• Dr Rachel Tan

Skin Checks, When, Where and How?

Updated: Nov 28

The Skin

The skin is the largest organ in the human body. Its main functions include protecting the body from the external environment, regulating body temperature and preventing dehydration.


The skin is composed of three main types of cell. Basal cells, which form the lower layer of the skin, squamous cells which form the top layer of the skin and melanocytes which produce a substance called melanin, the pigment that gives colour to the skin.


Skin Cancer


What is skin cancer?

Skin cancer occurs when either the basal cells, squamous cells or melanocytes in the skin begin to grow abnormally. This uncontrolled growth results in what is commonly termed a ‘skin cancer’. If the growth occurs in basal cells, it is referred to as a basal cell carcinoma, if the growth occurs in squamous cells, it is referred to as a squamous cell carcinoma and if the growth occurs in melanocytes it is referred to as a melanoma. Having regular skin checks means that these skin cancers can be detected very early, ideally when they are ‘in situ’ meaning that they have not spread beyond the layer of the skin where those cells are usually located..


What factors increase the risk of skin cancer?

While skin cancer is mostly a preventable disease, the main risk factors are exposure to ultraviolet (UV) radiation, family history and genetic susceptibility. Exposure to UV radiation normally occurs from sun exposure but can also be associated with past solarium use. Individuals with one or more first-degree relatives (for example, a mother, father, sibling or child) with melanoma are at a greater risk of developing a melanoma and should have annual comprehensive skin checks. Skin pigmentation or melanin protects the skin from the sun, so the fairer your complexion, the more susceptible you will be to skin cancers. Skin cancers can also occur in individuals with a darker complexion who do not burn easily in the sun so it is important to be aware of any changes on your skin and to have regular skin checks. There is also a strong association between the number of moles on a person’s body and their risk of developing melanoma with a greater number of moles increasing the chance that a melanoma will develop.

Reducing risk of skin cancers

Understanding the importance of sun protection and incorporating this into your daily life will reduce your risk of skin cancers. It is important to implement these measures when the UV index reaches 3 or above. There is a free downloadable SunSmart app that will let you know what the real-time UV index is at your particular location.


Preventative skin checks

The Royal Australian College of General Practice recommends that high-risk patients should routinely perform their own self-examinations every 3-4 months, in conjunction with a 6-12 monthly skin check with their doctor.


A full body comprehensive skin check should be completed during these visits. This will involve a longer consultation to ensure that your skin is carefully examined. This can either be with your GP or with a dermatologist. A GP who has a special interest in skin cancer medicine will have further training, use special equipment, for example, a dermatoscope, and will perform removal and biopsy of spots when necessary. A dermatoscope provides magnification of skin lesions with a polarised light that eliminates reflection of light from the skin surface and aids visualisation of important features of a specific skin lesion. Generally, seeing a GP costs less than seeing a dermatologist but both doctors work closely together at various stages.


TAKEAWAY

​The best way to prevent complications from skin cancer is having regular skin checks so that these skin cancers can be detected very early before they spread.

Main risk factors for skin cancers are ultraviolet (UV) radiation, family history and genetic susceptibility i.e. - high sun exposure or past solarium use - one or more first-degree relatives with melanoma - the fairer your complexion, the more susceptible you will be to skin cancers - high number of moles on a person’s body

​High-risk patients should routinely perform their own self-examinations every 3-4 months, in conjunction with a 6-12 monthly skin check with their doctor. Other individuals, including darker complexion, should also be aware of changes in skin and have regular skin checks.

​Your GP or dermatologist can do the skin checks in a longer appointment. Some GPs have special interest and training in skin cancer prevention and uses a dermatoscope for a more comprehensive check. They can perform more treatments before referring to the dermatologist.

Treatments for Skin Cancers

Your GP is able to provide some of the treatments required for the management of skin cancers. Some skin cancers can be treated with liquid nitrogen (commonly known as freezing with dry ice) at the time of your skin check. Some can be treated with ointments available only with a medical prescription. Others will require a follow up appointment for a small biopsy or excision. Skin cancers which are located on the neck, face and lower leg or which are very large are best managed by a plastic surgeon or dermatologist to ensure the best cosmetic result. This is also the case for patients who are on blood thinning tablets. If the initial biopsy or excision of a skin lesion confirms a skin cancer, your doctor will need to refer you to a plastic surgeon to remove a larger area of skin. This is called a wide local excision. This ensures that the skin cancer does not spread further.


How to spot a skin cancer?

It is important that you know your skin well so that you can report any early changes to your doctor. Skin cancers most commonly develop as a new mole on your skin. Changes that you should be monitoring are:



Want to know more?

Dr Rachel Tan trained at Monash University, after that, she worked at the Sydney Children’s Hospital in Randwick and completed a Diploma of Child Health with UNSW. Dr Tan is experienced in managing women’s health, paediatric health, mental health and chronic medical conditions, with additional skills and training in the prevention and management of skin cancers. Dr Tan is qualified to complete comprehensive full body skin checks and minor skin procedures. She has also completed training with Family Planning NSW and has experience with Implanon insertion and removal. An area Dr Tan is particularly interested in, is supporting children and their families who have additional behavioural or developmental needs. Married with two primary school aged children, Dr Tan lives locally and is truly a part of the local community network where she aims to provide exceptional care to patients. She can frequently be found enjoying pilates and going on walks. To consult with Dr Rachel Tan at her practice, or book a comprehensive skin check, please call 94999999 at the Gordon Doctors or book an appointment at www.gordondoctors.com/book-an-appointment.


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