--- May is Melanoma Awareness Month: Prioritize a Skin Exam with Your Dermatologist ---
You eat well, get lots of exercise and try to obtain at least eight hours of sleep a night — you’re doing everything right to maintain a healthy lifestyle. But when was the last time you had a skin exam?
The skin is the largest organ in the body and plays an extremely important role in our overall health and well-being. It serves as a barrier that protects the body from external stimuli, trauma and dangerous substances, it helps regulate the body’s temperature and is integral in balancing the body’s water. The skin is a warrior fighting on the outside to protect our insides — and it can also provide helpful clues about other issues the body may be experiencing, like stress or inflammation. For all these reasons, it is very important to take care of your skin — and not just the skin on your face! Regularly looking at the health of your skin and proactively monitoring for changes or abnormalities is a smart way to help ensure you’re identifying anything suspicious that may indicate a larger health concern.
One of the most serious skin conditions that is often overlooked is melanoma. Melanoma is a type of skin cancer that starts in melanocytes, the cells that produce melanin. Melanin is the pigment that gives skin its color. Melanoma can occur anywhere on the skin surface from the scalp to the soles of the feet. It occurs in areas that are easily seen on self-examination but can also occur in areas that are impossible to see without the help of a partner.
Melanoma, when identified early, has a 99 percent survival rate. This number drops to 27[KG1] percent if it spreads to other parts of the body.1 It is considered the deadliest form of skin cancer, and unfortunately, numbers are increasing worldwide.
While the exact cause of melanoma is still unknown, several risk factors have been identified — notably, exposure to UV rays, either via sunlight or tanning beds. Other risk factors may include family history, genetics and skin type.2Although people with any skin color can develop melanoma, individuals with lighter skin tones, red hair or those who’ve had several severe sunburns in their lifetime may be at increased risk. Additionally, people who have a large number of moles on their body and/or those who have a family history of skin cancer may also be more likely to develop melanoma.
Most of us wear sunscreen on our face, neck and arms when we know we’ll be in the sun for extended periods of time. But I’ve found melanoma in areas that have never seen the sun (think: below the belt), and these are often places overlooked by most people. While some of these “hiding places” are common for melanoma, these are often areas of the body that can be very difficult to catch during a self-exam. When I was in medical school, my institution embarked on an educational campaign to inform beauty school students about skin cancer and what to look for. Often, melanomas or other skin cancers hide on your scalp or behind your ears — areas most people don’t think to apply sunscreen to or to check for abnormal spots or moles.
If you’ve identified an area of the skin that looks suspicious, your doctor may recommend a surgical biopsy. This is the standard method for detecting melanoma and involves the removal of part of the lesion for testing. Unfortunately, biopsies require local anesthesia, which means an injection. Many people find these injections uncomfortable, and the biopsy itself may sometimes lead to a wound and, potentially, a permanent scar. In a study from 2018, over 90% percent of biopsies to diagnose melanoma actually tested negative for melanoma! While it’s smart to be thorough, that’s a lot of cutting.
Fortunately, there’s an innovative, non-invasive tool for detecting melanoma that is currently available by a California-based company — DermTech. The DermTech test uses a clear sticker to collect skin tissue samples. This “Smart Sticker™” painlessly and non-invasively removes the most superficial layers of skin to obtain genomic material. This genomic material is tested by DermTech to look for biomarkers correlated with melanoma, which help your doctor diagnose your lesion. The Smart Sticker is able to pull cells from the whole lesion by painlessly lifting away the outermost layer of cells from the surface. For context, a biopsy, which takes a small portion of the lesion, typically evaluates approximately 1-2 percent of a lesion.
The DermTech test helps to determine which skin lesions have the biomarkers correlated with a pathologic diagnosis of melanoma. If the test is negative, a biopsy isn’t required, but you and your doctor should continue to monitor for any changes. If the test is positive, your doctor will perform a biopsy to establish the diagnosis.
The DermTech test is a new, effective option for detecting genomic markers to help clinicians assess melanoma with genomic precision — but maintaining healthy skin starts with you. You can’t test an abnormal lesion on your body if you don’t know it’s there! I typically recommend an annual skin exam for most people. If an individual has undergone previous biopsies, has a family history of melanoma, or has other risk factors associated with skin cancer, a doctor may recommend more frequent visits.
Melanoma can have devastating consequences if not caught early. This Melanoma Awareness Month, make it a priority to see a doctor, encourage your friends and family to stay current on their skin exams, protect your skin from the sun by wearing sunscreen and other protective gear when outdoors, and avoid direct sunlight during midday hours.
This article was composed in partnership with DermTech.
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 Skin Cancer Foundation. “Skin Cancer Facts and Statistics.” 2021, https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/.
 American Skin Association. “Melanoma.” 2020, https://www.americanskin.org/resource/melanoma.php.
 Mayo Clinic. Melanoma: https://www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884.
 Lott JP et al. Population-Based Analysis of Histologically Confirmed Melanocytic Proliferations Using Natural Language Processing. JAMA Dermatol. 2018 Jan 1;154(1):24-29.
 Dermatology Online Journal. https://s7xkb1ayo481q3m2c10fqdqr-wpengine.netdna-ssl.com/wp-content/uploads/DOJ201912moFerris.pdf.
[KG1] Change “25” to “27” per reference listed: Bullet 8 listed under “Melanoma” section.