Where should I go to have a mole checked?

Choosing the right person or clinic for a mole check or skin check is a crucial step in detecting skin cancer. Your own GP might have experience in diagnosing and treating skin cancers. If not, a skin cancer clinic can be a suitable alternative.

Finding a reliable skin cancer clinic

Whether you have moles or other spots of concern, or if you are at risk of skin cancer and want a full body skin check for screening purposes, you need to decide where to have your mole check.

The person examining you should have experience in detecting and managing skin cancer, both melanoma and non-melanoma skin cancer. They should also have qualifications that demonstrate their competence in this field.

• All dermatologists should have appropriate experience and qualifications to competently diagnose and manage skin cancers. To see a dermatologist in Australia, you first need a referral from a general practitioner or other doctor. This can sometimes cause a delay before the dermatologist can see you, which in Melbourne is often compounded by long waiting periods to see dermatologists.
• Many general practitioners are easy to see on short notice and have suitable experience and qualifications. Unfortunately, many do not: their expertise is in other areas. If you see a GP for a skin check, one simple way to assess their familiarity with skin cancer examinations is to see if they use a dermoscope, a special instrument for magnifying and lighting the skin. Anyone attempting to examine a mole or spot without a dermoscope may miss signs of early skin cancer.
• Skin cancer clinics are usually staffed by general practitioners with a special interest and experience in skin cancer (although this is not always the case). In some clinics, you may be examined by a nurse or a relatively inexperienced GP. If you intend to visit a skin cancer clinic, you should check for the qualifications of the clinical staff. Skin cancer clinics are often equipped with technology to assist in skin cancer diagnosis and skin monitoring which is relatively uncommon in many general or dermatology practices.
• Skin photography and mole mapping clinics offer a service where your moles and/or the entire surface of your skin is photographed by a nurse and the photographs are reviewed by a dermatologist or other doctor. In these clinics, the nurse examining your skin may not be allowed or properly qualified to diagnose spots of concern which means you may have to wait for a report after a doctor has reviewed the photographs.  These clinics may not offer treatments for potential skin cancers they have detected, meaning that you would then need to find someone else to manage the suspicious spot.

What qualifications should the person examining your skin have? The Skin Cancer College of Australasia maintains a register of accredited skin cancer doctors who have undergone high-level training and demonstrated competence in skin cancer diagnosis and management.

You can easily find an accredited skin cancer doctor near you by using the Skin Cancer College’s Locate a Doctor directory at skincancercollege.org/locate-a-doctor.

Mole check

If you’re having a single spot or mole check, it’s probably because you’re worried about possible skin cancer. In this situation, your priorities should be:

• Appointment availability within the next few days.
• Accuracy of diagnosis: does the person examining you have experience and qualifications to reliably assess your spot of concern?
• Ability to manage most skin cancers or other suspicious spots detected quickly and competently within the clinic.

Full body skin cancer check

If you are at risk of skin cancer, you should consider a full skin check every year. In this situation, you might wish to prioritise:

• Diagnostic skill of the person examining you. Can they detect signs of melanoma and non-melanoma skin cancer among your other moles and spots?
• Documentation of your spots and skin so that it’s easier to detect changes at future visits.
• Can they offer advice on skin cancer prevention and manage sun-damaged skin? This includes advice on the most appropriate sunscreen and sun smart strategies to suit you, but also advice about treatments including supplements and topical preparations that will help maintain skin health.
• Do they treat other skin conditions related to sun exposure such as rosacea, freckles and age spots, blood vessels and angiomas?
• Can they remove unwanted moles for cosmetic purposes?

The importance of getting a skin cancer check

Melanomas diagnosed in their early stages are almost always curable. An experienced skin cancer doctor using dermoscopic examination will usually be able to detect skin cancer earlier than you can yourself. This means that if you are at risk, it’s important to have your skin checked regularly.

Catching abnormal moles early

Early detection of skin cancer is achieved in two main ways:

1. Dermoscopic examination of moles and other spots and lumps. This type of examination magnifies the skin many times and a polarised light allows the doctor to see more clearly through the top layer of skin to diagnose small skin cancer signs not visible to the naked eye.
2. Serial (repeat) photography of abnormal or odd-looking moles. Taking repeated high magnification photographs of moles allows the doctor to see small changes which might be due to early skin cancer.

Skin cancer is highly treatable if found in the early stages

Most skin cancers are curable if diagnosed early.

Melanoma in situ – the most diagnosed form of melanoma at Spot Check Clinic – is cured in over 99% of cases. Most of the time we can successfully treat it in our clinic.

Other skin cancers such as basal cell carcinoma and squamous cell carcinoma when they are diagnosed early, can be treated easily by a variety of methods. If your skin cancer doctor is familiar with clinical guidelines for the management of skin cancers, you can discuss treatment options for early skin cancer, such as:

• Surgical excision to prove that the skin cancer has been completely removed.
• Cryotherapy to treat the cancer quickly in a single session at minimal cost.
• Photodynamic therapy to give the best possible cosmetic result.
• Topical treatments to minimise discomfort.

A good skin cancer clinic will offer all these treatments and involve you in the process to decide which is the most suitable.

Keeping an eye on your skin at home

About half of the melanomas diagnosed in Australia are discovered by people at home. A good skin cancer clinic can support you with this in several ways:

• Provide access to clinical photos taken in the clinic so you can detect changes.
• Supplying a smart phone app that allows you to take photos of your own moles and file them in a specialised system for tracking them.
• Offering to examine photographs of moles of concern when you are unable to attend the clinic.

When to call your doctor for a skin check

You should consider having your skin checked if you notice a spot that is asymmetrical with irregular borders and/or multiple colours, particularly if it is growing, changing or doesn’t resemble your other spots. Alternatively, even if you don’t have spots of concern, you should consider a full body skin check if you have skin cancer risk factors, and it has been more than a year since your last full body skin check. Common risk factors include:

• Over 40 years of age with white skin.
• More than 100 moles, especially if there is a history of dysplastic moles.
• Family history of melanoma.
• History of skin cancer.
• History of solarium use.
• Disorders of the immune system or taking medications that suppress the immune system.

Finding a skin cancer clinic to serve your needs

Spot Check Clinic is a skin cancer and skin health clinic located in the Melbourne CBD. Our principal doctor is accredited by the Skin Cancer College of Australasia. He has qualifications and training in skin cancer medicine and surgery, advanced dermoscopy, photodynamic therapy, laser skin treatments, radiofrequency surgery, primary care dermatology and cosmetic medicine. He has 15 years’ experience working exclusively in the field of skin cancer medicine and skin health.

We use the DermEngine/MoleScope skin imaging system to store and analyse skin lesion and mole mapping images. Pathology results and educational information about conditions and treatments are also stored in this system. Photographs, results and information is available to all consenting adult patients of Spot Check Clinic. Using the MoleScope app, you can send us photos of skin lesions of concern if you are unable to attend the clinic in person.

We offer a range of surgical, medical and light-based treatments for skin cancers, pre-cancerous conditions, sun damaged skin, unwanted normal moles and skin lesions, and certain dermatological conditions.

Our doctor, nurses and dermal therapists can help devise a skin protection plan which reduces skin cancer risk and improves the health and appearance of your skin.

If you have a spot of particular concern, we will try to examine it within two working days, even if this means before or after hours or working through lunch.