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You should probably be getting an annual exam

What's there to worry about? A lot, unfortunately.

Compared to them, your occasional sunscreen use might seem like a major improvement. So what’s there to worry about?

A lot, unfortunately.

A great deal has changed since your grandparents' generation. Blame climate change: back in the 1950s and 1960s, “the ozone layer was much thicker, so the amount of time and exposure needed to cause damage was much increased,” says Michael Olding, M.D., a professor of cosmetic and reconstructive surgery at George Washington University.

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The ozone layer is like sunscreen for the Earth. It sucks up cancer-causing UVB rays before they can reach the planet’s surface. But chemicals used in consumer goods—especially a type known as chlorofluorocarbons—have significantly depleted the ozone layer's thickness and UVB-blocking abilities.

CFCs are now banned globally, and there’s evidence the ozone layer is gradually repairing itself. But those of us in our teens, 20s, and 30s grew up during the era of peak ozone layer skimpiness.

Our exposure to a weakened Ozone is evident in the skin cancer stats. Among Americans under 40, skin cancer is the #1 cause of disease-related death, according to the American Cancer Society. Roughly 9,000 of us die every year as a result of skin cancer.

But do you really need an annual skin cancer exam from a dermatologist? The answer is . . . it depends.

Just last year, a national skin cancer task force found there wasn’t (yet) enough evidence to support the recommendation that all healthy adults get annual expert skin exams. The task force’s report also pointed out that unnecessary skin biopsies and “over-diagnosis” were concerns.

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“I would agree that yes, if you go in for a full skin exam, chances are good you’re walking away with a biopsy,” says Adam Friedman, M.D., an associate professor of dermatology at George Washington University. “A dermatologist will err on the side of caution, so they’ll biopsy anything that looks suspicious.”

But that doesn’t mean at-risk groups won’t benefit from a regular exam.

Dr. Friedman says early detection of skin cancer is the best way to ensure you walk away from the disease. Large-scale studies have also shown that skin checks save lives and improve cancer outcomes.

“I don’t think the message should be that every healthy adult needs to come in yearly,” he says. “But for those with certain risk factors, some kind of regular screening is the only safe move.”

“If you have a family history of skin cancer, especially melanoma, you should have an annual exam,” Dr. Friedman says.

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Other experts agree. “The most important risk factor is a family history of skin cancer,” says Jeremy Davis, M.D., a clinical instructor in dermatology at UCLA.

But there are other reasons to get an annual skin cancer exam.

“The presence of fairer skin, light eyes, red hair, and freckles are all indications that you have a higher risk of burning—and a higher risk for skin cancer,” Dr. Davis says. Especially if you’ve been burned a bunch of times in the past, you should get an exam.

“A history of tanning bed use can also significantly increase your risk of developing skin cancer,” he says. “If you’ve spent a lot of time underneath the tanning bed lights, get to a dermatologist right away.”

Finally, if you have a lot of moles—more than 11 on any one limb—or your job leaves you exposed to the sun, you should have your skin checked, he says.

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If you’re not going in for an annual exam, “at least check yourself,” Dr. Friedman says.

By taking a good look at your skin at least every other month—or better yet, asking your partner to check you out—you’ll go a long way toward spotting potentially cancerous blemishes.

“Take pictures with your phone, and compare them every few months,” he says. Spotting changes is usually a lot easier than differentiating a cancerous mole or lesion from something harmless. If you notice something on your skin is changing or evolving, get into a dermatologist ASAP.

Sure, a self-exam is kind of a pain in the ass. But we’re talking 10 to 15 minutes every 2 months. That’s not a lot to ask for something that could save your skin—and your life.

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