My first dermatology appointment...at last. [Archive]

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Taucher

25-07-13, 14:20

So, Tuesday morning I had my first appointment at hospital with dermatologists. I first saw a skin cancer specialist nurse who looked at pretty much all my moles. She used a dermascope. She told me that all my moles look fine. Even the weird ones I pointed out to her that I was really worried about.

She then bought in a consultant dermatologist who looked me over, stared at some of my stranger moles, and said I shouldn't worry. She said that it's possible that the mole on my inside thigh was atypical but she doesnt think that any other of my moles are atypical. I showed her my newest mole on the palm of my hand and she said it "could" be a wart.

The skin nurse then asked me why I was anxious and maybe I should see my doctor for anxiety. She took a picture of, and measured, the weird mole on my inside thigh, near my groin. When I asked her why she took a picture of that one she said "because of where it is".

My worries are: -

1) They didnt remove a single mole! Pretty much everyone I speak to who goes to see a derm has at least one mole removed. And I have a lot of moles that I think are pretty weird. And they dont want to remove the possible (I think definite) atypical mole from my inside thigh?! So why take a picture? I have friends with much darker skin who have had moles removed. And when I saw 3 different doctors about my 2 bleeding moles (last week), 2 of them said that the derm will probably remove them as they will continue being irritated.

2) I was told that I am high risk for skin cancer (I knew that). My skin is skin type 1 (never tans, always burns). The derm. told me that my skin is the same as 1/5 of the population (which I dont believe).

3) I was expecting them to say I can come and see them every 6 months or even every year. But I was told that they don't do that. The best person for checking my skin is me, they said. Which I don't believe. So they said if I notice any changes to see the doctor and get a 2 week referral.

4) I asked the derm is, even with my moles and my VERY pale skin, I will statistically PROBABLY not get skin cancer, she said "I cant tell you that". Sigh.

So I left feeling sort of re-assured but sort of not. And now my anxiety is back (not QUITE as bad as before). So I dont have skin cancer now, but I am worried I might develop it. I promised the derm that I would not look at a single mole for 2 weeks. And then every six weeks.

Sorry about the length of this post. Anyone got any similar experiences?

joelhall

25-07-13, 14:37

1. If there's anything which might have to be tracked, removal would defeat the object. Possible suspect moles have to be tracked to spot morphologic changes. There's often little point removing benign moles, unless they pose an infection risk. You can always seek a second opinion reagrding the bleeding moles.
2. Skin typing reflects the reaction to UV radiation,so you obviously need to take precautions in the sun light.
3. Routine specialist appointments are a real pain to get now, so many non-urgent cases are managed by patients and GPs.
4. It's pretty much impossible for someone to give you the odds of an individual getting cancers, as there are so many variables.

Munchlet

25-07-13, 22:16

Hi

Just wanted to post because I have skin cancer as one of my main fears and my reasons are , very fair skinned, always burn, tons and tons of freckles, used loads of sunbeds when I was young and stupid enough to not know the dangers and I have a few darker freckles and one quite large mole.

My doctor works at the dermatology clinic and I recently saw him about some of my moles/freckles which were worrying me.

He looked at them all with a dermascope and said they all look perfectly healthy and to just keep an eye on them, he also said the one I'm worried about is abnormal in terms of size and it's a couple of different colours but he doubts it will ever cause me a problem.

I think with HA our natural reaction is if something concerns us we want it fixed or removed but they don't like cutting lumps out of people for the sake of it.

Having said that years ago I got badly burnt in Tenerife and within a couple of years a black mole with a red ragged border appeared on my chest. I showed it to my same doctor who said it was small and he was happy to leave it but because it was a lot darker than my other moles and it had a red border there was a chanced that in 10-15 years it could become a problem and as I was such a worrier he would remove it for me which he did.

So if they think theres a good chance they will change they do remove them.

I think you can be reassured by the fact that they didn't feel the need to remove any as they obviously aren't concerned. The other thing is that even though you do have skin that statistically is more prone to skin cancer it doesn't mean you will get it and even if you did the odds are it would more than likely be one of the very slow growing ones rather than melanoma because there are far more cases of the others than melanoma.

My doctor also said to me because I raised exactly the same thing about my skin type etc that the most important thing you can do is protect and look after your skin now, you can't change what's done but you can stop anymore damage and just be vigilant.

Try not to worry it sounds like you are fine.

take care

Torskus

25-07-13, 22:34

Skin Cancer is another big worry of mine. I am covered in moles (As is my brother and was my Dad) hard to keep track of them all. Being a worrier I do my very best !

