I am a dermatologist in the Emory Clinic and my focus is medical dermatology with a monthly melanoma clinic. I see patients of all skin types but a large part of my practice is seeing patients for total body skin exams (TBSE). We recommend that patients with all skin types get a total body skin exam, but patients who have a family history of melanoma, atypical mole syndrome or non-melanoma skin cancer should be particularly proactive about scheduling their skin checks. As a broad rule, once a year skin checks should suffice. These checks become more frequent in patients who have a personal history of melanoma or non-melanoma skin cancer.
A skin exam entails wearing a gown at the dermatologist’s office and getting all parts of your skin looked at for moles that may appear abnormal or growths that may be non-melanoma skin cancers such as basal cell skin cancer or squamous cell skin cancer. If we see anything suspicious, the spot is biopsied, which involves removing a small sample of skin tissue. It takes five minutes or less to perform a biopsy and the results are usually available in a few days.
During this visit, we educate patients to be good about self-examination. I recommend that patients pick the first of every month and put it on their calendar to examine their skin head to toe. They should look for any changing moles or any new bumps that may have come up. It can be difficult to know what to worry about or not, but in general a melanoma can show up as a new mole or a changing or bleeding mole. A basal or squamous cell generally presents as a new bump or flat lesion that can bleed, or hurt, or just be new and growing. If you are worried about something, you should make an appointment to be checked by your dermatologist right away.
Sun protection is a big part of preventing skin cancers. The AAD (American Academy of Dermatology) recommends everyone use sunscreen that is broad spectrum (protects against UVA and UVB), has a sun-protection factor (SPF) of 30 or greater and is water resistant. And you need to apply an adequate amount of sunscreen for it to be effective: generally one ounce (enough to fill a shot glass) for the exposed parts of your body for each application. This needs to be repeated every 2 hours on continued sun exposure. Remember to apply sunscreen at least 15 minutes before going outdoors.
You can use any type of sunscreen that works for you, such as lotions, creams, gels, sticks or even sprays. Sprays, though, have the disadvantage of accidental inhalation and it’s sometimes hard to know when using a spray if you have applied an adequate amount.
Tanning bed use has been proven to increase the risk of melanoma and also accelerate photo-aging. It should be avoided at all cost. Sunbathing and a history of blistering sunburns also increase your risk of skin cancer. It is very important to avoid the sun between 10 am and 2 pm, when the rays are the strongest, and to use additional protective clothing such as long sleeved shirt, pants, a wide-brimmed hat and sunglasses.
As you get ready for fun summer weekends, here’s a checklist to help you prevent skin cancer: avoid the sun when it’s at its strongest, use sunscreen and protective clothing any time you are out in the sun, never use a tanning bed, and when in doubt, check it out! Schedule an appointment with a dermatologist along with your annual physical visit, and for accurate information about safe sun practices, check the AAD website.
About Dr. Bhandarkar
Sulochana Bhandarkar, MD, is an assistant professor of dermatology at the Emory School of Medicine. She completed her medical school education from her home country, India, at Kasturba Medical College in Mangalore, where she also did a three-year dermatology residency with a special interest in vitiligo, a condition affecting skin pigmentation. After moving to the U.S., she did a clinical research fellowship at the University of California San Francisco, as well as a melanoma research fellowship at Emory University. She did her residency in dermatology at Emory University and became a faculty member at Emory in 2011. Her clinical interests are vitiligo and melanoma.