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Skin cancer

Diagnosing skin cancer

Diagnosing skin cancer usually begins with a visual examination. The Skin Cancer Foundation and the American Cancer Society recommend monthly self-examinations and annual doctor visits to screen for potential skin cancer. If a suspicious spot is found, your doctor will first examine the area, noting its size, shape, color and texture, as well as any bleeding or scaling. Your doctor may also examine nearby lymph nodes to see whether they are enlarged. If you are being seen by a primary care physician, you may be referred to a dermatologist who can perform more specialized tests and make a diagnosis.

A dermatologist may use a special microscope or magnifying lens to examine the suspicious spot more closely, a process called dermatoscopy. In many cases, the skin cancer is removed in the dermatologist's office. If a dermatologist determines the skin cancer is melanoma or Merkel cell carcinoma, more aggressive treatment may be required.

The two most common types of tests used in diagnosing skin cancer are biopsies and imaging tests.

Biopsy

In many cases, your doctor will remove the whole growth. During this procedure, your doctor will numb the area before removing a tissue sample.

There are several different biopsy methods, but an excisional biopsy in which the doctor removes the entire growth is often sufficient to treat the skin cancer.

Other types of biopsies include a shave biopsy, in which your doctor shaves off the top layers of the lesion, and a punch biopsy, in which the doctor uses a special tool to cut a tiny round piece of the tumor, including deeper layers of the skin.

Your doctor may also take a biopsy of any suspicious lymph nodes to see if they contain cancer cells.

Imaging tests

Most skin cancers—especially basal cell carcinoma, the most common form of skin cancer—remain local and do not spread to distant organs. Melanoma and Merkel cell carcinoma are more prone to spread. In those cases, one of several medical imaging procedures may be used to determine whether cancer cells have metastasized to internal organs and bones. Imaging procedures include:

These imaging procedures are non-invasive and painless. If they reveal suspicious spots or metastases, a more invasive biopsy may be required.