Do I Have Skin Cancer? Find Out if You’re at Risk

January 23, 2019

Woman checking for skin cancer

Skin cancer comes in many shapes, colors, sizes, and varieties. To best manage your risk for certain skin cancers, you need to know how high your risk is. One way to do this is to determine where you fall on a skin type grading system known as the Fitzpatrick Scale. Keep reading to learn more about how dermatologists determine their patients’ risk levels for skin cancers and about what you can do to decrease your risk.

Ask the Expert – Dr. Russell Peckham

According to Dr. Russell Peckham from U.S. Dermatology Partners of Cedar Park, “I may be able to make a determination prior to biopsy about whether or not a person has skin cancer based on their reported symptoms.” According to Dr. Peckham:

What I hear from patients that often turn out to be harmless growths:

  • I have this rough itchy spot
  • I have a fleshy mole
  • I scratch this spot, is it going to turn into skin cancer?
  • This flat skin growth is now raised and itchy

What I hear from patients that may turn out to be skin cancer:

  • I have a rough, tender spot that feels like a splinter
  • This spot on my nose bleeds occasionally
  • This mole has been getting bigger and darker
  • This spot looks like a pimple, but it’s been there for months

Dr. Peckham went on to emphasize that this is by no means an official diagnosis tool, but it does help him to determine where to begin his analysis. In order to know for sure whether or not you’re dealing with skin cancer, Dr. Peckham encourages patients to reach out to a trained dermatologist for help. Even if it’s nothing, it’s always better to know for sure.

Let’s Take a Quiz!

Did you know that there’s a scale created by a Harvard Medical School Chairman, Thomas Fitzpatrick, to help you and your dermatologist determine your risk for a variety of different skin conditions, including skin cancer? This assessment tool is aptly named the Fitzpatrick Scale. In order to determine where you fall within the Fitzpatrick Scale, simply answer the following questions:

  1. What is your eye color?
    1. Light blue, gray, or green – 0 points
    2. Deep blue, gray, or green – 1 point
    3. Hazel or light brown – 2 points
    4. Dark brown – 3 points
    5. Brownish black – 4 points
  2. What is your natural hair color?
    1. Red or light blond – 0 points
    2. Blonde – 1 point
    3. Dark blonde or light brown – 2 points
    4. Dark brown – 3 points
    5. Black – 4 points
  3. What is your natural skin tone?
    1. Ivory white – 0 points
    2. Fair or pale – 1 point
    3. Fair to golden – 2 points
    4. Olive or light brown – 3 points
    5. Dark brown or black – 4 points
  4. How many freckles do you have?
    1. Many all over the body – 0 points
    2. Several mainly on the face – 1 point
    3. A few – 2 points
    4. Very few – 3 points
    5. None – 4 points
  5. How does your skin respond to the sun?
    1. Always burns and peels – 0 points
    2. Often burns and peels – 1 point
    3. Burns moderately (typically without peeling) – 2 points
    4. Burns rarely and mildly – 3 points
    5. Never burns – 4 points
  6. Do you tan?
    1. Never – 0 points
    2. Seldom – 1 point
    3. Sometimes – 2 points
    4. Often – 3 points
    5. Always 4 – points
  7. How deep is your tan?
    1. Not at all – 0 points
    2. Light tan (usually after burning) – 1 point
    3. Moderately (usually without burning) – 2 points
    4. Deeply – 3 points
    5. My skin is naturally dark – 4 points
  8. How sensitive is your face to the sun?
    1. Very sensitive (I wear hats and sunblock daily) – 0 points
    2. Sensitive (My cheeks and the bridge of my nose burn easily) – 1 point
    3. Average (Extended exposure may cause burning) – 2 points
    4. Resistant (My face tans or maintains coloring) – 3 points
    5. Very resistant (No issues with face burning) – 4 points

What Your Points Tells Us about Your Skin

How many points did you get? Using that total, find your skin type in the following sections. This will help you to understand where you fall on the Fitzpatrick Scale and how that impacts your risk for skin cancers.

