The Skin Check Most People Skip After Summer
Summer is when the skin takes in most of its ultraviolet exposure for the year, and autumn is when it is easiest to look at it properly. The tan has faded, new marks stand out against it, and the long sleeves of winter are about to cover most of the body for months. It is a sensible moment for a full skin check, and one that most people let pass.
Summer is when your skin takes in most of its sun for the year, and autumn is when it is easiest to look at it properly. The tan has faded, new marks show up against it, and the long sleeves of winter are about to cover most of your body for months. It is a sensible moment for a full skin check, and one that most people let pass.
Skin checks: the essentials
The short version
A fading tan makes new marks easier to see, and winter clothing is about to cover most of the body
A fading tan makes new marks easier to see, and winter clothes are about to cover most of your body.
Basal cell carcinoma and squamous cell carcinoma are the most common; melanoma is less common but spreads more readily if missed
Basal cell and squamous cell cancers are the most common. Melanoma is less common but more likely to spread if it is missed.
A new spot, a change in an old one, a spot unlike the rest, or a sore that does not heal
A new spot, a change in an old one, a spot that looks different from the rest, or a sore that does not heal.
Asymmetry, irregular border, varied colour, larger diameter, and evolution or change over time
Uneven shape, ragged edge, more than one colour, a larger size, and any change over time.
Anyone, of any skin tone; darker skin is not protected, and melanoma can arise on palms, soles and nails
Anyone, of any skin tone. Darker skin is not protected, and melanoma can start on the palms, soles and nails.
A full-body examination with magnification, and a biopsy of anything suspicious for a definite answer
A head-to-toe examination with a magnifying scope, and a small sample of anything suspicious to give a definite answer.
Why autumn is a good moment
Why autumn is a good moment
Ultraviolet damage accumulates over a lifetime, and summer adds the largest instalment. The consequences are not visible at once, which is the subject of Why Your Skin Has a Memory for Sunlight, but some are: a new freckle-like spot, a rough patch that does not go away, a mole that looks different from how it did in spring. A tan can hide all of these, and autumn is when the tan lifts and they become readable.
Sun damage builds up over a lifetime, and summer adds the biggest portion. You cannot see most of it straight away, which is the subject of Why Your Skin Has a Memory for Sunlight, but some of it does show: a new freckle-like spot, a rough patch that does not go away, a mole that looks different from how it did in spring. A tan can hide all of these, and autumn is when the tan lifts and they become easy to read.
There is also a practical reason. For the next several months most people wear sleeves, trousers and socks, and the parts of the body that are rarely examined, the back, the scalp, the backs of the legs and the soles of the feet, stay out of sight and out of mind. A check now means the skin has been looked at before it is covered for the winter, rather than discovered in the following summer.
There is a practical reason too. For the next several months most people wear sleeves, trousers and socks, and the parts of the body that are seldom examined, the back, the scalp, the backs of the legs and the soles of the feet, stay out of sight and out of mind. A check now means your skin has been looked at before it is covered for winter, instead of being discovered next summer.
How to check your own skin
How to check your own skin
A good self-check takes about ten minutes in good light, once a month, and covers everything: the scalp, behind the ears, the face and neck, the chest and abdomen, the back with the help of a mirror or another person, the arms and hands including between the fingers and under the nails, the legs, the soles of the feet and between the toes. Taking a photograph of anything of interest, with a coin beside it for scale, makes later change easy to judge.
A good self-check takes about ten minutes in good light, once a month, and covers everything: your scalp, behind the ears, face and neck, chest and tummy, your back with the help of a mirror or another person, arms and hands including between the fingers and under the nails, legs, the soles of your feet and between the toes. Taking a photo of anything that catches your eye, with a coin beside it for scale, makes it easy to tell later whether it has changed.
