Australia has among the highest rates of skin cancer in the world, and the Central Coast has the lifestyle to match — beaches, boats, and a lot of hours outdoors. Most skin cancers found early are straightforward to treat. The difficulty is that people wait.
Who should have a skin check, and how often
There is no national skin cancer screening program in Australia, which surprises people. The reason is that whole-population screening has not been shown to do more good than harm. What is recommended is that people at higher risk have their skin checked regularly, and that everyone gets a new or changing spot looked at promptly.
You are at higher risk if you have fair skin that burns easily, a lot of moles, a history of sunburn or solarium use, a personal or family history of melanoma or other skin cancer, years of outdoor work or recreation, or you take medicines that suppress your immune system.
How often is a conversation rather than a formula. Your GP will suggest an interval based on your skin, your history and what is found on the day. For many higher-risk people that ends up being annual. For someone with a strong melanoma history it may be more often, and often alongside a specialist. See skin cancer checks.
What happens on the day
A skin check is more straightforward than most people expect. There is no preparation, nothing to fast for, and no needles unless something needs a biopsy.
- Come without makeup and with nail polish off if you can — skin cancers do turn up under nails.
- You will undress to your underwear and be given a gown or sheet. Tell us if you would prefer a chaperone present.
- Your GP examines your skin systematically, head to toe, including your scalp, behind your ears, between your toes and the soles of your feet.
- A dermatoscope is used on anything of interest — a magnifying device with a light that shows structures under the surface a naked eye cannot see.
- Point out anything that worries you. The spot you noticed is often the reason you booked, and you know your skin better than anyone.
Most of the time the answer at the end is reassurance and an interval for the next check. Sometimes it is a photograph and a review in three months to see whether something is changing. Occasionally it is a biopsy.
What we are looking for
The single most useful signal is change. A spot that is new, or that has changed in size, shape, colour or feel over weeks to months, is worth showing someone. That matters more than whether it looks textbook.
Worth an appointment
- A new spot that appears after about the age of 40.
- A mole that changes shape, size or colour, or develops an uneven edge.
- A spot with more than one colour in it.
- Anything that itches, bleeds, stings or will not heal.
- A sore or scab that keeps coming back in the same place.
- A spot that simply looks different from all your others.
You do not need to be certain before you book. Deciding whether something matters is our job, not yours. Booking an appointment about a spot that turns out to be nothing is a good outcome, not a waste of anyone’s time.
If something needs removing
Where a spot needs a closer look, the usual next step is a biopsy — local anaesthetic, a small sample or the whole lesion removed, and the tissue sent to pathology. It is done in the treatment room, usually at a follow-up appointment rather than on the spot.
Results usually take several days. We aim to contact you to discuss them — if you have not heard, please call us. If further treatment is needed we will explain the options and arrange it, including referral where a specialist is the right person. See biopsies and minor procedures.
Some sun-damaged spots that are not cancer — solar keratoses in particular — can be treated in the clinic with liquid nitrogen, which takes seconds. See cryotherapy.
Sun protection that actually gets used
The best sun protection is the sort you will keep doing. On the Central Coast that means planning around the middle of the day rather than trying to out-sunscreen it.
- Check the UV level rather than the temperature — UV damage happens on cool, overcast days too.
- Sunscreen is one layer of five. Shade, a shirt, a hat and sunglasses do more work than sunscreen alone.
- Reapply every two hours, and after swimming or heavy sweating. Most people apply far less than the tested amount.
- Cars, narrow-brimmed hats and cloudy days all give less protection than people assume.
- Get to know your own skin. A monthly look in the mirror finds changes earlier than an annual appointment can.
This article is general information for people in the Gosford and Central Coast area. It is not advice about your situation and it does not replace a consultation with your own doctor. If you are worried about a symptom, book an appointment or call us on (02) 4311 3800. In an emergency, call 000.
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