I recently had two moles removed, they were a very strange shape, not round at all, more like splat if that makes sense. I haven't had the results yet (3 weeks later) hoping that is good news.

I am certain if there were any concerns at all they would remove them. Easy for me to say, I understand how you feel, because I have the same feelings, even though I was assessed only a few weeks ago, and had the suspect moles removed, I am still constantly checking my skin for changes.

Good luck for the future,

Taucher

26-07-13, 18:18

Thanks so much for the replies everyone.

joelhall -
Ok thanks for explaining (first 3 points) - I guess that I have to track my possible atypical mole though, as I have no follow up derm appointments. On the last point, I understand that it is impossible to give odds on catching cancer, I just feel like I am definitely going to get it one day, like it's inevitable. I was trying to find out from them if people with my skin type often live to old age without ANY type of Skin cancer.

Munchlet -
Thanks for sharing. It's nice to hear that your experience was remarkably similar to mine. I like the way your dermatologist explained it to you though. Mine was ok - I dont doubt that she is right, but some doctors dont feel so much need to explain, and I think because she was giving me the all-clear, she thought that would be enough for me. But it wasn't quite enough for my HA. But yes, I was expecting to have a couple of moles removed. And if I am SO high risk for skin cancer, why not just do it. I overheard them saying that they had 5 biopsys to do that day, so they DO do them. But yes, she said they dont take moles out for no reason. But saying something is fine and then photographing it and measuring it is not the MOST reassuring thing ever!

Torskus-
Yes it's hard not to worry. I am trying not to look at ANY moles for two weeks, but I hate some of them - I just wanted them gone. My most suspect mole is a 'splat' and it is almost touching another quite large mole next to it. They have both been looked at by a doctor (who said it was "so benign"), a skin cancer nurse and the dermatologist, so I cant really worry about it too much. It is even colour and has a definite border and is kind of symmetrical.
Yes, if they havent told you in 3 weeks that is a massive sign that you had nothing to worry about. I suspect that the vast majority of moles, even really dodgy looking ones, are completely fine.

The skin cancer nurse did say to me that the average age of her patients with skin cancer is 75 and that the majority of them have the less serious skin cancers. I think she was trying to reassure me :)

T

Speranza

26-07-13, 18:36

I used to live in the South of France and people were scarily complacent about their skin cancers (the Brits that is), saying, "Oh, that onewill need removing in a few months." We always used Factor 50 sunscreen but many people didn't bother. ONe really silly woman used olive oil.

My point being, even then I didn't know anybody who died of it, although one woman was pretty near a disaster with one of her cancers because it was on her face so she left it until after her daughter's wedding so she would look good in the photos. She almost left it too late, she was complacent having had several minor surgeries. I doubt she will ever be so foolish again.

You don't sound anything like silly enough to let yourself become ill.

backfromthebrink

26-07-13, 22:09

I have a lot of experience with this kind of thing, as I have a LOT of atypical moles which it would be impossible to remove all of, even if that were the best thing, because I'd look like a battle field. (There was a time when I asked about doing just that, as I wouldn't be able to be anxious about them if they'd been removed.) It's normal for them not to remove moles unless they are worried.

A few years ago I was referred to a dermatologist who did remove 2 of them they were worried about - the most atypical ones - and they came back fine after biopsy. No one is worried about any of the others.

They have sent me for photos, so I can compare the photos to my body and see if any change - but it is hard to look at photos mole by mole, because I have so many and because many are on my back. Whenever I tell them this, they say to ask my husband to look - but he is reluctant to assume this responsibility and says he can't tell.

The NHS used to let me go annually for a check up, and that was very reassuring to have the dermatologist cast an eye over me - it takes more than a year for them to develop into anything nasty and I was reassured anything would be picked up like that. But due to NHS cut backs, a few years ago they told me they would no longer do this and instead I'd have to go to my GP if I was worried and get a referral.

I can just never tell if they are changing or not, so I went to my GP this year and of course, with atypical moles, I got a referral to dermatology - and the dermatologist made me feel like I shouldn't be there and everything was fine and I was worrying unnecessarily.

I don't think they realise how hard it is is to keep track of changes in moles if you have many of them, which are already weird shapes and sizes. The 'normal' pieces of advice you're given for what to look out for just don't apply or you'd be worried about them all, all the time. You need someone to cast an eye over them regularly who knows what they're looking for. Even a GP doesn't know (mine doesn't) so I think a regular check up with a dermatologist should still be offered. It takes about 5 minutes, and it saves going to see the GP first and paperwork/referral letters.

