Once you have observed changes in your skin or found a new or existing mole that looks suspicious, it is important to make an appointment with your physician. If your doctor suspects you should have the skin changes or mole examined further, you may be referred to a dermatologist, a doctor who specializes in diseases of the skin.
Your doctor will ask about any medical conditions you have had and your current symptoms. He or she also asks about your skin, moles, any other marks on your skin, any history of melanoma or other skin cancers, and risk factors for melanoma. Questions are also asked about your immediate family and any skin cancers family members may have had.
The doctor inspects your skin for any lesions, or abnormalities. A dermatologist or a doctor will do a thorough skin check, including the scalp, between the toes and fingers, even around the genitals. The doctor may also check other parts of your body for signs of cancer. Your doctor will then determine if a biopsy is necessary.
A biopsy, or removal of tissue for examination under a microscope, is taken of suspicious moles. The doctor first numbs the skin with an injection of a local anesthetic. There are several types of biopsy. The entire lesion and a border of normal skin around it should be removed.
- Excisional biopsy: The doctor uses a scalpel to remove the entire growth and some tissue around it. This is the most common type of biopsy when melanoma is suspected.
- Incisional biopsy: Sometimes a lesion is very large or in a place where it can’t be easily removed. In these cases, an incisional biopsy is done. An incisional skin biopsy removes only part of the lesion.
- Punch biopsy: The doctor uses a sharp, hollow instrument to remove the lesion and some normal tissue around it. This type of biopsy may be used for specific areas of the body, such as the face.
- Shave biopsy: The doctor uses a thin, sharp blade to shave off a lesion and some normal tissue around and under it. A shave biopsy removes epidermis and part of the dermis. This type of biopsy is used to remove some skin lesions that look abnormal. A shave biopsy is usually not performed when melanoma is suspected as it makes assessment of the melanoma difficult.