Skin Exams: What Are They?

By Sierra Mahoney, PA-C.

March is a beautiful time of the year here in Florida. The sun is shining, the weather is warm, and the skies are blue. We live in an amazing state that allows us the privilege of being outside- sometimes for hours on end, soaking up every last drop of sun- not thinking about the consequences of tomorrow.

50 minutes of sun exposure (or less!) is enough to damage skin. In people with fair skin such as myself, a sunburn can occur in as little as 5 minutes. Studies have shown that even one bad sunburn can place you at an increased risk of developing skin cancer such as basal cell carcinoma, squamous cell carcinoma or melanoma. In fact, according to The Skin Cancer Foundation, a person’s lifetime risk of developing melanoma doubles if they have had more than five sunburns in their lifetime.

That’s some scary stuff. But never fear- MidState Skin Institute is here! This is where we come in: Skin exams.

Skin exams are the bread and butter of our practice. On average, each provider performs 20+ skin exams every single day. So, what is a skin exam?

I always explain to my patient’s that skin exams- also called skin cancer screenings- are like easter egg hunts. I’m examining a patient head to toe in search of the “golden egg”. I’ll start by examining the scalp for anything suspicious such as irregular moles, lumps, bumps or skin cancers and work my way down to the toes, taking photographs or biopsies of any “eggs” that I want to collect along the way. Another common practice preformed during a skin exam is called cryotherapy, where pre-cancerous lesions or pesky seborrheic keratosis (AKA “barnacles” or “wisdom spots”) are frozen using liquid nitrogen.

Skin exams are a screening tool- we can’t always prevent skin cancers, but if we can catch them early, the prognosis is excellent. In fact, even melanoma (one of the more dangerous skin cancers) has a 100% 5-year survival rate if caught in the beginning stages, according to the American Cancer Society.

What do I as the patient need to do to prepare for a skin exam?
Very little. Showing up is the most important thing. Sometimes I ask patients not to wear makeup or lotion to the appointment, so I can see and feel things accurately.

At what age should I start getting routine skin exams?
We recommend routine skin exams once a year for everyone living in Florida, starting at age 30. Genetics, personal or family history of skin cancer or people with excessive sun exposure may want to consider skin cancer screenings starting at a younger age or at more frequent intervals. Sometimes we do skin exams on kids! In my opinion, no one is ever too young to start having routine skin exams and patients are encouraged to come in for skin exams as often as they would like. One of my patients even comes in for skin exams every 2 months, which is the perfect interval for him.

What should I expect as a patient during the skin exam?
Typically, a medical assistant will escort you back into an exam room and ask if there are any spots that you would like to bring to the provider’s attention. This may be a new mole that you have noticed, a spot that has recently changed, a spot that is painful/tender/itchy/discolored, etc. A gown will then be handed to you will be asked to undress down to your comfort level for the examination. I always encourage my patients to undress completely due to the fact that “melanoma can hide!” A mantra that is often sung in our office. Skin cancers- especially melanoma- can hide in places “where the sun doesn’t shine” such as the pubic region or in between the toes. Removing your underwear, shoes and socks just may save your life.

If a biopsy is taken during my skin exam, how long until I hear back regarding the results?
Sometimes biopsy results come back within a few days. I always tell my patients to allow up to two weeks to hear back regarding biopsy results. Rest assured- we will call you with the results regardless of whether they are benign or abnormal. You will always hear from us.

How is a biopsy performed? What do I do to take care of my biopsy site?
A biopsy is performed using local lidocaine, a blade of some sort and electrocautery or a stick. It can take several weeks for biopsy sites to heal, so we recommend keeping the area clean using warm soapy water and placing Vaseline or Aquaphor to the area and covering with the bandage one to two times a day until the biopsy site is healed.

I had my skin exam; a biopsy was taken, and the results were abnormal. Now what?
When we call our patients to inform them of biopsy results, we also go over treatment options to definitely treat the site where the abnormal cells were noted. This may include surgery, local chemotherapy or radiation or sometimes a procedure where skin cancer cells are scraped away and the base is then burned called an ED&C. When possible, surgical and non-surgical options are provided to best accommodate patient preferences.

My biopsy site is all healed and I don’t see anything there, do I still need to undergo additional treatment for my abnormal biopsy results?
More than not, the answer is YES. This is a common question I hear (and rightfully so). I explain to patients that sometimes-abnormal cells can still be present even if we can’t see them. I always compare skin cancers to an iceberg. When we take a biopsy, we remove the tip of the iceberg. Typically, additional treatment is needed to remove/destroy abnormal cells that may be lurking in deep dark depth of the ocean, or in this case, the skin!

I had pre-cancerous lesions frozen, and it looks like I’ve been bitten by mosquitos. Is this normal? I was also told to use a precancerous cream and my skin is now red and raw, is this normal?
The answer to both questions is YES! When destroying cancerous or precancerous cells, it shows on the skin. It’s normal to have little blisters that turn into scabs in areas where the skin has been frozen and it’s normal to have a red, raw, sunburn like reaction when using a prescribed chemotherapy cream. Using Vaseline or Aquaphor on the areas to help soothe the skin may be recommended. If needed, a prescription of topical steroid may be prescribed to help with the reaction. Remember…the more vigorous the reaction, the better the end result.

Protect Your Skin, Protect Your Future
Taking care of your skin isn’t just about looking good—it’s about safeguarding your health. Florida’s sunshine is beautiful, but it comes with risks. The good news? Regular skin exams can catch potential problems early, often before they become serious.

If it’s been a while since your last skin exam—or if you’ve never had one—consider this your friendly reminder to schedule an appointment. Prevention and early detection are key to keeping your skin healthy for years to come.

Your skin is your body’s largest organ—treat it with the care it deserves. We’re here to help every step of the way!

Mid State Skin Institute