What an annual skin check actually involves.

Why bother

Skin cancer is the most commonly diagnosed cancer in Australia. Two thirds of Australians will be diagnosed with a skin cancer before they reach 70. The reason for an annual skin check is not paranoia; it is the simple statistical fact that early detection changes outcomes for most types of skin cancer, and that the examination is cheap, quick, and almost entirely without downside.

The pitch here is not “come in so I can find a melanoma you didn’t know about”. The pitch is “most of the time there is nothing serious to find, and a structured look gives you certainty about that for another twelve months”.

Who should consider regular skin checks

Risk in Australian skin medicine is broadly stratified. The factors that should make you think about regular checks include:

• Personal history of skin cancer (any type).
• Family history of melanoma in a first-degree relative.
• Multiple moles, or any moles that have changed.
• Fair skin that burns easily, light eye colour, light hair colour.
• Significant cumulative sun exposure — outdoor work, frequent beach time, time spent overseas in high-UV regions.
• Childhood sunburns (especially blistering ones).
• History of solarium use.
• Immunosuppression — transplant medications, certain blood disorders, biological therapies.

If two or more of those apply to you, an annual structured examination is reasonable. If none apply and you have already had a baseline check with no concerning findings, every two to three years is often enough. If you have already had a skin cancer, the interval is short and individualised.

How long it takes

A first skin check appointment in this practice usually runs twenty to thirty minutes. Subsequent annual checks, with familiar skin, are often shorter. People are sometimes surprised that a thorough examination doesn’t take longer; the structured approach is efficient, but it is not rushed.

What happens in the room

The check has a predictable shape. Briefly:

1. Discussion. Personal and family history. Any spots you have already noticed and want me to look at. Any recent changes — new lesions, itchy spots, anything that has been bleeding.
2. Examination. A head-to-toe look at the skin, with you in your underwear. Scalp, behind the ears, between the toes — everywhere skin cancer can appear, including the places that don’t get sun. A chaperone is offered as a matter of course.
3. Dermoscopy on anything that catches the eye. See the next section.
4. The decisions. If something needs further assessment, the options are explained — monitor, biopsy, excise, or refer.
5. A plan, written down. What I am doing, what you are doing, when we are seeing each other next.

What dermoscopy is, and why I use it

A dermatoscope is a small magnifying device with cross-polarised light that lets the examiner see through the surface reflection of the skin and into the structure of a lesion. It is the single most important tool in modern skin cancer medicine. Studies show that dermoscopy used by a trained clinician improves diagnostic accuracy substantially compared with naked-eye assessment alone — both in finding melanomas you might otherwise miss, and in confidently not biopsying things that look ugly but are benign.

In practice this means a lot of lesions that look concerning to the naked eye turn out to be reassuring under dermoscopy, which spares you a biopsy. It also means lesions that look fine to the naked eye but have a worrying pattern under dermoscopy will be biopsied early.

The decision to biopsy

A biopsy is not the default. The default is “reassure and watch”. A biopsy is recommended only when there is a real clinical question that the answer to changes management. The options I will discuss with you, where they apply, are:

• Photographic monitoring — for a borderline lesion where a short-interval re-check (typically three months) will likely settle the question.
• Excision — for lesions where the suspicion is high enough that going straight to definitive treatment makes sense.
• Shave or punch biopsy — for diagnosis when the histology will guide further treatment.
• Referral — for lesions on cosmetically sensitive sites, lesions requiring wider margins, or complex cases.

Whichever path applies, the procedure is explained, the cost is agreed, and informed consent is obtained in writing before anything is done.

After the check

You will receive a clear written summary of what was found and what the plan is. If a biopsy was taken, you will be contacted with the result — regardless of what the result is — typically within one to two weeks. Significant or unexpected findings are communicated by phone on the day they are reviewed.

The thing I most want patients to take away is the date of their next examination. The check is only useful if it happens regularly.

What it costs

A skin examination attracts a standard consultation fee. Where eligible, a Medicare rebate applies under the relevant MBS items. Procedures — biopsy, excision, cryotherapy — are quoted before they are performed. Specific dollar amounts are not published on this website; reception can give you a current estimate at the time of booking. The reasoning is set out at length in Private GP, explained honestly.

A small note on photographs

Where a lesion needs photographic monitoring, dermoscopic and clinical photographs are taken with your consent and stored within your medical record. They are used for clinical purposes only — this practice does not use patient photographs for marketing, social media, or before-and-after galleries, and never will. The full position is on the Clinical Photography Policy page.

How to book a skin check

Through HotDoc — the booking link is on the Skin cancer medicine and surgery page — or by calling reception on (08) 6188 5555. Mention you are coming for a skin check so the appropriate length of appointment is allocated.