Harvard Health Letter

By the way, doctor: What should an exam for skin cancer include?

Q. Since having a basal cell carcinoma removed from my forehead in 1992, I've gotten a full-body examination by a dermatologist every six months. In addition to the basal cell carcinoma, I've had several melanocytic nevi removed from my back, neck, and hairline.

I recently went to a new dermatologist. My previous exams had taken about half an hour. The doctor checked my entire body under bright lights, including looks between my toes and a careful inspection of my scalp, and a nurse noted mole measurements in my medical chart. My new dermatologist just took a quick look at my back, arms, and legs — he said there's no need to examine areas that wouldn't have been sunburned in the past — and no bright lights were used. I wonder what the standard is for a full-body exam.

A. There are three main types of skin cancer: basal cell, squamous cell, and melanoma. Basal cell is the least serious of these because it's the least likely to spread, or metastasize. There's no question that exposure to sunlight, particularly the ultraviolet (UV) portion of the light spectrum, is a risk factor for basal and squamous cell skin cancers. Both types occur on the head, the face, and other areas of the body that get lots of sun exposure.

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