After spending a few days in the sun without sunblock I noticed a smaller mole on my face became elevated and is now kind of sore to touch. I suppose it could be a pimple but I’d rather be safe than sorry and have it and some of my other moles inspected by a dermatologist.
I’ve never been to a dermatologist for a mole check so I haven’t a clue what to expect. I also have a few moles around my body that I’d like looked at. Is there some kind of a per-mole inspection fee? Are they likely to do a biopsy of several moles? How does a mole biopsy work in the first place? Or are they more likely just to remove them, and if so, is such a procedure typically covered by insurance (or is it considered cosmetic if they don’t test it for being cancerous first)? Many questions, I know.
Disclaimer: I know not to solicit medical advice here, so I’m not… I’m just asking what to expect since I already plan on going to the doctor.
As long as nothing appears to be wrong, the check is extremely fast but you will have to strip. Each normal mole only takes a few seconds to be evaluated. It is almost always covered by insurance. Melanoma is one of the deadliest forms of cancer and the chance of it has to be taken very seriously. The rest of it depends on what the dermatologist finds. A minor biopsy is just done by local anesthetic and a quick swipe by an instrument for removal and the mole is sent off to the lab. That doesn’t take very long either. A more complex procedure involves minor surgery under local anesthetic, deep removal and stitches. I have had all of these things done and they aren’t bad at all. There is cosmetic mole removal that insurance may not pay for but your dermatologist will have to determine that for you. Mole identification is pretty difficult and it takes a specialist to do it correctly and thoroughly.
Expect a complete skin inspection for one low, low visit fee. (well; maybe not low, but definitely the complete skin inspection part). It is not a per mole fee.
Expect the doctor to be on your side getting anything categorized as coverable by insurance. It is to her advantage to do so, usually.
Expect a recommendation for an excisional biopsy for every mole that is suspicious (i.e. a removal of the entire lesion). This might include its current appearance, or any new changes in an existing lesion. Expect a recommendation to return for further evaluation if the biopsy is suspicious for serious types of cancer such as melanoma.
Expect a diagnosis of infection if the change is new tenderness. Skin cancers are not typically painful.
The method of removal is highly dependent on the suspicion for what sort of lesion it might be.
Typo Knig will doubtless pop in at some point but I can answer a couple of your questions.
You’ll pay for an office visit (or your insurance will). The doc will look at the various moles and decide if any look suspicious. If so, he’ll numb the area and excise the mole (probably with something like a paper punch, I know the term is “punch biopsy”) and send it off for pathology. That is certainly covered by insurance, even if the biopsy comes back negative. The removal / biopsy is how they test it for being cancerous.
If it does come back as Bad Things, they’ll possibly schedule a second visit so they can take a bit more of your hide to make sure they have clear margins.
Oddly - there was one time where the doc wanted to take more than 2 moles at a visit, but made my husband come back for #3 and #4 in a separate visit. Something about insurance being fussy about paying for more than 2 per day. Weird.
The office visit bill may be higher if he takes moles than if he just has a look-see and says everything’s fine. And of course there’ll be the lab fees for looking at the sample.
It’s quick and pretty easy, but be prepared to fully expose your naked body, including genitalia. Any removals of moles will hurt not much and not for long.
Punch biopsy is one way. I have also had a shave-biopsy, in which they scrape off the top layer of the mole for analysis. However they choose to sample the mole, the lab results will likely take a week or so. If it’s found to be suspicious, they’ll call you back in to remove the rest of the mole plus a safety margin. I suspect the same is true for a punch biopsy, unless the punch goes full depth and includes a safety margin around the perimeter of the mole.
I’ve also had a full-depth removal of a somewhat larger mole. Rather than excising a round patch of skin, they take a “football”-shaped piece so that they can cleanly stitch the two sides back together without causing a major skin wrinkle/pucker.
Others are right, they’ll check your whole body out in one visit: feet, hands, crotch, scalp, back, anywhere you’ve got skin. You may find yourself surprised at which ones they are and are not concerned about. In any event, it’s a good idea to go for these checks on a regular basis (perhaps at an annual physical?), especially if you’ve got a family history of skin cancer.
There’s not much for me to add, really. Here are links to a recent [thread=528568]thread[/thread] and a not-so-recent [thread=507754]thread (Feb. 2009)[/thread] about this same topic.
Please don’t be put off by anything you read in the other threads. Please do have any suspicious mole checked by a pro. It’s much better to have these problems dealt with when they are small.
Anecdote: My bad mole in January 2005 was melanoma. At my most recent visit with the dermatologist earlier this month (I see him every 6 months now that I have a history), I asked him about the removal of that bad mole. He said “you’re not in remission, you’re cured!” (emphasis his) I asked him where I’d be if I had not had the mole removed, and he said I would have metastatic disease with a 3-5 year life expectancy. :eek: My guess is those would not be 3-5 good years.
I was at my docs for a routine checkup, and he noticed a black spot just above my shoulder blade - a part of my body I don’t often see. He sent me off to the dermatologist, and they did a punch biopsy. A week later it came back as superficial melanoma - at a stage so early that it is no worse that basal cell carcinoma. Treatment is the same: chop it out and follow up for a full body check every year. So far the worst side effect is making it more difficult to renew my life insurance.
I had a mole on my shoulder done last year. The doc did a punch biopsy (and got the whole thing in one go) and it came back pre-cancerous. Now we do a full-body check every six months.
I’ve seen a dermatologist (same one) a few times to check out a mole. In each occasions I waited a while in the waiting room, and the actual time with the doctor was really quite short, no more than 5 minutes. The doctor quickly assessed the benign nature of the moles and removed them pronto. Then he sent me a big bill. So I learned first hand why dermatology is such a desirable area of specialization!
Okay, I have been to dermatologist 4 times in the past two years. I had my first skin check done in 2013. I was told to strip to my underwear and cover my lap with a drape. I told the nurse it is easier for me just to be naked and cover myself with the lap drape. The drape and the underwear come off anyway.
The doctor came in, a female dermatologist. She started examining my scalp, neck and face and arms. She examined me very closely. I then stood up with the drape over my lap. She examined my back and butt carefully. Then she examined my chest. I then was asked to drop the drape. She examined my penis and testicles and legs carefully. The doctor found some cysts in my scrotum, which she lance with a small needle. I had a suspicious area next to my penis which she biopsied and sutured. I then sat on the table and covered my lap again with the drape. She found a marble sized growth in my right elbow. She cut out a marble sized piece of tissue. Before she did the two biopsies, she did numb the areas up with lidocaine, so it was not painful. She also froze off about 8 small precancers with liquid nitrogen. The biopsy on my leg turned out to be nothing. The elbow actually was squamous cell cancer. I was glad to get the cancer off of my body. It was worth a moment moments of embarrassment t0 be cancer free. I see her once a year now. Get a skin check done. It will save your life.
Good advice even if it is a few years after the OP. I hope your dermo did a Moh’s procedure on your elbow. A squamous-cell that large would be at considerable risk for growing deeper roots.
Are they likely to do a biopsy of several moles? How does a mole biopsy work in the first place? Or are they more likely just to remove them, and if so, is such a procedure typically covered by insurance (or is it considered cosmetic if they don’t test it for being cancerous first)? Many questions, I know.
I asked him where I’d be if I had not had the mole removed, and he said I would have metastatic disease with a 3-5 year life expectancy. :eek: My guess is those would not be 3-5 good years. 