If you are concerned about a mole or skin lesion it is important to seek medical advice as soon as possible. This information aims to guide you through the process of confidently taking action with concerns, the options available to you and the referral process for the various types of suspected skin cancer.
If you are concerned about a lesion or mole then you should get them checked as soon as possible. You should first make an appointment to see your GP who may ask you to send in a photograph first. When you see your GP, they will examine the lesion or mole of concern and if needed, refer you to a skin specialist called a dermatologist for professional clinical assessment. Alternatively you may wish to have concerns checked privately by a consultant dermatologist.
Skcin recommend when making your appointment to ask if there is a doctor at your practice that has a specialist interest in skin cancer. Some GPs have more knowledge about skin cancer than other GPs who may have had very little training in this subject.
Most GPs with a specialist interest in skin cancer will be trained to use a dermatoscope – a hand-held instrument, a bit like a magnifying glass that is used to examine the area very closely. This does not hurt or affect your skin.
Your doctor should be familiar with your medical history, but during your appointment they may talk to you about your history of sun exposure and if you have a family history of skin cancer to help them determine your level of risk. If you have used the Skcin app to generate your personalised risk assessment, you can show it to your doctor to help communicate that.
If you have taken photographs of your lesion or mole you should show them to your doctor along with any notes you have made with regards to dates, sizes and changes in appearance or sensation to help communicate and validate your concerns.
It is important that you feel satisfied with the outcome of your GP appointment. Unfortunately many GPs have very little training in dermatology, so it is not uncommon for skin cancers, including melanoma (the most serious form) to be misdiagnosed.
To help you assess your level of satisfaction based on the outcome of your appointment, it’s useful to understand the referral process that your GP may use to determine whether or not you should be referred to a dermatologist for clinical assessment. This process is outlined below using the weighted 7-point check list.
If you decide that you are not happy with the outcome of your appointment, you should either; make another appointment to discuss your concerns further; ask to see a different doctor for a second opinion; or consider booking a private consultation with a dermatologist. If changes to a lesion or mole persist, so should you!
When making referral decisions, your doctor may use the weighted 7-point checklist, which is recommended by NICE (National Institute for Health and Care Excellence) for routine use in UK general practice, as follows:
All suspicious pigmented skin lesions that score 3 points or more using this checklist should be referred urgently (within 2 weeks) to a dermatologist for professional clinical assessment.
MAJOR FEATURES OF THE LESION (2 points each):
MINOR FEATURES OF THE LESION (1 point each):
Patients should also be referred urgently (within 2 weeks) if dermoscopy suggests melanoma skin cancer and if a pigmented or non-pigmented skin lesion is suggestive of nodular melanoma or other forms of rarer skin cancers.
Your GP should also refer you if you are taking medicines or have a medical condition that lowers your immune system.
Squamous Cell Carcinoma (SCC)
If a SCC is suspected, an urgent cancer pathway referral (for an appointment within 2 weeks) should be made by you GP.
Basal Cell Carcinoma (BCC)
If a BCC is suspected a routine referral (non-urgent referral) should be made, unless your doctor is particularly concerned that a delay in treatment may have a significant impact due to factors such as lesion size or location – for example larger lesions on the face or close to the eye.
Despite this guidance, please be aware that in the UK there is a huge shortage of dermatologists who are under a great deal of pressure to cope with increasing numbers of NHS referrals. If you are experiencing delays, or want to see a specialist sooner, you may wish to consider booking a private consultation. Due to demand, booking a private consultation with dermatology services local to you, may or may not decrease your waiting time, so you would need to research this before making a decision.
Please note: In England an urgent referral means that you should see a specialist within 2 weeks. However this 2 week time frame does not form part of the waiting times for Scotland, Wales and Northern Ireland. Wherever you live, you are seen as quickly as possible and you should ask your GP when you are likely to get an appointment.
For further information on the various forms of skin cancer and diagnosis go to: Skin Cancer Types, Signs and Symptoms
Install the Skcin app on your mobile device to access all the tools and resources you need to confidently perform full-body skin examinations, set monthly reminders, and track lesions for signs of change using close-up photography.
The Skcin app is a comprehensive, educational, and self-management tool dedicated to the prevention and early detection of skin cancer. The app comprises six key service areas to help you learn more and take charge of your skin health and surveillance.
