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  • Q&A with Australian Health Practitioners

    How often should I have a skin exam?

    Related Topics
    Cancer Skin Cancer
    I live by the beach and usually swim/sunbathe at least twice a week. I always apply sunscreen, but I have very fair skin with many freckles. How often should I go to my doctor for a skin exam?
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    Dr Jillian Tomlinson

    Hand Surgeon, Plastic Surgeon

    Dr Jill Tomlinson is a fully qualified plastic, reconstructive and hand surgeon. After graduating dux in her year at University High School, Jill completed medical … View Profile

    Great question!
    I recommend that Australian adults who are 40 years or older have an annual skin check. In between these checks it is wise to keep an eye on your own skin. A partner or friend can help you check your back and other areas that are hard for you to check yourself (such as behind your ears). If you notice any new or changing skin lesions it is wise to seek advice from a qualified healthcare professional.
    As you have very fair skin and freckles you are at relatively high risk of skin cancer. It's great that you swim regularly and apply sunscreen - these are both sensible health choices. I would also recommend that you avoid sunbathing and that you use additional sun protection methods to protect your skin - such as wearing a hat and sun smart clothing when you're out at the beach.
    Protecting your skin from the sun will not only protect you from skin cancer, it will also significantly reduce the signs of ageing that result from sun exposure - both are good reasons to Slip, Slop and Slap.
    Good luck! JT

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    Prof Rodney Sinclair

    Dermatologist

    Professor Sinclair is a Professor of Dermatology at the University of Melbourne and Director of Sinclair Dermatology. He is past-president of the Australasian Society for … View Profile

    There is no one answer for everybody. It will depend on your skin type, family history of skin cancer and a number of other considerations.

    I have prepared a table that takes some of these factors into account. please go to:


    http://www.racgp.org.au/afp/2012/july/skin-checks/

    This link may also be of interest, but please note Victoria's Skin Cancer Triage Clinic relocated tothe Epworth Hospital in 2012.

    http://www.theage.com.au/news/national/faster-skin-checks-set-to-save-lives/2008/02/19/1203190822632.html

    Rod Sinclair
    Professor of Dermatology
    Epworth Hospital

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  • Dr John Mahony

    Cosmetic Physician

    Dr John Mahony studied Medicine at Sydney University 1980-1984 graduating early 1985. Internship and residency years followed in the Illawarra, covering general medical and surgical … View Profile

    It certainly seems a very sensible idea to regularly attend a doctor for a “skin check” to allay one's fears regarding skin cancer. How can it not be a good idea?

    Well, the Cancer Council of Australia, the Australasian College of Dermatologists, and the Royal Australian College of General Practitioners all do *not* recommend to the general Australian population that they go off to a doctor once a year for a skin check.

    http://www.cancer.org.au/content/pdf/CancerControlPolicy/PositionStatements/PS-Screening_early_detection_skin%20cancer_August_2007.pdf

    http://www.racgp.org.au/your-practice/guidelines/redbook/early-detection-of-cancers/skin-cancer/

    Why would these august bodies *not* advise skin checks?

    One reason might be that in Australia a melanoma has been present for an average of only 4 months at the time it is detected. Obviously, annual skin checks will miss a lot of these and not, by themselves, improve this average.

    Only about a quarter of melanomas are first detected by doctors: the rest are first noted by the patient on self-examination, or by friends and relatives.

    But, over all, published recommendations from certain professional bodies may not be made on a utilitarian “greatest good for greatest number” basis, nor on a “precautionary principle” basis, nor on a “balance of probabilities” basis, but on a “not until and unless it's beyond reasonable doubt” basis. That is, some authorities won't recommend a preventative strategy until and unless the accumulated medical evidence favouring the strategy is utterly overwhelming. Think smoking, for example. 

    So, what way forward?

    Well, personally I think annual skin checks are a good idea. I have one.

    But, *more* important than the actual check, is the opportunity it presents to be educated and reminded about skin cancer detection.

    As Anzac Day approaches, we are reminded of the tradition of Anzac mates in the trenches watching each other's backs. And in the current war against skin cancer Aussies of today could do a lot worse than revive the tradition of watching each other's backs. And legs. And arms.

    Doing that every month, or every season change is a good idea

    Season change Skin check Season change Skin check.

    That's how often (to answer the original question)

    Cheers

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