Category: Kimball

A monthly self-skin check is one of the simplest things you can do to catch skin cancer early, and it takes about 10 minutes. You stand in front of a mirror, examine your skin from head to toe, and look for anything new, changing, or unusual. That’s it. No special equipment required. The reason this matters is straightforward: skin cancer is the most common cancer in the United States, affecting one in five Americans in their lifetime according to the American Academy of Dermatology. When caught early, most skin cancers are highly treatable. When caught late, treatment becomes more complex and outcomes get worse. The gap between early and late detection often comes down to whether someone was paying attention. A self-skin check fills the months between your annual professional skin exams and gives you a baseline understanding of your own skin, so when something does change, you notice. At Chattanooga Skin and Cancer Clinic, our board-certified dermatologists encourage every patient to build this habit. Here’s how to do it well.

What Do You Need for a Self-Skin Check?

You need a well-lit room, a full-length mirror, and a hand mirror. Good lighting is non-negotiable because shadows and dim light make it easy to miss subtle changes. Natural daylight or a bright overhead bathroom light works best. The hand mirror is for areas you can’t see directly: your back, the backs of your legs, your scalp, and behind your ears.

If you have a partner or close friend who’s willing to help, an extra set of eyes on your back and scalp makes the process more thorough. A smartphone camera can also be useful for photographing spots you want to track over time. If you notice a mole that looks a little off but you’re not sure if it’s changed, snap a photo with something for scale (a coin or ruler next to it) and compare it at your next monthly check.

What Is the Best Way to Examine Your Skin Head to Toe?

Start at the top and work your way down. Consistency matters more than speed. If you follow the same routine each time, you’re less likely to skip areas.

Begin with your face. Look at your nose, lips, mouth, ears (front and back), and around your eyes. Use the hand mirror to check behind your ears and along your hairline. Then move to your scalp. Part your hair in sections and look at the skin underneath. A blow dryer on a cool setting can help move hair out of the way. Scalp skin cancers are easy to miss because they hide under hair, so take your time here.

Next, examine your neck, chest, and torso. Women should check under the breasts. Raise your arms and look at your underarms and the sides of your torso. Then check both arms: upper arms, forearms, the tops and palms of your hands, between your fingers, and under your fingernails. Melanoma can develop under nails, appearing as a dark streak or band.

Sit down to check your legs. Look at the fronts and backs of your thighs, shins, ankles, the tops of your feet, the soles of your feet, and between your toes. Then use the hand mirror to examine your back, buttocks, and the backs of your legs. If a partner is helping, this is where they’re most useful.

What Are the ABCDEs of Melanoma?

The ABCDE system is a straightforward framework dermatologists use to evaluate moles and pigmented spots. It stands for Asymmetry, Border, Color, Diameter, and Evolution. Not every melanoma hits all five criteria, but any one of them is reason enough to get a spot checked.

Asymmetry means one half of the mole doesn’t match the other. If you drew a line down the middle, the two sides would look different in shape or size. Border refers to the edges of the mole. Melanomas often have ragged, notched, or blurred borders, while benign moles tend to have smooth, even edges. Color is about variation within a single spot. A mole with multiple shades of brown, black, red, white, or blue is more concerning than one that’s a uniform color throughout.

Diameter refers to size. The traditional guideline is to pay attention to moles larger than 6 millimeters, about the size of a pencil eraser. That said, melanomas can be smaller than 6mm when first detected, so size alone isn’t a reason to dismiss a spot. Evolution is the most important of the five. Any mole that is changing in size, shape, color, or texture, or any new spot that looks different from your other moles, deserves a closer look from a dermatologist.

What Other Changes Should You Watch For?

The ABCDEs apply primarily to melanoma, but non-melanoma skin cancers (basal cell carcinoma and squamous cell carcinoma) have their own warning signs. A sore that won’t heal is one of the most reliable red flags. If you have a spot that scabs over, seems to improve, then opens up again, and this cycle repeats for more than three to four weeks, get it evaluated.

Other things to watch for include a pearly or waxy bump (common in basal cell carcinoma), a flat flesh-colored or brown scar-like lesion, a firm red nodule, a rough or scaly patch that may bleed or crust, and any growth that’s new and doesn’t look like your other spots. The “ugly duckling” rule is a helpful mental shortcut: if one spot on your body looks noticeably different from everything around it, it’s worth having a professional look.

How Often Should You Do a Self-Skin Check?

Once a month is the standard recommendation. Pick a consistent day that’s easy to remember, like the first of the month, and build it into your routine. The whole process should take about 10 minutes once you’re familiar with it.

Monthly checks are not a replacement for an annual professional skin exam. Your dermatologist has specialized tools like a dermatoscope (a magnifying device with polarized light) and years of training in pattern recognition that you simply can’t replicate at home. Self-checks and professional exams work as a team: you monitor for changes between visits, and your dermatologist provides the clinical evaluation once a year (or more often if you’re at higher risk).

When Should You Call Your Dermatologist About a Spot?

