms).
- Then work from the top down. Using a blow dryer and a comb to make parts through your hair – one row at a time – over the top of your head and down to your ears to check for any lesion covered by hair. Use a hand-held mirror to check the back of your head, or ask someone. Make notes.
- With your back to a full-length mirror, use the hand-held mirror to check your neck (front and back) shoulders, chest and torso. Check the upper back and sides. Women should check the undersides of the breasts. You may want to use a checklist so you don’t forget any area.
- Still using both mirrors, check your lower back, backs or both legs, and buttocks.
- Sit down, prop each leg in turn on a second chair and check the front and sides of both legs (thigh to skin), ankles, the tops of feet, between the toes, and under the toenails. Examine the heels and soles of feet. Use a checklist to be sure you have covered everything.
- Still sitting, again prop each leg in turn on a second chair and use a hand-held mirror to examine the genitals.
Once you complete the entire body check, enter all information in notebook with a date. This is especially important for those at high risk of melanoma, those who are monitoring changes for a doctor, and those who are helping to monitor others.
The ABCDE’s of Melanoma
The ABCDE’s of melanoma were developed so everyone can easily understand what to look for when conducting a self-examination.
A = Asymmetry. Draw an imaginary line down the middle of any mole and ask yourself if the two halves match. Ordinary moles are usually round and symmetrical, while melanomas are often asymmetrical
B = Border. Ordinary moles are round or oval and have well-defined, smooth, even borders. Melanomas often have irregular, uneven, or notched borders.
C = Color. If your mole has several colors – including black, brown, red, white and blue – or an irregular pattern of colors, it may be melanoma
D = Diameter. Watch for change in the size of your moles.
E = Evolving. A mole that changes in size, shape, shades of color, surface or symptoms may be suspicious of melanoma. Further, if it tingles, itches, burns or feels strange, it may be evolving and should be checked.
It is also important to understand your need for vitamin D. As this vitamin is naturally produced by exposure to the sun, diet and supplements will help maintain the levels needed while you use sun protection.