American Melanoma Institute · 5 min read
How to prepare for a full-body skin exam, what the dermatologist checks, how privacy is handled, and what happens if a spot needs a biopsy.
A full-body skin exam is a visual check of your skin from scalp to soles. The exam involves no blood tests, scans, or special preparation beyond a few practical steps. Knowing the routine ahead of time makes the visit quicker and more useful.
Look over your own skin a few days before the appointment. You see your skin every day, and you are the person most likely to know that a spot is new, has changed, or itches or bleeds. Write those spots down. Some people circle them lightly with a pen so none gets forgotten.
Photos help. If you have a picture of a mole from a year ago, or have been tracking a spot with your phone, bring it. Change over time is one of the most useful clues a dermatologist has, and a photo shows it far better than memory.
Bring the dates of any past skin cancers or biopsies and whatever you know about skin cancer in your family.
A staff member will ask you to undress and put on a gown. Most people keep their underwear on, and the American Cancer Society notes that the doctor typically uncovers 1 area at a time. The dermatologist then works in a set order, usually starting at the scalp and face and moving down, front and then back.
The check includes places people don't think to look or can't see on their own:
For any spot that needs a closer look, the dermatologist uses a dermatoscope. This handheld device combines a magnifying lens with a bright, polarized light, and it lets the doctor see color and structure beneath the skin surface that are invisible to the naked eye. The tool may touch your skin, and it causes no pain.
Dermoscopy picks up melanomas that look ordinary to the eye, and it confirms that many odd-looking spots are harmless, which spares you a biopsy. Some dermatologists photograph moles, a practice called mole mapping, so future visits can compare against a baseline.
The exam itself is short. The American Cancer Society says a thorough check by an experienced dermatologist can take less than 5 minutes, and the Skin Cancer Foundation puts it at about 10 minutes for someone with no history of atypical moles or skin cancer. People with many moles, a lot of sun damage, or prior skin cancers should expect longer.
You are in charge of what gets examined. Skin cancers can occur on the genitals, the buttocks, and the breasts, so dermatologists usually offer to check those areas, and they ask first. You can decline, or you can mention a specific spot there that you'd like checked.
You may ask for a chaperone, a staff member who stays in the room during the exam. The American Medical Association's ethics guidance states that patients are entitled to request a chaperone and that practices should honor the request. A family member or friend can also come in with you.
Most exams end with no procedure at all. When a spot looks suspicious, the dermatologist will recommend a biopsy, which is often done during the same visit and takes a few minutes. The skin is numbed with a small injection of local anesthetic, which stings for a few seconds. The doctor then removes part or all of the spot, using either a thin blade to shave it off or a small round tool that takes a core.
The sample goes to a laboratory, where a pathologist, often a dermatopathologist with special training in skin, examines it under a microscope. Results usually come back within 1 to 2 weeks. A biopsy recommendation does not mean cancer is likely. Dermatologists biopsy many spots that turn out to be benign, because the microscope is the only way to be certain.
Expert groups differ on screening for people at average risk. In April 2023 the U.S. Preventive Services Task Force concluded that the evidence is insufficient to weigh the benefits and harms of routine visual skin screening by a clinician in adolescents and adults who have no symptoms. The task force did not recommend against screening. Studies have not yet settled whether routine exams of low-risk people reduce deaths, and possible harms include scarring from biopsies and overdiagnosis.
That statement does not apply to people with a suspicious spot, a personal or family history of skin cancer, or a condition that places them at high risk. For those groups, regular dermatologist exams are standard. People with a prior melanoma, many or atypical moles, a strong family history, a suppressed immune system, or multiple past skin cancers are usually seen at least once a year, and some are seen every 3 to 6 months. The Skin Cancer Foundation recommends a yearly professional exam for all adults.