Call sooner rather than later if you notice any of the following: a new mole or growth that appeared recently and looks different from your other spots, a mole that has changed in size, shape, or color, a sore that bleeds and doesn’t heal within three to four weeks, a spot that itches, hurts, or feels tender without an obvious cause, or a dark streak under a fingernail or toenail that you haven’t injured.

I’d rather a patient come in for something that turns out to be nothing than wait six months on something that turns out to be serious. Dermatologists expect these appointments. It’s literally what the job is for. At Chattanooga Skin and Cancer Clinic, you can schedule a skin evaluation at any of our three offices: Chattanooga (423-899-2700), Cleveland (423-479-8648), or Kimball (423-815-9975).

What Are Common Spots That Look Concerning but Are Usually Harmless?

Not everything unusual is skin cancer, and it helps to know what the common impostors look like so you don’t panic every time you spot something new.

Seborrheic keratoses are waxy, raised, brown or tan growths that look almost like they’ve been stuck onto the skin. They’re extremely common after age 40 and completely benign, though they can look alarming if you’ve never seen one before. Cherry angiomas are small, bright red dots caused by clusters of blood vessels near the skin’s surface. They tend to appear on the torso and increase in number with age. Dermatofibromas are firm, small, brownish bumps that often show up on the legs. They’re harmless and usually don’t need treatment.

Even with this list, self-diagnosis is unreliable. If you’re unsure about a spot, the right move is to have a dermatologist take a look. The peace of mind is worth the appointment.

Frequently Asked Questions About Self-Skin Checks

Can I use a smartphone app to check my moles?

Some apps claim to analyze photos of moles for cancer risk, but no app should replace a professional evaluation. Apps can miss cancers and can also flag benign spots as suspicious. Use your phone to photograph spots for your own tracking purposes, but always bring concerns to a dermatologist for a definitive assessment.

What if I have a lot of moles and can’t tell which ones are new?

If you have a high mole count (50 or more), full-body photography can help establish a baseline. Some dermatology practices offer clinical photography services, or you can take your own photos at home. Compare photos month to month to spot new or changing moles more easily.

Where can I get a professional skin exam near Chattanooga?

Chattanooga Skin and Cancer Clinic offers full-body skin exams at all three locations: Chattanooga (6061 Shallowford Road, 423-899-2700), Cleveland (3891 Adkisson Drive, 423-479-8648), and Kimball (400 Dixie Lee Center Rd, 423-815-9975). Appointments are available Monday through Friday.

Mohs micrographic surgery is a precise, layer-by-layer technique for removing skin cancer while preserving as much healthy tissue as possible. It is considered the gold standard treatment for basal cell carcinoma and squamous cell carcinoma, particularly when tumors are located on the face, ears, hands, or other areas where tissue conservation matters. The procedure boasts cure rates up to 99% for primary basal cell carcinomas and up to 97% for primary squamous cell carcinomas, according to the American College of Mohs Surgery. Unlike standard excision, where the surgeon removes the tumor and a wide margin of surrounding skin all at once, Mohs surgery maps and examines each thin layer of tissue in real time. This means the surgeon can confirm that all cancer cells have been removed before closing the wound, reducing the chance of recurrence and minimizing scarring. At Chattanooga Skin and Cancer Clinic, we perform Mohs surgery at our Chattanooga and Cleveland locations, and our board-certified dermatologists have been providing this specialized care to patients across Southeast Tennessee for over 50 years.

How Is Mohs Surgery Different From Standard Skin Cancer Removal?

In a standard excision, the surgeon cuts out the visible tumor along with a buffer zone of healthy-looking skin around it. That tissue is sent to a lab, and results come back days later. If the margins aren’t clear (meaning cancer cells are found at the edges of the removed tissue), you go back for another surgery. It works, but it’s a bit of a guessing game when it comes to how much skin needs to come out.

Mohs flips that process. Instead of removing a wide margin and hoping for the best, the Mohs surgeon removes one thin layer at a time. Each layer is immediately processed, mapped, and examined under a microscope right there in the office. If cancer cells are still present at a specific edge, the surgeon knows exactly where to go back and remove more. If the margins are clear, the procedure is done. No second surgery. No waiting days for lab results.

The practical result is twofold: you get the highest possible cure rate, and you lose the least amount of healthy skin. That second part matters a lot when the cancer is on your nose, eyelid, ear, or lip, where every millimeter of tissue affects both function and appearance.

Who Is a Good Candidate for Mohs Surgery?

Mohs surgery is typically recommended when the stakes of incomplete removal are highest. That includes cancers on the face, scalp, neck, hands, feet, and genitals, where preserving tissue is critical for cosmetic and functional reasons. It’s also the preferred approach for large tumors, tumors with poorly defined borders, aggressive subtypes (like morpheaform basal cell carcinoma or poorly differentiated squamous cell carcinoma), and cancers that have come back after previous treatment.

