A full-body skin exam is a visual, head-to-toe check of your skin, including your scalp, your nails, the soles of your feet and the skin between your toes. The clinician looks for spots that are new, changing or unusual, and takes a closer look at any that stand out. If one looks suspicious, they may suggest a biopsy: a small sample of skin sent to a lab for testing.
Step 1: Your history, concerns and the spots you've noticed
The visit starts with a conversation. Expect questions like these:
- Have you, or a parent, brother, sister or child, ever had skin cancer?
- Have you had blistering sunburns, used tanning beds or spent years working outdoors?
- Do you take any medicines that weaken the immune system?
- Is there a spot you are worried about, and what about it has changed?
This is your moment to point out anything new, itchy, bleeding or different from the rest. Dated phone photos make it easier to show how a spot has changed. For the days before your visit, our skin exam prep checklist covers what to do.
Step 2: Changing into a gown
Next, you'll be asked to undress and put on an exam gown, which usually opens at the back. The American Cancer Society (ACS) notes that you can usually keep your underwear on and that only one area is uncovered at a time. The clinician should explain each step and ask your permission before examining sensitive areas such as the breasts, buttocks or genitals.
You are in charge of your own exam. If you'd rather an area wasn't examined, say so, and feel free to ask questions as you go or request a chaperone.
Step 3: The head-to-toe check, area by area
Clinicians usually follow a set route so nothing is skipped:
- Scalp. Hair is parted to see the skin.
- Face. Including the eyelids, nose and lips.
- Ears. Front and back.
- Neck.
- Trunk. Chest, belly, back and underarms.
- Arms and hands. Including the palms and the skin between the fingers.
- Nails. Fingers and toes, checked for dark streaks.
- Legs. Front and back.
- Feet. Tops, soles and between the toes.
- Groin and buttocks. A quick look, with your permission.
The ACS points out that the scalp, soles and spaces between the toes are easy to overlook, and that nail beds matter because melanoma is the skin cancer most often linked to nail changes.
As they go, the clinician checks spots against the ABCDEs of melanoma taught by the American Academy of Dermatology (AAD):
- A is for asymmetry: the two halves don't match.
- B is for border: the edge is jagged, notched or blurry.
- C is for color: several shades appear in one spot.
- D is for diameter: wider than about 6 millimeters, roughly a pencil eraser, though melanoma can be smaller.
- E is for evolving: it grows or shifts in shape or color over time.
They also watch for a mole that doesn't match your others, and for signs of the more common skin cancers, such as a pearly bump, a rough scaly patch or a sore that doesn't heal.
Step 4: A closer look at single spots
When a spot catches the clinician's eye, they examine it more closely. A tool many dermatologists reach for here is the dermatoscope, a lighted handheld magnifier that shows detail below the skin's surface. The ACS describes it as a lighted magnifying tool, and MedlinePlus, from the National Library of Medicine, notes that a provider may use a magnifier with a light on certain moles.
The clinician may also measure a spot, or note or photograph it to compare at a later visit.
Step 5: If something looks suspicious, a biopsy
An exam can flag a spot, but it can't confirm what it is. The AAD explains that a skin biopsy is needed to diagnose skin cancer, because looking at the tissue under a microscope is the only way to know for certain.
Bay Ridge Dermatology performs shave biopsies in its office (see our surgical services). In a shave biopsy, the spot is generally numbed first, and then a thin blade takes off the raised part of the spot or a thin top layer of skin for the lab. In general, a biopsy may happen during the exam visit or on another day.
Needing a biopsy doesn't mean you have cancer: MedlinePlus notes that not every suspicious spot turns out to be skin cancer. Ask how and when your results will reach you. If a biopsy does show melanoma, the diagnosis is made at Bay Ridge, and you are referred to an NYC cancer center for treatment.
Step 6: Wrap-up and next steps
Before you leave, the clinician should go over:
- What they found, including spots that need nothing at all
- Any spots to keep an eye on, and what change would mean coming back sooner
- Any biopsy, and how the results will reach you
- When to schedule your next exam
There's no single schedule for everyone. The ACS says yearly exams are often recommended, and people at higher risk may need them more often. Between visits, a monthly look at your own skin helps you catch changes. To judge whether an exam covered everything, use our checklist of what a good skin cancer screening includes.
Does it hurt, and how long does it take?
The exam itself shouldn't hurt. The ACS calls a full-body skin exam brief, painless and non-invasive, and says a thorough check by an experienced dermatologist can take under five minutes, or longer if some spots need a closer look. MedlinePlus puts the exam at about 10 to 15 minutes. The whole appointment, with check-in and conversation, takes longer than the exam alone.
If a biopsy is done, you may feel a brief sting as the area is numbed.
Who you might see at Bay Ridge Dermatology
Bay Ridge Dermatology offers full-body skin exams and sees patients of all ages, pediatric through geriatric. The clinical team:
- Dr. Evangeline Perez, a board-certified dermatologist with more than 20 years of experience
- Nicole Marie Colucci, PA-C, board-certified physician assistant
- Kerry Ly, PA-C, who speaks Mandarin and Cantonese as well as English
Ask the office who will do your exam. If you would prefer to speak Mandarin or Cantonese at your visit, say so when you book. Each clinician has a profile on our providers page.
You'll find the practice on the 1st floor of 515 84th Street, Brooklyn, NY 11209, open 9 a.m. to 5 p.m. Monday to Thursday and 9 a.m. to 4 p.m. on Friday.
When to book sooner than a routine exam
Don't wait for a scheduled exam if you notice:
- A spot that is growing, or changing in shape, color or height
- A mole that itches, bleeds or crusts for no clear reason
- A new spot that looks unlike your others
- A sore that doesn't heal, or keeps returning after it seems to
- A new dark stripe under a nail
- A pearly bump or rough, scaly patch that sticks around
Many checked spots turn out to be harmless, but a changing one deserves a look soon. Bay Ridge does offer same-day appointments, but availability varies and can't be promised for any particular visit, so call the office to ask.
Whether you are due for a routine check or have one spot on your mind, book online or call (347) 497-4984.
This article is general information, not medical advice. For advice about your own skin, see a dermatologist.