| Type | May look like | Behaviour |
|---|---|---|
| Basal cell carcinoma | A shiny or pearly bump, a scaly patch, a scar-like area, or a sore that heals and returns | Usually grows slowly and rarely spreads, but can grow deeply and damage nearby tissue |
| Squamous cell carcinoma | A rough or scaly patch, a firm dome-shaped or wart-like growth, or a sore that does not heal | Can grow deeply and sometimes spread, particularly in higher-risk tumours or when immunity is reduced |
| Melanoma | Often a changing or unusual pigmented spot, but sometimes pink or red with little colour | Less common, but more likely to spread if it is not found early |
| Type | What it may look like | How it behaves |
|---|---|---|
| Basal cell carcinoma | A shiny or pearly bump, a scaly patch, a scar-like area, or a sore that heals and comes back | Usually grows slowly and rarely spreads, but can grow deep and damage nearby skin |
| Squamous cell carcinoma | A rough or scaly patch, a firm dome-shaped or wart-like lump, or a sore that does not heal | Can grow deep and sometimes spread, especially in higher-risk cases or when the immune system is weakened |
| Melanoma | Often a changing or unusual dark spot, but sometimes pink or red with very little colour | Less common, but more likely to spread if it is not found early |
Two ideas help in knowing what matters. The first is the ABCDE rule: asymmetry, an irregular border, more than one colour, a diameter larger than a pencil eraser, and evolution, meaning change in size, shape, colour or symptoms over time. Evolution is the most useful of the five, because a spot that is changing deserves attention whatever else it looks like.
Two ideas help you know what matters. The first is the ABCDE rule: an uneven shape, a ragged edge, more than one colour, a size larger than a pencil eraser, and evolution, meaning any change in size, shape, colour or how it feels over time. Evolution is the most useful of the five, because a spot that is changing deserves attention whatever else it looks like.
The second is the ugly duckling sign. Most of a person’s moles resemble one another, and the one that does not, whether darker, lighter, larger or simply different in character, is the one to have examined. It is a comparison with your own skin, which is more reliable than comparison with a picture.
The second is the ugly duckling sign. Most of a person’s moles look like each other, and the one that does not, whether darker, lighter, bigger or just different in character, is the one to have looked at. It is a comparison with your own skin, which is more reliable than comparing with a picture.
What a professional skin check involves
What a doctor's skin check involves
A dermatologist’s examination covers the whole skin surface, usually using a dermatoscope, a handheld instrument that magnifies the skin and uses polarised light to show structures below the surface that the eye cannot see. It also includes your history: previous sunburns, previous skin cancers, family history, the number of moles, and any medicines that affect immunity. The aim is to separate the large majority of spots that are harmless from the few that are not.
A dermatologist’s check covers the whole surface of your skin, usually with a dermatoscope, a handheld scope that magnifies the skin and uses special light to show what lies below the surface, which the eye cannot see. It also covers your history: past sunburns, past skin cancers, family history, how many moles you have, and any medicines that affect your immunity. The aim is to separate the large majority of spots that are harmless from the few that are not.
When a spot is suspicious, the next step is a biopsy: all or part of it is removed under local anaesthetic and examined under a microscope by a pathologist. The result identifies the type and the features that guide treatment, and it replaces guesswork with an answer. Many early skin cancers are straightforward to treat when found early. In this practice Dr. Gallacher, a board certified dermatologist, examines the skin, and lesions that need removal can be dealt with by excision.
When a spot looks suspicious, the next step is a biopsy: all or part of it is removed under a local anaesthetic and looked at under a microscope by a pathologist. The result tells you what it is and guides treatment, and it replaces guesswork with an answer. Many early skin cancers are straightforward to treat when they are found early. At this practice Dr. Gallacher, a board certified dermatologist, examines your skin, and spots that need to come out can be dealt with by minor surgery.
Who should be checked, and how often
Who should be checked, and how often
Anyone can develop skin cancer, but risk is not equal. It rises with a history of sunburns, chronic or indoor tanning exposure, a previous skin cancer, a large number of moles, a family history of melanoma, and reduced immunity. Darker skin tones are not protected, and in them melanoma more often occurs on the palms, soles and nails, which are the places least likely to be checked.
Anyone can develop skin cancer, but the risk is not the same for everybody. It rises with a history of sunburns, years of sun or sunbed use, a previous skin cancer, lots of moles, a family history of melanoma, and a weakened immune system. Darker skin tones are not protected, and in them melanoma more often starts on the palms, soles and nails, which are the places least likely to get checked.
