How often should you have a skin check?

If you live around Port Stephens, you probably spend time outdoors without thinking about it. Walking at Fingal Bay, on the water, in the garden, watching junior sport on a Saturday morning. The sun exposure that matters for skin cancer is rarely the dramatic sunburn — it is the accumulation of ordinary days over decades.

That is why skin checks are a routine part of general practice here rather than something exotic. The question patients ask most often is simply how often they should have one.

How often is right for you

There is no universal interval, and anyone who gives you one without asking about your history is guessing. Your GP works it out from a handful of things:

• Your skin type — whether you burn easily and tan rarely.
• Your sun history — blistering sunburns, particularly in childhood, and any use of solariums.
• How many moles you have, and whether any of them are unusual.
• Your family history, especially melanoma in a parent, sibling or child.
• Whether you have had a skin cancer before — the single strongest predictor of having another.
• Outdoor work or hobbies, which is most of us on this coast.
• Medication that suppresses your immune system, which raises risk considerably.

Someone with fair skin, a lot of moles and a previous skin cancer may be checked every six to twelve months. Someone with darker skin, few moles and no family history may need checking far less often. The useful thing is to ask your GP for a specific recommendation for you, and then to keep to it.

What actually happens in a full skin check

People put this off because they imagine it is more of an ordeal than it is. You undress to your underwear, and your GP examines your skin from your scalp to the soles of your feet using a dermatoscope — a magnifier with a polarised light that shows structures beneath the surface of the skin.

It takes around fifteen minutes. Nothing is removed on the spot without discussing it with you first. Anything worth monitoring is photographed and measured, so next year's check has something to compare against rather than relying on anyone's memory.

You can ask for a chaperone at any point, for any examination. You can keep items of clothing on, and you can ask to stop. Tell your GP at the start about any spot you are specifically worried about — your own concern about a particular lesion is genuinely useful clinical information.

What to look for between checks

You will see your own skin far more often than any doctor will. Three things are worth acting on:

• A spot that is new, particularly after the age of 40.
• A spot that is changing — in size, shape, colour, or how it feels.
• A spot that looks different from all your others.

The ABCDE guide is useful for moles: Asymmetry, an irregular Border, more than one Colour, a Diameter over about 6mm, and Evolving — changing in any way.

But not every skin cancer is a mole, and some of the more serious ones do not fit that pattern at all. Also worth booking for: a sore that has not healed after a month, a spot that bleeds or itches persistently, a scaly patch that keeps coming back after it seems to clear, or a firm lump that is growing over weeks.

What happens if something needs treating

Most of what turns up is straightforward. Sunspots — the rough, scaly patches on faces, scalps and forearms — are treated with liquid nitrogen in a few seconds each, or with a cream where there are a lot across one area.

Where a lesion needs to be removed or sampled, several of our GPs perform biopsies and excisions on site under local anaesthetic, so it often happens here rather than somewhere else on another day. Everything removed goes to pathology, and we contact you with the result either way — not only when something is found.

The thing most worth remembering

Do not wait for a scheduled annual check if you have noticed something. A short appointment for one spot takes minutes, and it is exactly the right thing to book. Most of the time it turns out to be nothing, and finding that out is a good use of an appointment rather than a waste of one.