And do you actually have to get naked? This is what you can expect.
Call me a prude, but my idea of fun doesn’t include having a stranger examine every square inch of my bare skin at close range with a dermascope.
But that’s exactly what happened this week when
Katy, a registered nurse specialising in dermoscopy, has spent the past two decades surveilling skin cancers — everything from actinic keratoses, basal cell carcinomas, squamous cell carcinoma and melanoma (but more on that below).
Meaning, if there was any dodgy sunspot, mole, skin tag or blemish to be found — Katy would find it.
Nervous, I called my mum as I drove over Auckland’s Harbour Bridge, lamenting the thought of getting my kit off and wary of the damage caused during my former life as a sun-worshipping lizard as a teen.
The Consult
Upon arrival, I was welcomed by a smiling Katy who managed to put my mind at ease with her bubbly demeanour and lighthearted banter (although she did tease that she looks out for freckles and sunspots that kill, which struck the fear of God back into me temporarily).
Nothing if not thorough, Katy chatted through what I could expect from my appointment and reinforced the importance of annual skin checks. As this was my first ever, Katy explained that starting checks from age 30 onwards was an essential, “very adult” thing to do — adding that I wasn’t likely to add any more non-suspicious moles to the constellation on my skin between now and 40 anyway.
I was questioned about my family history of melanoma, basal cell carcinomas (BCC) and squamous cell carcinomas (SCC), of which I could recall two family members going under the knife. I never had but again this was my first check, so I’d never really bothered to self-examine all that much.
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Advertise with NZME.Katy spoke about how it’s the moles we can’t see day to day (like the ones on our backs, behind our knees, or near our genitals) that are often the ones to watch out for. Since we can’t easily monitor changes in colour, shape or size, she recommended I grab a mirror to inspect the state of my skin in those areas regularly or ask my husband to help.
All of my information was noted down in DermEngine, an online portal that will also store imagery from my visit — especially important for Katy to refer back to in a year’s time to see if anything sinister crops up.
The Skin Check
Now for the not-so-fun part: undressing. Katy had laid a robe out for me and asked me to step behind a privacy screen to undress. I was told to leave my underwear on but could remove my bra should I wish.
I did so, wrapped the robe around me and lay down on my back on the examination table.
I nervously joked that this wasn’t the kind of beauty treatment I was used to, and she assured me that she’s only ever looking for one thing — skin cancer. Every body hang-up I had was invisible to her by comparison.
She only removed the robe from the areas she was treating, rendering the process modest and I felt very comfortable throughout. Katy began with each arm, using the dermoscope to inspect every sunspot, freckle and mole from my shoulders to my fingers, explaining that most Kiwi’s shoulders get a hammering every summer.
This was one of the areas I was most nervous about, I tend to get burnt shoulders very easily and have noticed in recent years that my freckles have tripled as a result.
While she worked, she explained that 30 per cent of melanomas develop from existing sunspots or moles, while 70 per cent appear on unblemished skin. You can tell she’s passionate about early detection, she recalls a recent patient who had two BCCs appear on her forehead during her first-ever skin check, and subsequently had to have them surgically removed.
Next came my stomach. I have a kidney-bean-shaped mole on my right side which has stretched and grown with each pregnancy, and now is a misshapen blob. After close inspection, thankfully it’s just that and doesn’t need to be removed.
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Advertise with NZME.More bothersome aesthetically were the two seborrheic keratoses on my chest, which again I’ve had for a while, but Katy explained they’re harmless. The problem is, once you have a couple, you’re sure to get more, so for vanity’s sake I think I’ll look into having them removed. Katy recommended visiting a clinic that offered laser treatment or removal via scalpel (I’ll do the former, thanks) as she doesn’t perform any minor surgeries herself.
Then it was on to my legs and feet, and Katy showed me images of what a melanoma looks like when it grows out from under the nailbed (which coincidentally was what killed Bob Marley in his mid-30s — a malignant melanoma in his toe which later metastasised into a brain tumour).
Deaths like this, Katy says, are avoidable. She’s adamant about prevention and says that’s why she offers an affordable option for those who wish to be proactive about the health of their skin.
Rather than operate like a big chain clinic, whose skin checks can cost close to $400, Espy Skin offers a 30-45 minute full-body skin check for $125.
I was invited to roll on to my stomach (while Katy held the robe for modesty) before she got to work on my back. She asked if I was happy to unhook my bra and I’m glad I agreed — she found two moles hidden on my bra line which she said weren’t sinister but should be monitored for future changes, so took a photo for her records.
Moving down from my lower back to my legs, Katy continued to scan and inspect every spot, but found nothing.
The final step was to run her fingers through my hair (which felt heavenly) simultaneously searching for any nodules that cropped up from years of having a sunburned parting. She recommends always applying sunscreen to your hair parting for that reason.
The Results
And just like that ... it was over. I was invited to dress and sit with Katy while we debriefed.
The picture of my back looked like a game of connect-the-dots, the MoleScope technology had pinpointed every single mark on my back and provided a zoomed-in image so Katy could assess each one. She detected a couple of cherry angiomas (little red or purple pin-head-like bumps) which sound cute and are harmless, but added that I’d likely collect a few more over my lifetime as I age.
An infographic of the different stages of melanoma was a rude awakening, with Katy explaining early detection of melanoma at stages 1-3 is your best bet at treating the disease before it spreads to the lymph nodes and metastasises throughout the body.
Another few images were shared (not purely for shock factor, although most did elicit that response) of lips affected by basal cell carcinomas which hammered home the point of using a lip product that contains a broad-spectrum SPF.
All-in-all, getting partially naked in front of a stranger wasn’t nearly as nerve-racking as I thought it would be. I’d hardly call the experience fun, but at least this time next year I know I won’t be dreading it.
I’m very glad (and very lucky) to have received the all-clear and not needed any removals or further treatments, but the experience reinforced the importance of keeping every centimetre of skin protected over the summer break.
Katy’s Sunscreen Recommendations
An excellent option for oily/combination skin types, this lightweight emulsion contains Avene’s hero ingredient — Thermal Spring Water — to maintain skin hydration while keeping it protected from harmful UVA and UVB rays. Katy says it dries matte so it’s a good idea to work quickly to achieve good coverage all over your face.
Katy’s current go-to facial sunscreen, this broad-spectrum facial sunscreen also contains niacinamide, an ingredient Katy says has been clinically proven to cut the rate of SCCs and BCCs by up to 23 per cent, as determined by the US National Library of Medicine.
This spray format is suitable for use on even the most sensitive skin types, promising high broad-spectrum protection against UVA and UVB rays from top to toe. It’s certified to fit within Australia’s rigorous sunscreen standards (AS/NZS 2604:2012) and is hypoallergenic.
Katy notes the lack of choice with lip care products made in Aotearoa which are laced with sunscreen, and is quick to point out her favourite pick from Australian brand Naked Sundays — a lip oil with SPF50 that keeps lips safe in the sun and tastes like salted caramel.
A lip lacquer and SPF in one, Ultra Violette’s glossy offering hydrates, protects and lends shine all at once. Not to mention it’s scented with peppermint for a welcome pick-me-up.