How often a professional check is advisable is an individual decision, made after the first examination, and it can range from once a year to more often for higher-risk skin. The rule that holds for everyone is that a new or changing spot does not wait for the annual appointment.
How often you should have a doctor’s check is an individual decision, made after the first examination, and it can range from once a year to more often for higher-risk skin. The rule that holds for everyone is that a new or changing spot does not wait for the yearly appointment.
Why a photograph or an app is not a substitute
Why a photo or an app is not a substitute
Apps that claim to assess a mole from a photograph are widely available, and the evidence for them is much weaker than the marketing, as examined in Can a Photograph Diagnose Skin Cancer?. A phone image cannot show what dermoscopy shows, cannot account for your history, and cannot be followed by a biopsy. Used to track change in your own spots over time, a photograph is useful. Used to decide that a spot is fine, it can give false reassurance.
Apps that say they can judge a mole from a photograph are easy to find, and the evidence for them is much weaker than the advertising, as explained in Can a Photograph Diagnose Skin Cancer?. A phone picture cannot show what a dermatoscope shows, cannot take your history into account, and cannot be followed by a biopsy. Used to keep track of changes in your own spots over time, a photo is useful. Used to decide that a spot is fine, it can give false reassurance.
Questions patients ask
Are moles dangerous?
Are moles dangerous?
Most moles are harmless. Having many moles raises the overall risk of melanoma, and a new mole appearing in adulthood or an existing mole changing is what deserves attention. A mole that looks the same year after year is generally reassuring.
Most moles are harmless. Having lots of moles raises your overall risk of melanoma, and a new mole appearing in adult life, or an old one changing, is what deserves attention. A mole that looks the same year after year is generally reassuring.
Can skin cancer occur in darker skin?
Can skin cancer happen in darker skin?
Yes. Risk is lower in skin with more natural pigment, but it is not absent, and melanoma in darker skin is more likely to arise on the palms, soles and nails and to be found later. Skin checks and attention to new or changing marks matter for every skin tone.
Yes. The risk is lower in skin with more natural colour, but it is not zero, and melanoma in darker skin is more likely to start on the palms, soles and nails and to be found later. Skin checks, and attention to new or changing marks, matter for every skin tone.
Does a skin check hurt?
Does a skin check hurt?
No. The examination is visual, using good light and a handheld magnifier, and it is painless. If a biopsy is needed, the area is numbed first, so the experience is a small injection followed by a brief procedure.
No. The check is done by eye, with good light and a handheld magnifier, and it does not hurt. If a biopsy is needed, the area is numbed first, so what you feel is a small injection and then a short procedure.
What happens if a spot needs a biopsy?
What happens if a spot needs a biopsy?
Part or all of the spot is removed after numbing, and it is sent to a pathologist who examines it under a microscope. The result identifies the type of lesion and guides any further treatment. A biopsy is how a suspicion becomes a definite answer, and most results are reassuring.
Part or all of the spot is taken away after numbing, and it is sent to a pathologist, who looks at it under a microscope. The result tells you what it is and guides any further treatment. A biopsy is how a worry becomes a definite answer, and most results are reassuring.
What should I do if I find a spot that worries me?
What should I do if I find a spot that worries me?
Photograph it with a coin for scale, do not pick or scratch it, and book an examination rather than waiting to see what happens. Most spots turn out to be harmless, and the ones that are not do better when they are seen early.
Take a photo of it with a coin beside it for scale, do not pick or scratch it, and book an examination instead of waiting to see what happens. Most spots turn out to be harmless, and the ones that are not do better when they are seen early.
Where to go next
Talk it through with a physician first.
Every plan starts with an assessment of your skin, your anatomy and what you actually want to change.
This page is general health information, not medical advice. It cannot tell you whether a treatment is right for you. Approved uses, risks and results differ from person to person, and product labelling changes. Ask us at Dermatology and Laser Centre about your own situation, or make an appointment, and seek urgent care for any serious symptom.
