How frequently should I undergo a full skin examination and perform self‑skin checks, considering risk factors for skin cancer?

Skin Examination Frequency Based on Risk Stratification

For average-risk adults ages 20-40, undergo professional skin examinations every 3 years and perform monthly self-skin checks; for those 40 and older, increase professional examinations to annually while continuing monthly self-checks. 1

Average-Risk Population

Ages 20-40

• Professional skin examination every 3 years as part of cancer-related checkup 1
• Monthly self-skin examinations 1
• Complete skin examinations (not partial) detect melanoma 6.4 times more frequently 1

Ages 40 and Older

• Annual professional skin examinations 1
• Continue monthly self-skin examinations 1

High-Risk Patients Requiring Dermatology Referral

High-risk patients should be referred to a dermatologist for specialized monitoring at any age, with more intensive surveillance schedules. 1

High-Risk Criteria Requiring Dermatology Referral:

• Familial melanoma syndrome 1
• First-degree relative with melanoma 1
• Multiple atypical nevi 1
• Personal history of melanoma 2

Surveillance Schedule for Melanoma Survivors:

Stage IA melanoma:

• History and physical examination (emphasizing nodes and skin) every 3-12 months for 5 years, then annually 2
• At least annual professional skin exam for life 2
• Monthly self-skin and lymph node examination 2

Stage IB-IIA melanoma:

• History and physical examination every 6-12 months 2
• At least annual professional skin exam for life 2
• Monthly self-skin and lymph node examination 2

Stage IIB and higher:

• Every 3-6 months for the first 2 years 2
• At least every 6 months for years 3-5 2
• At least annually thereafter 2
• Monthly self-skin and lymph node examination 2

Special High-Risk Populations:

Patients with prior basal cell carcinoma:

• Nearly 50% risk of developing a second basal cell carcinoma within 3-5 years 3
• Regular screening at frequent intervals is warranted 3

Organ transplant recipients:

• At least annual dermatological examination due to marked immunosuppression and elevated skin malignancy risk 3

Patients with classic atypical mole syndrome (CAMS):

• Annual total cutaneous examination with total cutaneous photography and dermoscopy 4
• 10-year cumulative melanoma risk of 14% 4

Moderately Increased Risk Patients

• Annual skin examinations by primary care physician 1
• Monthly self-examinations 1
• Discuss individualized screening frequency with physician 1

Self-Examination Technique

Use ABCDE Criteria to Identify Suspicious Lesions:

• Asymmetry: irregular shapes or halves that don't match 1
• Border irregularity: jagged, notched, or blurred edges 1
• Color variation: multiple colors or uneven distribution 1
• Diameter: lesions larger than 6mm 1
• Evolution: changes in size, shape, color, or symptoms over time 1

Additional Assessment Tool:

• "Ugly duckling" sign: moles that look different from surrounding moles 1

Critical Pitfalls to Avoid

Melanomas can occur in non-sun-exposed areas, particularly in people with darker skin, who are often diagnosed at later stages when treatment is more difficult. 1 This means complete body examination is essential, not just sun-exposed areas.

Partial skin examinations are inadequate – complete skin examinations are 6.4 times more likely to detect melanoma compared to partial examinations 2

Don't assume younger patients are low-risk – an estimated 4-8% of patients with melanoma develop new primary melanomas, typically within the first 3-5 years following diagnosis 2

Evidence Quality Note

While the USPSTF and Canadian Task Force concluded there is insufficient evidence to recommend for or against routine screening in average-risk asymptomatic individuals 1, the American Cancer Society provides clear age-based recommendations that balance detection benefits with practical implementation 1. The more recent 2019 American Academy of Dermatology guidelines provide the most detailed risk-stratified surveillance schedules for melanoma survivors 2.