“Am I Going to Have to Get Totally Naked?”

Each year when I write about my skin checks (and subsequent “fuck I’m pre-cancerous again and going back in to get hacked up”) I get quite a few comments and emails from people with questions about the process. I love-love-love this because it makes me feel helpful and for a disease best combatted by prevention and early detection, I feel each person I convince to go in for a check is a little battle won.

So I figured today I’d walk you through my latest appointment to give you a better idea what to expect, and/or convince you it’s not as intimidating as it may seem. And this is coming from a girl who really hates going to any doctor for anything.

(reminds me I should probably hit the dentist… for the first time in three years)

This is by no means a “here’s this post so you’ll stop asking me all these questions” – please PLEASE if you need or want to someone to talk to about skin cancer prevention, detection, treatment, etc get ahold of me! onceuponalime at gmail.com. I’m way happy to help however I can.

Well let’s get to it.


I had visited an insurance in-network dermatologist for acne a few years back and learned they did skin checks, which is how I chose to go there. I believe some family physicians will also perform the exam, but you’ll need to ask. Derms are a pretty surefire bet.

My insurance covers preventative exams, so I pay a small co-pay and the visit is covered. This seems to be pretty standard (think of routine annual physicals, teeth cleaning, pap smear, etc) but do check your coverage before believing my fat mouth.

Annual Skin Check Appointment

After signing in like any other doctor’s appointment, I busied myself browsing all the age-reversing, cold-sculpting, latisse-this, collagen-that flyers and frequent botox’er loyalty programs before getting taken back to an exam room. Ahh, life in the OC. I was given a paper sheet and told to strip down to bra and undies, and lie on the table with the sheet over top of me like a blanket.

A very thin blanket, with a slight draft blowing right on me, made for a slightly uncomfortable 5 minute (?) wait.


2011 at the plastic surgeon for post-op (spoiler alert) – paper gown >> paper sheet

The doctor looked over each square inch – hands, arms, chest, neck, behind the ears – then uncovered ‘blanketed’ quadrants at a time to check breasts, stomach, and pelvis – moved down to legs and feet, then after a flip finished the back side. The whole process took less than two minutes.

Anything a little larger, darker, or misshapen than normal she measured and noted on my chart to keep an eye on in the future. Anything alarming – like the suddenly appeared mole on the sole of my foot and a stomach freckle that had grown since last appointment – gets removed for biopsy to check if the cells are cancerous. Otherwise you’re good to go.

cue last post’s mention of nickname “Abby Normal”. I go in now just assuming something needs taken off. #extremewhitegirlproblems

Skin Check Bonus Round! Biopsy Time!

After a few injections of local anesthetic which stings a teeny bit, she used a flat little square tool with a hole cut out of it (lined I assume with a sharp edge but I did not inspect that closely because, kinda creepygross) to “shave” the area off and send off to a lab for testing. A regular bandage handles the bleeding and a faint scar might be left, otherwise it’s easy peasy. I’ve been told not to workout for 3-5 days, but it’s just a tiny scrape so I say go sweat on just clean it up after (but I’m not a doctor, listen to them not me!)


This bitch on my foot might keep me out of my Brooks a few extra days though. Sad face.

Post-Appointment : In Case of Abnormal Results

After a week the office calls to share the results of the biopsy. I’ve heard:

“cells were normal, nothing to worry about,” and …

“cells were pre-cancerous but margins of the shaved area were clear so it looks like we got it all out – we’ll keep an eye on the area,” and…

“cells are pre-cancerous (blah blah nevus atypia), margins were not clear so we have to hack off a bigger area to get all the bad stuff out – when can you come in?” and my least favorite…

“cells are cancerous, but the mostly non-life-threatening kind (basal cell carcinoma), so you’re probably not dying but we need to cut that shit out like, yesterday.”

I’ve been lucky to not get option 5: MELANOMA and hopefully with regular check ups I’ll never land there, but do keep in mind that is an unfortunately common diagnosis and can be very very serious. Scare tactics – check.