Munchlet

27-07-13, 11:40

Hi Taucher

I think the photos is fairly standard if you are referred to dermatology, it's just so they can keep a record of the mole and if you end up being referred again they have something to compare to.

The other thing is my understanding is that the dermascope allows them to look very closely at moles and if anything looked remotely suspicious they would remove it. The photographing and measuring is more for records than concern.

I don't know if you know but if you are unduly worried Superdrug offer a mole clinic where you can go along and have moles checked. They do charge for it, I think it's £30 to check a single mole or £95 to check every mole. I know it seems unreasonable to have to pay for something that the NHS should offer but for those of us with HA it is sometimes worth paying for piece of mind.

I don't go myself but know of people that do pay for it annually just for piece of mind.

joelhall

27-07-13, 13:47

princesszelda

27-07-13, 19:29

I live in Los Angeles...where the sun shines all the time, and I am the same skin type as you. :(

My GP actually does a quick mole check every year during my regular physical just to check. She has also advised me to take a look as well. Once a year is less than every 6 months, but it isn't too bad.

I also have trouble accepting the doctors word when they say nothing is wrong. :( I wish I had better advice on this. It sounds like you take care and keep watching things, which leads me to believe that if something was wrong, you would notice. :) I am glad you take care of yourself. :)

I have gotten a couple of bad sun burns so I get this fear sometimes. :(

backfromthebrink

27-07-13, 19:59

I forgot to add - where I live there is a charity which offers free mole clinics. It is staffed by GPs but they have a dermatologist circulating who the GPs call over for a 2nd opinion on any moles they're not sure about. It is totally free. The last one they offered, there were queues out the door for it. There is obviously huge demand for this kind of thing. It's the same for the CRY cardiac clinics - any sort of preventative health care offered seems to have huge take-up. Perhaps the NHS should learn from that…if only the current govt weren't ruining it..!

Taucher

28-07-13, 22:53

Thanks again everyone. I would have replied earlier but I have broadband issues!

backfromthebrink - I agree that it's quite daunting to be told to keep an eye on your own moles, exactly like my dermatologist told me. I know it's normal for them not to remove moles if they are not worried about them, but mine get irritated. Also, I wish they had explained a little bit more about WHY they weren't worried. I mean, I have a new mole on the palm of my hand. It's small and even and seems to have stopped growing, but the derm looked at it and said "it's nothing, might be a wart". Well, it doesnt look like a wart, and shouldn't she have looked so she could be sure? Gah! And like you, my other half is not that keen to look at my hard to reach moles. And I STILL cant believe that not a SINGLE ONE of my moles warranted removal. And thanks for the info re: free charity mole clinics. Will definitly look into that.

Munchlet - Is the Superdrug mole check any good? I'm not sure how much I would trust them, although I may use them while I wait for a 2 week emergency referral in the future, if I ever get one.

joelhall - thanks for the info. Very reassuring. And your other post re: skin cancer.

princesszelda - It's good that your doctor checks every year. It sounds like they are confident to do that. This was my first ever dermatology appointment and I am 34 and skin type 1; no doctor has ever mentioned it to me before, anything about moles or checking. Although I have always been pretty careful in the sun. Got my neck badly burnt when I was young and go a bit pink every year, despite using factor 50 and staying out of the sun etc.

The other thing that I would like some response about (either reassuring noises or gasps of horror!) is that, despite being skin type 1 and neurotic about the sun, I have married a lovely girl from South America. So, for the last 2 years I have spent 3 weeks (each year) high up in the Andes where the UV factor is 11+ (I know, sigh). Now, I have used factor 50, avoided the sun AND covered up both times I was there. Went a little bit pink anyway (on the face and neck) but nothing really bad. Do you think it would be advisable to never go again? Is it damaging me even if I manage to not get burnt? I mean, despite the high UV rate the temp is 13 - 18 degrees so easy to cover up and also there is thick thick cloud for at least half the time I am there! But is it really possible to protect myself from sun THAT strong?

T

Munchlet

29-07-13, 09:05

Hi

I've never used it myself but a couple of my friends have and are completely reassured by it, they go annually.

I believe it's operated in the same way as an NHS dermatology clinic would be and they map and check all your moles.

If you google it it tells you all about it :)