Medical Oncologist
CION Cancer Clinics
Skin surveillance for inherited skin cancer risk | CION Cancer Clinics
Skin surveillance means regular full-skin checks by a dermatologist, plus your own monthly look at home, for people who carry a gene fault that raises skin cancer risk. In Indian patients, melanoma often starts on the soles, palms or under a nail, so the check covers places the sun never reaches. This page explains who needs it and what each visit involves. At CION Cancer Clinics, our team helps carriers and their families plan checks, next steps and support after a genetic result.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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On this page
- Who needs regular skin checks for an inherited reason?
- Which inherited conditions need skin surveillance?
- What happens at a skin surveillance visit?
- What do the words on a skin report mean?
- What can you check at home, and what needs the clinic?
- What this page cannot tell you
- Four things families tell us about skin cancer
- Common questions about skin surveillance
The short answer
Who needs regular skin checks for an inherited reason?
Skin surveillance is for people who carry a gene fault that raises the risk of melanoma or other skin cancers, such as CDKN2A, BAP1 or Gorlin syndrome. It combines a full skin check by a dermatologist at set intervals with your own monthly look at home. Most people with a relative who had skin cancer do not need it.
Why skin is different in India
Melanoma is less common in darker skin, but when it does appear in Indian patients it often starts where the sun rarely reaches: the soles of the feet, the palms, under a nail or inside the mouth. These places are easy to overlook, and they are exactly where a check needs to look.
Why two pairs of eyes matter
A dermatologist sees you at intervals. You see your own skin every day. The dermatologist knows what a worrying spot looks like, and you know what has changed since last month. Surveillance works best when both are part of it, and when photographs connect one visit to the next.
Skin surveillance finds changes early. It does not stop new moles or skin cancers from forming.Not one plan, several
Which inherited conditions need skin surveillance?
The gene decides what the dermatologist is looking for and how often you are seen.
CDKN2A and CDK4
Faults behind many families with several melanomas. Carriers often have many unusual moles. Skin checks usually start young, and CDKN2A carriers may also need pancreatic checks.
BAP1
Raises the risk of skin melanoma, melanoma inside the eye, kidney cancer and mesothelioma. Carriers may have raised, skin-coloured bumps that look harmless but are worth removing.
Also checked
- Eyes, by an eye specialist
- Kidneys, by scan
Gorlin syndrome (PTCH1)
Causes many basal cell skin cancers, often from a young age, along with jaw cysts. Radiation can trigger new skin cancers, so X-rays and CT are kept to a minimum.
Xeroderma pigmentosum and albinism
Recessive conditions, where both parents carry a fault. They are seen more often in families where parents are related by blood. Strict sun protection from infancy matters as much as the checks.
Not sure whether this applies to you?
Ask an oncologistAt the clinic
What happens at a skin surveillance visit?
A full undress
You change into a gown so the whole skin can be seen. A female doctor or chaperone can be asked for. Remove nail polish beforehand.
Head to toe, including hidden places
The scalp, behind the ears, between the toes, the soles, the palms, under the nails, inside the mouth and the genital skin are all checked.
A closer look with a dermoscope
A handheld magnifier with a light shows the pattern inside a mole that the naked eye cannot see.
Photographs for next time
Pictures of your moles are saved so the next visit can compare them exactly. Change over time is the strongest clue.
Removing a mole if needed
A suspicious mole is removed under local anaesthetic and sent to the laboratory. Most turn out to be harmless.
On your report
What do the words on a skin report mean?
- Atypical mole
- A mole that looks unusual in shape or colour. It is not cancer, but people with many of them are watched more closely.
- Dermoscopy
- Examining a mole through a lit magnifier to see its inner pattern.
- Acral melanoma
- Melanoma on the palms, soles or under the nails. Among the most common types in Indian patients.
- Excision biopsy
- Removing the whole mole with a small margin so the laboratory can examine it.
- Basal cell carcinoma
- A slow-growing skin cancer that rarely spreads but can damage the skin around it if left alone.
- Mole mapping
- Photographing the whole skin so new or changing spots can be found at the next visit.
Side by side
What can you check at home, and what needs the clinic?
