Diagnosing Skin Cancer: Tests and Screenings, Early Diagnosis, and Your Doctors Everyday Health MenuNewslettersSearch Skin Cancer How Is Skin Cancer Diagnosed Tests and Screenings Early Diagnosis and Your Doctors By Julie Lynn MarksMedically Reviewed by Thomas Urban Marron, MD, PhDReviewed: August 20, 2020Medically ReviewedThe process of diagnosing skin cancer always begins with a visual exam.Liliia Kyrylenko/iStockIt’s important to spot skin cancer in its beginning stages when it’s easier to treat. Most skin cancers that are diagnosed early have a five-year survival rate of 99 percent or higher, according to the Skin Cancer Foundation (SCF). (1) This includes melanoma, which is the deadliest type, per the SCF. (2) Getting an early diagnosis requires you to see your doctor regularly and to schedule an appointment whenever you notice an unusual looking spot. If your physician thinks the lesion looks suspicious, certain tests and procedures may be done to see if it’s cancerous, notes the Cancer Treatment Centers of America. (3) RELATED: A Parent’s Guide to Skin Cancer in Children What Tests Do Doctors Use to Make a Skin Cancer Diagnosis Doctors will usually first perform a visual exam to check for skin cancer. They’ll assess the size, shape, color, and texture of the spots on your skin. You may also be asked about any symptoms you have and your family history of skin cancer. If you’re seeing your primary care physician, you might be referred to a dermatologist who specializes in skin diseases. Dermatologists often use special microscopes, magnifying lenses, or other tools to examine a spot more closely. This process is called a dermatoscopy. Your doctor might also feel your lymph nodes to see if they’re enlarged. (3) Biopsies If a lesion looks suspicious, your doctor will probably perform a skin biopsy to remove a sample of the tissue and test it for cancer. A biopsy typically leaves a small scar, but this will depend on the size of the lesion and the method used. After your doctor performs the biopsy, samples are sent to a lab for a pathologist to analyze under a microscope. The American Cancer Society (ACS) says there are different types of biopsies for skin cancer, including: (4)Shave (Tangential) Biopsy Your doctor shaves off the top layers of the skin with a small surgical blade. Then an ointment, chemical, or electrical current is applied to stop the bleeding.Punch Biopsy With this type, a tool that looks like a round cookie cutter is used to remove a deeper sample of skin. Your doctor will rotate the tool on the skin until it cuts through all of the layers needed. The sample is taken out and the skin may be stitched back together.Excisional Biopsy The entire tumor is removed with a surgical knife that cuts through the full thickness of the skin. The edges of the skin are usually stitched back together.Incisional Biopsy Only a portion of the tumor is removed with a surgical knife. Stitches may be used to close up the edges.Lymph Node Biopsy If your doctor suspects that the cancer has spread to your lymph nodes, a lymph node biopsy may be performed. With this procedure, parts or all of a lymph node may be removed to test for cancer. Imaging Tests Imaging tests are sometimes used if doctors suspect skin cancer has spread to other areas of the body. The ACS says these may include: (5)A chest X-rayUltrasoundComputerized tomography (CT) scanMagnetic resonance imaging (MRI)Positron emission tomography (PET) scan RELATED: What Doctors and Specialists Treat Skin Cancer? What Newer Tools Are Available to Diagnose Skin Cancer Some newer devices allow doctors to spot problematic skin lesions. One approach, called reflectance confocal microscopy (RCM), uses a low-power laser to scan skin lesions and provide important clues about whether they’re cancerous or not. RCM is sometimes used in combination with another method called optical coherence tomography (OCT), notes the Memorial Sloan Kettering Cancer Center. (6) 3D total body photography is another new technology that’s used to track changes in the appearance of moles or lesions in people at risk for melanoma. Dozens of digital cameras snap pictures of patients simultaneously. Then a computer creates a 3D avatar to show all the lesions on an individual’s body, so doctors can inspect them further. (6) Skin cancer apps are also becoming popular detection devices. These apps, available via most smartphones, claim to assess skin changes and help people decide whether they should see their dermatologist. While they can be helpful at promoting awareness, the accuracy of these programs is questionable. One recent study found the most accurate skin cancer detection app missed nearly 30 percent of melanomas, per the Roswell Park Comprehensive Cancer Center. (7) RELATED: The Right Hat Can Help Prevent Skin Cancer Staging Skin Cancer