Skin Type 1

If you got 0 to 6 points total, you are at the greatest risk for skin damage, including basal and squamous cell carcinomas and melanoma. Make sure you’re covering your skin with umbrellas, protective clothing, sunglasses, hats, and other shade items as much as possible. You should use a broad-spectrum sunscreen every day, and you need to reapply your sunscreen every half hour when in direct sunlight. Check your skin for changes or new bumps from head to toe each month. Alert your dermatologist right away if you notice any signs of concern. You should schedule a professional exam at least once a year.

Skin Type 2

If you got 7 to 12 points total, you are still at high risk for skin damage and basal and squamous cell carcinomas. You are also at risk for melanoma but less than those who fall within the first skin type. You should still limit sun exposure as much as possible and check your skin for changes once a month. Alert your dermatologist right away if you notice any signs of concern. You should schedule a professional exam at least once a year.

Skin Type 3

If you got 13 to 18 points total, you are still at risk for skin damage, basal and squamous cell carcinomas, and melanoma, but you are at significantly diminished risk compared with those in the first two skin types. You should avoid sunlight or protect your skin on very hot days and at the peak sunlight hours between 10 am and 4 pm. Check your skin from top to toe each month and alert a dermatologist of any changes in your skin’s color or texture as well as new lumps or bumps. Consider scheduling an appointment with a dermatologist for a screening annually if you have a family history of skin cancer or have been regularly exposed to direct sunlight.

Skin Type 4

If you got 19 to 24 points total, you are still at moderate risk for skin damage, basal and squamous cell carcinomas, and melanoma. However, you are less likely to experience these conditions than those in the above categories. You should avoid sunlight or protect your skin on very hot days and at the peak sunlight hours between 10 am and 4 pm. Check your skin from top to toe each month and alert a dermatologist of any changes in your skin’s color or texture as well as new lumps or bumps. Consider scheduling an appointment with a dermatologist for a screening annually if you have a family history of skin cancer or have been regularly exposed to direct sunlight.

Skin Type 5

If you got 25 to 30 points total, you are at minimal risk for skin damage, basal and squamous cell carcinomas, and melanoma. You are at higher risk for one of the rarer forms of skin cancer, acral lentiginous melanoma. This form of skin cancer often appears on body parts that aren’t typically exposed to the sun, and acral lentiginous melanoma may go undiagnosed until after spreading to other parts of the body. You should avoid sunlight or protect your skin on very hot days and at the peak sunlight hours between 10 am and 4 pm. Check your skin from top to toe each month and alert a dermatologist of any changes in your skin’s color or texture as well as new lumps or bumps. Pay special attention to changes to the palms, soles of feet, and mucous membranes. Consider scheduling an appointment with a dermatologist for a screening annually if you have a family history of skin cancer or have been regularly exposed to direct sunlight.

Skin Type 5+

If you got 31 points or more total, you are at a very minimal risk for skin damage, basal and squamous cell carcinomas, and melanoma. You are also at an increased risk for acral lentiginous melanoma. This form of skin cancer often appears on body parts that aren’t typically exposed to the sun, and acral lentiginous melanoma may go undiagnosed until after it has spread to other parts of the body. You should avoid sunlight or protect your skin on very hot days and at the peak sunlight hours between 10 am and 4 pm. Check your skin from top to toe each month and alert a dermatologist of any changes in your skin’s color or texture as well as new lumps or bumps. Pay special attention to changes to the palms, soles of feet, and mucous membranes. Consider scheduling an appointment with a dermatologist for a screening annually if you have a family history of skin cancer or have been regularly exposed to direct sunlight.

Work with U.S. Dermatology Partners

Dr. Peckham is one of the many skilled dermatologists who are part of the U.S. Dermatology Partners network of specialists. If you want to work with one of our dedicated professionals, complete our simple online appointment request form. A U.S. Dermatology Partners team in your community will be in touch soon to schedule your appointment time and discuss your treatment options.

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