Skin Exams

Many of my friends outside of work and people that I talk with are always asking me when they should get a skin exam and what to expect when they come to the clinic.  This is not a question I can answer simply without a little history from the person asking.  The American Academy of Dermatology (AAD) recommends that all people over the age of 40 get an annual skin exam.  At the age of 40, most people have gotten enough sun exposure over the course of their life that their risk of developing a skin cancer or pre-cancer is increased.  However, the over 40 recommendation is not a hard and fast rule.  I have diagnosed skin cancers in patients as young as 22.



So what are some of the exceptions to the over 40 rule and how often should you be checked?  When do you need to be seen earlier?

1) A personal history of melanoma.  If you have been diagnosed with a melanoma, you should have a full body skin exam including having lymph nodes checked at least once a year.  In our clinic, patients diagnosed with a melanoma are seen every 3-4 months for two years, every 4-6 months for the third year, and then annually after that if no new cancer diagnoses have been made.

2) A family history of melanoma.  If you have a first degree family relative (mother, father, brother, sister, child) with a history of melanoma you should have a full body skin exam annually.

3) Transplant patients.  Many transplant patients are at higher risk of developing skin cancer because of the medications they must take to prevent their bodies from rejecting their new organ.  They should at least be seen annually starting as soon as they have their transplant.

4) Patients with genetic conditions that predispose them to developing skin cancers.  Patients with dysplastic nevus syndrome, basal cell nevus syndrome, and xeroderma pigmentosa among others should all be seen regularly.

5) Fair complexion, significant sun exposure, history of tanning bed use, red hair.  All of these increase the risk of developing skin cancer and would likely benefit from skin exams before that age of 40.


There are obviously many reasons to come in for a skin exam before the age of 40.  I recommend that most patients come in at the age of 18 for a baseline skin exam unless you fit one of the previous criteria.  Your dermatology provider will then decide after your baseline how often to come in.

When you come in for a skin exam, your provider will look at as much or as little skin as you feel comfortable.  Personally, it would be ideal to have patients remove all clothing and only wear a gown so that I can thoroughly evaluate their skin and give them the best possible exam.  However, I understand that some patients are uncomfortable with this and prefer a more limited exam.  After one of my patients is roomed for their skin exam, our nurses will take their history and have them change into a gown.  When I do a skin exam I have a systematic top down approach so that I do not miss any areas.  I start on the scalp and end with the bottoms of the feet.  I also pay special attention to any specific areas the patient has of concern.  After completing the exam, I discuss findings and treatment options if indicated.

Skin exams are a quick and easy way to help keep your skin in top shape and to help find skin cancers at their earliest stages.  As always, If you have a question about your skin or would like to schedule a skin exam with one of our excellent dermatology providers please give us a call.

Bentonville:  701 NW McNelly Rd., Bentonville, AR 72712 (479-268-3555)

Fayetteville:  1444 E Stearns St., Fayetteville, AR 72703 (479-718-7546)

Harrison:  620 N Main, Harrison, AR 72601 (870-204-5279)

Ryan Crowder, MPAS, PA-C

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