Follow Up : Cut That Shit Out

For my two procedures (four separate removals) I’ve gone two routes:

1) plastic surgeon, full-anesthesia, hospital stay and huge medical bills way my derm suggested and I didn’t know other options existed,

and 2) the “can’t you just do it here in your office? I don’t care if I have a gnarly scar or you haven’t thrown a stitch since medical school, I’m cheap and don’t want to take the time off for full-on surgery” sorta sketchy back alley (but equally effective) way.

2011 surgery

2012 skin surgery

(for the record, both left scars, IMO the more faded ones were definitely not worth $xxx. If it had been on my face, maybe it’d be a different story…)

Depending on your level of atypia, size of the area, and doctor the removal process can vary greatly so I’m not going to weigh in much. Plus the whole not-a-doctor thing. My last two were taken care of with a simple punch biopsy (a circle tool cuts out the bad spot) and sewn together with 3-5 stitches in the derm’s office. That did take a few weeks to heal and get the stitches removed, so don’t plan on any peak training or races post-op.

(since mine were non-metastasizing, I was able to push the procedure back a few weeks until after racing season was over. non-runner doc shook her head but said it was fine.)


And that’s it. I don’t mean to scare or gross you out with the details, but I believe it’s easier going into something like this not completely blind. The initial skin check is easy, painless, and only like, 15% embarrassing, so do yourself and my worried soul a favor and make an appointment. And if shit happens at least you know I’ve probably got a matching scar we can bond over.


or half-taped ankles to hold bottom-of-foot bandages on? so fetch.

Again feel free to contact me with any questions or concerns. I’m no expert of medical professional but I’ve spent enough time in that exam room to shed some light on the process.

And “What Celebrity is a Fan of Cool Sculpting?”

Sarah OUaL, the human biopsy doll

*disclosure – this is my personal experience. Obviously people’s experiences will vary based on situation and doctor. If you are concerned about the process you can always call and ask what type of exam the doctor performs and their typical course of action for any abnormal results. Don’t be afraid to ask ‘stupid’ questions!


29 thoughts on ““Am I Going to Have to Get Totally Naked?”

  1. Thanks for reminding your readers to get their check ups. Don’t forget to remind them to slather on the really good sunscreen and get their hats on when they’re out running in the sun too. PROTECT YOUR SKIN!!


  2. This is great info! I get a check every year with my physical and so far, so good, but since I spend a lot of time outside doing triathlete-y things, I feel better having someone eyeball my spots every year.


  3. Last time you did a post, I went in for my first check up. With two grandparents and a dad who’ve all had spots removed/frozen off, I’m a high candidate for skin cancer. Luckily I’ve only had one bad spot. Better to be safe than sorry, get checked and stay out of the sun.


  4. Your story sounds familiar. I’ve been there. Had a basal cell carcinoma removed from my back. Big scar. I don’t care. Thanks for promoting skin health and skin checks.


  5. I’ve had one removed as well and rather than scar it grew right back even darker haha. Luckily non-cancerous, just stubborn. In the tanning age I think lots of us are guilty of not taking our skin seriously enough in terms of getting it checked regularly. Great post.


  6. I don’t normally respond to blog posts but I am the same. Very fair skinned and just went for my first full body check. I have always gone to my doctor when I have had a mole I was concerned about. They have removed two moles for me and my process was almost exactly like yours except I had a horrible reaction to the bandaid. The last time I went they suggested a full body scan by a derm. Since going through both I would recommend a derm. They look at moles all day every day and that is their area of expertise. I felt comfortable with my doctor but way more comfortable with my derm. My derm also took pictures. I was very embarrassed since my underwear that day did not cover much but got over it very quickly. Highly recommend getting a full body check each year.


  7. I am so happy you posted this. Melanoma runs in my fam and I strip down for a derm at least once a year. I’m also the mom of the group and spraying friends with sunscreen every chance I get.


  8. Thanks for posting this! I am a pathologist and look at these skin biopsies. I’m also feeling pretty lucky that I haven’t had any myself, yet. But a friend who’s my age (38) just had a basal cell carcinoma removed! Thanks for the openness and disclosure. I think it really helps people who might be on the fence about getting a “funny mole” looked at!


