Annual skin check-ups during coronavirus: How can you get one?

Many dermatologists are turning to telemedicine appointments during this time. But how effective are they?
/ Source: TODAY

Due to the coronavirus outbreak, medical facilities across the country are postponing nonessential procedures, and that includes routine skin checks.

Many people rely on these exams to assess their risk for melanoma and other skin cancers annually. According to the Skin Cancer Foundation, one in five people will develop skin cancer by 70, making it the most common type of cancer.

Right now, only some patients can get preventive full-body exams, Dr. Adam Friedman, professor of dermatology at George Washington University's School of Medicine in Washington, D.C., told TODAY. They're generally reserved for especially high-risk people who already see their dermatologist every few months.

But if you're not in this group, you can still get the care you need. Here's how.

Conduct self-exams

Friedman recommends that patients conduct self-exams every one or two months. To do so, strip down and examine your skin starting with the scalp. If possible, ask someone to look at your back, as this area is hard to see and consequently the most common spot for malignant melanomas.

Look for the ABDCEs of melanoma, Dr. Kathleen Suozzi, assistant professor in the dermatology department of Yale School of Medicine in New Haven, Connecticut, told TODAY.

  • Asymmetry: One half unlike the other half
  • Border: Irregular borders
  • Color: Within a mole, light and dark variations or red and blue hues
  • Diameter: Greater than a pencil eraser
  • Evolution: It looks different from the last time you noticed

Suozzi noted that bleeding or painful spots can also be signs of melanoma or carcinoma.

If, during your self-exam, you notice anything abnormal, contact a dermatologist. Don't consult "Dr. Google," Friedman warned.

Schedule a telehealth appointment

Both Suozzi and Friedman noted that the developments in telemedicine for dermatology have moved fast since the outbreak began.

"We’ve advanced five to 10 years in a matter of three weeks," Friedman said.

While dermatologists likely won't conduct a full-body exam virtually, they will be able to look closely at the specific spot you're concerned about. You may also be asked to send a high-quality photo.

During the appointment itself, consider asking your doctor to stand by while you conduct a self-exam, said Dr. Seemal Desai, a member of the American Academy of Dermatology's board of directors and dermatologist based in Plano, Texas. That way, you can have some guidance as you go through it and talk about any concerns in real time.

"Over video, I've found many suspicious skin cancer lesions over the past six weeks," he added.

Suozzi also called out that because many in-person visits have been postponed, now is a good time to reach out to a dermatologist if you don't have one. You don't need to have found a mole of concern to do so, Desai added.

Schedule an in-person visit, if your doctor requests it

Depending on what happens in your telehealth appointment, you might need an in-person visit for a biopsy. If it's positive, it will be up to your doctor to decide the next step, and telemedicine may come into play again.

Suozzi said remote technology is being used to assess which patients' visits can be postponed and "which patients need to be treated more urgently." She added that if your doctor decides to delay care, make sure to ask why.

Another crucial factor that will affect whether you receive follow-up care is your risk for the coronavirus.

"For many of our elderly patients with underlying illnesses, the risk of going to a doctor's office during the COVID pandemic outweighs the risk of whatever ... skin condition that we're treating them for," Suozzi explained.

Desai noted that his facility is taking extra precautions to minimize patients' risk when seeking in-person care, such as waiting in the car and going directly to the exam room.

Follow up, if necessary

For most people, it's unlikely your condition will change drastically over the course of a few days or a week, but the indefinite end to the pandemic could mean you'll go months without seeing a dermatologist in person. And "it's months where we get worried," Friedman added.

So, continue to monitor your skin over this period, especially if you had a positive biopsy and your doctor decided you could safely postpone care.

Last, Desai stressed the importance of protecting your skin when you go outside to get a break from stay-at-home orders.

"Now ... we have more people spending time in the sun," he said. "Even in a time of COVID ... the sun is as strong as ever. You need to seek shade when appropriate, wear sun-protective clothing and talk to your dermatologist about new or changed lesions."