Getting tested for skin cancer starts with a full-body skin exam, usually performed by a dermatologist. You can request one from your primary care doctor or book directly with a dermatologist, depending on your insurance. The exam itself is quick, painless, and typically takes 10 to 15 minutes. If anything looks suspicious, your dermatologist may perform a biopsy the same day or schedule one shortly after.
Who Should Get Screened
There’s no universal recommendation for routine skin cancer screening in people without symptoms or risk factors. The US Preventive Services Task Force currently says there isn’t enough evidence to recommend for or against visual skin exams for the general population. But that guidance explicitly doesn’t apply to people with a personal or family history of skin cancer, or anyone who has noticed changes in a mole or skin growth.
In practice, dermatologists use their own judgment. If you have fair skin, a history of sunburns or tanning bed use, many moles, or a family history of melanoma, most dermatologists will recommend regular screenings, often annually. Even without those risk factors, you can request a baseline skin exam at any age. Many people schedule their first one after noticing a spot that concerns them.
How to Spot Warning Signs Yourself
Before you ever see a dermatologist, your own eyes are your first screening tool. The National Cancer Institute uses the ABCDE framework to describe the features of early melanoma:
- Asymmetry: One half of the mole doesn’t match the other.
- Border: The edges are ragged, notched, or blurred, and pigment may spread into surrounding skin.
- Color: The color is uneven, with shades of black, brown, tan, white, gray, red, pink, or blue.
- Diameter: Most melanomas are larger than 6 millimeters (about the size of a pencil eraser), though they can be smaller.
- Evolving: The mole has changed in size, shape, or color over the past few weeks or months.
Not every melanoma follows this pattern, and non-melanoma skin cancers (like basal cell and squamous cell carcinoma) often look different entirely. A sore that won’t heal, a shiny bump, a flat reddish patch, or any new growth that bleeds or crusts over is worth having checked. When in doubt, get it looked at. A quick appointment can rule out something serious.
How to Prepare for Your Appointment
A full-body skin exam covers every inch of skin from your scalp to the soles of your feet, so a little preparation helps your dermatologist see everything clearly. Before your appointment, remove all nail polish (skin cancer can develop under nails), take off any makeup, and leave jewelry at home. Remove bandages or braces that cover skin. Wear your hair loose so your scalp can be examined.
It also helps to do a self-check beforehand and note any spots you want to point out. If a mole has changed recently, try to recall when you first noticed the change. Photos from a few weeks or months prior can be especially useful.
What Happens During the Exam
You’ll change into a gown and your dermatologist will systematically examine your skin, working from head to toe. They’ll check areas you might not think of: between your toes, behind your ears, your scalp, and the skin under your nails. The exam is visual and doesn’t involve any blood work or imaging.
If a spot needs a closer look, your dermatologist will use a dermatoscope, a handheld device with a bright light and a magnifying lens (typically 10x magnification). It lets them see structures beneath the skin’s surface that aren’t visible to the naked eye, like pigment patterns and blood vessel arrangements that help distinguish harmless moles from potentially cancerous growths. The tool simply presses gently against the skin. It doesn’t cut or hurt.
Most of the time, the exam ends there. Your dermatologist will note any spots to monitor and let you know if everything looks normal. If something does look suspicious, the next step is a biopsy.
What a Biopsy Involves
A biopsy is the only way to definitively diagnose skin cancer. Your dermatologist removes a small sample of skin and sends it to a pathology lab, where it’s examined under a microscope. The procedure is done in the office with local anesthetic, so you’ll feel a brief sting from the numbing injection but not the biopsy itself. There are three main types, and your dermatologist will choose based on the size, location, and depth of the suspicious spot.
A shave biopsy removes a thin layer from the skin’s surface. It’s the least invasive option and usually doesn’t require stitches. A punch biopsy uses a small circular cutting tool to remove a deeper core of tissue, including layers below the surface. Depending on the size, stitches may be needed. An excisional biopsy removes the entire suspicious area along with a border of healthy skin around it. This approach is common when melanoma is suspected, and it typically requires stitches.
After the procedure, you’ll get instructions on wound care. The site may be tender for a few days. Most biopsy wounds heal within one to three weeks depending on the type and location.
Getting Your Results
Biopsy results generally come back within one to two weeks. The pathology lab examines the tissue sample to determine whether cancer cells are present, and if so, what type of skin cancer it is. Some complex cases, particularly when melanoma is suspected, can take longer because the pathologist may need to evaluate the depth of the growth and other detailed features.
Your dermatologist’s office will typically call you with results. If the biopsy is benign, no further treatment is needed. If it shows skin cancer, your dermatologist will explain the type, how advanced it is, and what treatment looks like. For many non-melanoma skin cancers caught early, the excisional biopsy itself may have already removed the cancer completely.
Insurance and Cost Considerations
How your visit is billed affects what you’ll pay. A screening exam (you have no symptoms, you’re just getting checked) and a diagnostic exam (you’re coming in because of a specific suspicious spot) are often the same physical exam, but insurance treats them differently. Diagnostic visits, where your doctor orders the exam because of a symptom or concern, are more likely to be covered under standard medical benefits, though copays and deductibles still apply.
Preventive skin screenings without a specific medical reason may or may not be covered depending on your plan. Before booking, call your insurance company and ask whether a skin cancer screening is covered and whether you need a referral from your primary care doctor. If you’re going in because you noticed a changing mole, make sure your provider documents it as a diagnostic visit rather than a routine screening. That distinction can mean the difference between full coverage and an unexpected bill.