At home, once a month
At the dermatology clinic
Spot a new mole or one that is changing
Judge whether that change is worrying
Check soles, palms and nails in good light
Look inside moles with a dermoscope
Ask a family member to check your back
Compare against saved photographs
Take a phone photo of anything new
Remove a mole and send it for testing
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Being straight with you
What this page cannot tell you
It cannot tell you how often you should be seen or at what age checks should begin. That depends on your gene, how many moles you have, and whether you or your relatives have already had a skin cancer. Guidelines for these rare syndromes rest on small studies, and your dermatologist will adjust the plan to what they find.
It cannot judge a mole from a description
A spot that sounds worrying in words can look completely harmless, and the reverse is also true. A photograph sent on a phone helps, but it does not replace a proper look. What a specific mole or report means is a question for the dermatologist who examined you.
Who this does not apply to
Most people with a relative who had skin cancer do not need surveillance. A single relative with a skin cancer on a sun-exposed area in later life rarely points to an inherited fault. Having many ordinary moles is also not, on its own, a reason for genetic testing.
A mole that bleeds, a dark streak that appears under a nail, or a sore on the sole that will not heal should be shown to a doctor without waiting for your next visit.Commonly believed
Four things families tell us about skin cancer
"Indian skin does not get melanoma."
It is less common, but it happens, and it is often found late because nobody was looking. In carriers of these faults, the risk is real whatever the skin colour.
"Skin cancer only appears where the sun hits."
In Indian patients, melanoma is often found on the soles, palms and under the nails. A dark mark on the foot deserves the same attention as one on the face.
"Removing all my moles would prevent melanoma."
Most melanomas start in normal skin, not in an existing mole. Removing every mole leaves scars without removing the risk. Watching for change works better.
"A mole I have had since childhood must be safe."
Old moles are usually harmless, but any mole that changes in size, shape or colour needs a look, however long you have had it.
Questions we are asked
Common questions about skin surveillance
How often will I need a skin check?
It depends on your gene and your moles. Many carriers are seen once or twice a year, and more often if a mole is being watched. Your monthly self-check fills the gaps between visits. Keep your own photographs so you can show what has changed.
Do children in the family need skin checks?
For some faults, yes. Children in CDKN2A or Gorlin families may be checked from a young age, and children with xeroderma pigmentosum need care from infancy. For other genes, checks usually start in adult life. Your counsellor will say when testing a child makes sense.
What should I look for in my monthly self-check?
Look for any new spot, or one that is changing in size, shape or colour. Check the soles, palms, nails, scalp and the inside of your mouth in good daylight. Ask someone to check your back. Photograph anything new and show it at your next visit.
Does a BAP1 carrier need eye checks too?
Yes. BAP1 raises the risk of melanoma inside the eye, which a skin check cannot see. An eye specialist examines the back of the eye with drops that widen the pupil. Plan to have someone drive you home, as your vision stays blurred for a few hours.
Is sunscreen enough protection?
Sunscreen helps, but it works best alongside shade, hats and covering clothes during the brightest part of the day. For xeroderma pigmentosum, protection must be far stricter. For most other carriers, sensible protection and regular checks are the plan.
Will removing a mole leave a scar?
Yes, a small one. The dermatologist removes only moles that look worrying or keep changing, and chooses the method that leaves the neatest scar. Most removed moles turn out to be harmless, which is the cost of catching the few that are not.
Can the skin check be done in my own district?
A trained dermatologist with a dermoscope can do it anywhere. What matters is keeping your photographs and reports together, so each visit can be compared with the last. Carry them to every appointment, wherever it is.
Where do I start if melanoma runs in my family?
List who had melanoma or other unusual cancers, where on the body, and at what age. Take this to a genetic counsellor or dermatologist. Call the CION helpline if you are not sure who to see, and someone will point you to the right clinic.
Your Specialists
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
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Sources
- National Cancer Institute — Genetics of Skin Cancer (PDQ) - Health Professional Version
- GeneReviews (NCBI) — BAP1 Tumor Predisposition Syndrome
- MedlinePlus Genetics — CDKN2A gene
- Cancer Research UK — Risks and causes of melanoma
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Why some syndromes avoid CT and X-rayWhy Gorlin families keep radiation to a minimumPancreatic surveillance: who qualifiesThe extra check CDKN2A carriers may needKeeping track of a multi-organ screening scheduleSkin, eye and kidney checks in one diarySurveillance for hereditary cancer risk: the complete pictureEvery organ-by-organ plan in one place
Talk to us
Not sure whether your family needs skin checks?
Tell us which gene was found, or who in the family had melanoma and at what age. We will explain whether surveillance applies and help you find the right dermatologist. One helpline serves every CION centre.