Skin cancers – especially melanoma – can occur anywhere on your skin.  Since skin cancers are the most common cancer of all cancers and we don’t require fancy imaging such as CTs, MRIs or PET scans to pick them up – skin self-checks should become a monthly habit. 

Did you know that your nails are also areas of skin that can potentially get melanomas?

Melanomas do not always occur in sun exposed areas, the sun protected groin area is also at risk. While melanoma makes up only a small part, it is the one that causes the most deaths.  The upside: it can be detected early; there is a 99% chance of a 5-year survival rate for melanomas that are detected early.  So please examine your skin regularly, even those areas that are difficult to visualize. Here are some tips for those hard-to-reach spots.

Scalp

Don’t forget that about 4% of your skin is on your scalp.  Although it is usually protected by the hair, this part of skin is exposed to the sun a lot. Approximately 13 percent of skin cancers are found on the scalp.  Of melanomas, about 3-5 percent occur on the scalp.  Have a feel through your hair for any scabs or bumps on the scalp.  Get close to the mirror and have a good look at the hairline, you might want to ask a friend for help to have a good look at the scalp. You could also mention at your next hairdresser appointment to have a quick look at the scalp.  At your annual skin check your dermatologist will have a good look at your scalp.

The Feet

Did you put sunscreen on your feet this summer?

The top of our feet gets exposed to a lot of sun, especially during flipflop weather.  Cumulative sun exposure puts this area at risk of developing skin cancers.  When last did you have a look under your feet or between your toes?  Legendary reggae artist Bob Marley died at age 36 of a rare, fast-growing skin cancer called acral lentiginous melanoma (ALM) that started under his toenail. ALM is the most common type of melanoma in people with dark skin and those of Asian descent. However, it may occur in people of all skin colors.

Nails

A dark (or even red) line growing in your nail might be a sign of a melanoma.  The nail matrix is an area under your proximal nail fold that produces new nails, the ‘nail factory’.  This area can also develop a melanoma and you can see it as a new dark line in your nail. Dark lines in the nail are not always a sign of cancer, worrying signs would include:

– If the dark pigmented area is a large part of your nail

– If the nail is crumbling or splitting

– If the nail pigment moves onto the skin surrounding the nail

Lips

The lips, especially the lower lip gets a lot of sun exposure.  The lips also have no pigment to protect the DNA from the harmful rays of the sun. If you notice a sore on the lip that doesn’t want to heal in 1 months’ time, rather have it seen to. Precancerous lesions on the lower lip looks like white plaques, at this stage it can already be pre-emptively managed by your dermatologist.  Smoking is another risk factor for the development of lip cancers.

Groin

But this area never sees the sun?

Can I still get a skin cancer there?

Melanoma can occur in sun protected and sun exposed skin. It is common to have moles in the groin area, these moles also need to be monitored.  A handheld mirror might be the easiest tool to review this area. 

What am I looking for?

Just a quick reminder of what to look out for – remember ABCDE

Asymmetry: Are two sides of your mole different?

Border: Is the border irregular or jagged? Bleeding spots?

Colour: Is the mole one colour or varied throughout? A melanoma may be black, tan, brown, white, red, blue, or a combination of any.

Diameter: Is the mole over 6mm? This is common for a melanoma, but they can be smaller. 

Evolving: Have you noticed changes in the mole over time, such as size, shape, or color?

The most common areas to potentially get a melanoma still remains the back (in men) and the legs (in women).  But let’s not forget the hidden spots.  Vigilant monthly self-checking might literally save your life!.