Patients with suppressed immune systems, such as organ transplant recipients, are also strong candidates because their skin cancers tend to be more aggressive and more likely to recur. In these cases, the precision of Mohs surgery provides an extra layer of confidence that the cancer has been fully removed.

For small, well-defined skin cancers on the trunk or extremities, standard excision is often perfectly adequate. Your dermatologist will recommend Mohs when the specific characteristics of your cancer make it the better option.

What Happens During the Mohs Surgery Procedure?

The procedure takes place in the dermatologist’s office, not a hospital operating room. You’ll be awake the entire time under local anesthesia, which means the area around the tumor is numbed but you’re fully conscious. Most patients say the numbing injection is the only uncomfortable part, and it lasts about two seconds.

Once the area is numb, the surgeon removes the first thin layer of tissue and applies a temporary bandage. You’ll wait in a comfortable room while the lab team processes the tissue. This part takes about 30 to 45 minutes per layer. A technician freezes, slices, stains, and mounts the tissue onto slides, and the surgeon examines them under a microscope, checking the entire margin for remaining cancer cells.

If cancer cells are found at a specific edge, the surgeon marks exactly where on the map and removes another targeted layer from only that area. This cycle repeats until the margins are completely clear. Most cases require one to three layers, though complex tumors may need more.

Once all the cancer is confirmed gone, the surgeon discusses wound closure options. Small wounds may heal on their own or with stitches. Larger or more complex wounds may require a skin flap or graft, which the Mohs surgeon can often perform the same day.

How Long Does Mohs Surgery Take?

Plan for most of the day, even though the actual cutting and stitching may total less than an hour. The waiting periods between layers are what stretch the timeline. A straightforward case with one or two layers might wrap up in two to three hours total. A more complex case requiring multiple layers could take four to six hours or longer.

Bring a book, your phone charger, or a friend. You’ll spend more time waiting than you will in the procedure chair. The office will keep you updated on timing, and you’re free to eat, drink, and use your phone between layers.

What Does Recovery Look Like After Mohs Surgery?

Recovery varies depending on the size and location of the wound and how it was closed. Most patients experience mild soreness, swelling, and bruising for the first few days. Over-the-counter pain relievers like acetaminophen are usually enough to manage discomfort. Your surgeon will give you specific wound care instructions, which typically involve keeping the area clean, applying petroleum jelly, and changing the bandage daily.

Stitches are usually removed within one to two weeks. During that time, you’ll want to avoid strenuous exercise, heavy lifting, and anything that increases blood flow to the area (including bending over for extended periods and alcohol consumption in the first 24 to 48 hours). Most people return to desk work the next day, though physically demanding jobs may require a few days off.

Scarring depends on the size of the wound and its location. Because Mohs surgery removes the least amount of tissue necessary, scars tend to be smaller than those from standard excision. Your surgeon may also refer you to a reconstructive specialist if the wound is in a particularly visible area.

What Are the Risks and Side Effects of Mohs Surgery?

Mohs surgery is very safe, but like any surgical procedure, it carries some risks. Bleeding and infection are possible, though uncommon with proper wound care. Nerve damage can occur in rare cases, particularly with tumors near the eyes, nose, or lips, which may cause temporary or (rarely) permanent numbness or muscle weakness in the surrounding area.

Pain during the procedure is minimal because of the local anesthesia. Some patients feel pressure or tugging, but actual pain is unusual. If the numbness starts to wear off between layers, the surgeon can add more anesthetic.

The most common “side effect” is simply the scar itself, and even that is typically smaller and less noticeable than what you’d get from a wider excision.

How Much Does Mohs Surgery Cost, and Does Insurance Cover It?

Mohs surgery is a recognized, FDA-cleared medical procedure, and most insurance plans cover it when it’s medically indicated for skin cancer treatment. Medicare also covers Mohs surgery. Your out-of-pocket cost will depend on your specific plan, deductible, and copay structure.

If cost is a concern, call your insurance provider before the procedure to verify coverage and get an estimate of your responsibility. Our billing team at Chattanooga Skin and Cancer Clinic (423-894-2234) can also help you understand what to expect.

Frequently Asked Questions About Mohs Surgery

Is Mohs surgery painful?

The procedure is performed under local anesthesia, so you should not feel pain during the surgery itself. The numbing injection feels like a brief pinch. Most patients report that the experience is far less uncomfortable than they anticipated.

Can Mohs surgery be used for melanoma?

Mohs surgery is sometimes used for certain types of melanoma, particularly melanoma in situ (the earliest stage) on the face or other sensitive areas. However, it is most commonly associated with basal cell and squamous cell carcinomas. Your dermatologist will recommend the best approach based on the specific type and stage of your cancer.

Where is Mohs surgery available near Chattanooga?

Chattanooga Skin and Cancer Clinic performs Mohs surgery at our Chattanooga office (6061 Shallowford Road, 423-899-2700) and our Cleveland office (3891 Adkisson Drive, 423-479-8648). Mohs is not available at our Kimball location, but we coordinate referrals to Chattanooga or Cleveland for patients who need the procedure.