Once you get a skin cancer diagnosis, your doctor will want to stage the disease. Staging is a way to describe the extent of the cancer in your body. Imaging tests and lymph node biopsies are often done to see if cancer has spread. Skin cancer is staged using the number 1 through 4. Stage 1 cancers are small and only present in the area they start. Stage 4 skin cancers are the most serious and have spread to other areas of the body. Knowing your cancer’s stage can help your doctor recommend treatment options and better predict your prognosis, according to the Mayo Clinic. (8) What Are the Screening Recommendations Though many organizations promote regular total body skin checks, the Centers for Disease Control and Prevention (CDC) notes that the U.S. Preventive Services Task Force has concluded that there’s not enough evidence to recommend for or against routine screening to detect skin cancers early. (9) However, skin checks are recommended for people with a history of skin cancer or those who have any suspicious-looking lesions or moles. Additionally, the CDC says you may want to talk to your doctor if you have certain risk factors for skin cancer, such as: (10)Light skinSkin that burns, freckles, or reddens easilyBlonde or red hairBlue or green eyesA large number of molesA personal or family history of skin cancerOlder ageA weakened immune systemCertain disorders that increase your risk for skin cancer RELATED: Can Turmeric Help Skin Cancer? What Should You Look for You should be on the lookout for any unusual spots on your skin. One study found more than 40 percent of melanomas are discovered by patients themselves, according to the American Cancer Society (ACS). (11) Regular self-exams can help you spot new growths or changes. Many doctors recommend performing these checks once a month. It’s best to examine your skin in a well-lit room in front of a full-length mirror. You can use a handheld mirror for harder-to-see areas, like the back of your thighs. Be sure to look at all areas of your skin, including your palms, soles, ears, scalp, nails, and your back. If you can’t see these spots, ask a family member or friend to help you. Look for any lesions that are new or have changed in size, shape, color, or texture. Any sore, lump, or blemish that looks or feels unusual may also be a warning sign. Some skin cancers may appear as red, scaly, crusty, or swollen, and they may ooze or bleed. They can be painful, itchy, or tender. According to SkinCancer.net, signs of melanoma may include a spot that: (12)Is asymmetrical (one side doesn’t match the other)Has an irregular, blurred, or ragged borderIncludes different shades of brown or black, or sometimes patches of pink, red, white, or blueIs larger than 6 millimeters in diameterChanges in shape, size, or color Why Is an Early Diagnosis Important Skin cancer is the most common type of cancer that affects Americans. One in five people in the United States will develop some type of skin cancer by the time they reach age 70. (2) The good news is early detection of all types of skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma, can greatly improve your chances of being cured. Additionally, catching a skin cancer early on could make treatments easier. Smaller, simpler lesions are easier to remove surgically and less likely to result in scarring or disfigurement. It’s important to pay attention to new or changing skin spots and see your doctor if you notice anything out of the ordinary, notes the ACS. (13) Editorial Sources and Fact-Checking Skin Cancer Facts & Statistics. Skin Cancer Foundation.Early Detection: Overview. Skin Cancer Foundation.Diagnosing Skin Cancer. Cancer Treatment Centers of America.Tests for Basal and Squamous Cell Skin Cancers. American Cancer Society. July 26, 2019.Tests for Melanoma Skin Cancer. American Cancer Society. August 14, 2019.Stallard J. Noninvasive Imaging Tools Enable Better Detection of Skin Cancer. Memorial Sloan Kettering Cancer Center. May 17, 2018.How to Detect Skin Cancer. Roswell Park Comprehensive Cancer Center. July 16, 2019.Skin cancer. Mayo Clinic. Feb. 20, 2019.What Screening Tests Are There? Centers for Disease Control and Prevention (CDC). April 9, 2020.What Are the Risk Factors for Skin Cancer? Centers for Disease Control and Prevention. April 9, 2020.Can Basal and Squamous Cell Skin Cancers Be Found Early? American Cancer Society. July 26, 2019.How Is Skin Cancer Diagnosed? SkinCacner.net. April 12, 2017.Signs and Symptoms of Melanoma Skin Cancer. American Cancer Society. August 14, 2019.Show LessNEWSLETTERS Sign up for our Cancer Care Newsletter SubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. The Latest in Skin Cancer 14 Great Sunscreens for People of Color Looking for a sunscreen that’ll work with dark skin? 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