  9. Even here in rural PA, the dermatologist’s office is chock full of “make yourself look younger” pamphlets.

    Work brings a team of docs in once a year so we can sign up for free screenings. Which is great, except stripping down for a skin check is way more awkward in a conference room at your place of employment than it is at a doctor’s office.


  10. Awesome post!! I have gotten checked 2x in the last 5 years and am very moley, so I’m trying to make it a point to go more often as a “now-adult”.

    One question – is the initial biopsy covered for you? I’ve had samples taken/biopsied both times, last time was the first time on my own (not parents’) insurance and the cost for 2 biopsy samples was over $600. The visit itself is a $20 copay but since I have so many moles I am expecting to need biopsies again in the future… And so far they have all come back normal!! Sadly this makes me hesitate to go back… Just curious if your costs are in the same ballpark or I should look for a new doc!


    • My out-of-pocket for biopsies is very little, nowhere near that much. I know if they code “medical” instead of “preventative” it sometimes bills differently, but that depends on your insurance. Or maybe the lab they send to is not in your network? I think you can call ins. ahead of time for a predetermination of benefits, too, to see what’s covered. I know it sucks getting blindsided with a bigass bill after – insult to injury, literally. Hope that helps a little!


  11. I have had six basal cell carcinomas removed since May. If you have fair skin, it may not look like a freckle. All of the spots that I have had removed have all been pink and crusty or pink and uneven borders. By crusty, I mean it just looks like dry skin, but won’t ever go away no matter how much lotion you apply. The spots are also a little thicker. I always feel “judged” by my deem and her squad and they always ask if I have children in a way that makes me feel like death is imminent! They just want to make sure that I apply sunscreen to their little fresh skin.


  12. Thank you do much for this. I’m 30 and have never seen a dermatologist, due to being dark-skinned/half-Mexican. But my dad was a freckled redhead and I spend a lot of time running outdoors and have new moles, so I know I need to bite the bullet. This post takes a lot of anxiety out of the process. Muchas gracias!


  13. This is a great post. I’ve been going for mole checks for so long that I don’t even think twice about it (or the subsequent biopsies and possible removals), but didn’t realize that so many people have hesitations and fears about this process. My experience is much like yours, although I also recommend a dermatologist over a general practitioner – I prefer someone who looks at moles all day to judge mine! [And I, too, get mine removed by the dermo. No need to fuss with the plastic surgeon – of course it depends on the placement and size, but for me, the scars usually end up fading over the years into nothing much serious at all.]

    I think the other important point to remember is that the most harmless looking ones are usually the ones to worry the most about (this goes with the “it doesn’t even look like a mole!). It’s not usually the lumpy, bumpy annoying ones that are trouble – it’s often the flat, harmless-looking ones.

    My only additional word of advice is: Know your own body! Dermatologists are quite thorough, but I have 2 “hidden” moles – one in hair, and one between my toes – that sometimes get missed if I don’t point them out. Of course the docs try to be thorough, but I see myself naked in the shower every day – so I have a huge advantage….


  14. The bottom of the foot mole got me twice. I didn’t mind hobbling around with the bandages, but not being able to run for about a week made me angry. Once the “pebble under your foot” feeling goes away, you get over it. Thanks for sharing!


  15. MOHs surgeon. Derm who specializes in cancer removal…they tend to do a better job than in office regular derms and are cheaper than plastics (I believe). I’ve learned a lot about the cool-sculpt side of the business in my job now. Pretty entertaining. Still won’t bite the bullet on any of it, but i will happily let someone laser my face to help with aging. :)


  16. Hello! My sister, who is a 9 time marathoner, recommended your blog to me. I’m a beginner runner, training for my first half, and also battling skin cancer. Last June I had a mohs surgery for a basal cell on my face removed, and subsequent plastic surgery to clean it up (I’m 26). A couple of days ago, at my few monthly check up with the derm, it was discovered that I have another basal cell on my nose and a squamous cell on my shoulder. I instantly contacted my sister (my running motivation) to alert her of my possible training set backs. That’s when she pointed me your way. (She also lives in LA). Its just really great to know there are others out there battling the same thing as I, and still getting their grind on. Thank you for the extra motivation, from a north Texas resident constantly battling the sun.



Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s