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CION Cancer Clinics
Skin surveillance: how a melanoma family is watched | CION Cancer Clinics
Skin surveillance is a regular, planned check of your whole skin by a dermatologist using dermoscopy, a lit magnifier that shows what the naked eye cannot. It is how people at raised melanoma risk are watched, because no blood test or scan finds melanoma early. This page explains who needs it, what happens at a visit, and which changes should not wait. At CION Cancer Clinics, our oncologists plan screening and care for families with an inherited cancer syndrome, explained in plain words.
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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
- What is skin surveillance, and why does a melanoma family need it?
- Who is usually offered regular skin surveillance?
- What happens at a skin surveillance visit?
- The terms your dermatologist may use, in plain language
- What can wait for your next visit, and what should not
- What this page cannot tell you
- Four things people tell us, and what is actually true
- Common questions about skin surveillance
The short answer
What is skin surveillance, and why does a melanoma family need it?
Skin surveillance is a planned, regular examination of your whole skin by a dermatologist, for people at raised risk of melanoma. The doctor uses dermoscopy, a lit handheld magnifier, to look closely at moles. There is no blood test or scan that finds melanoma early, so careful looking is how it is done.
What dermoscopy adds to the naked eye
Pressed gently against the skin, the dermoscope shows colours and patterns beneath the surface that cannot otherwise be seen. In trained hands it makes the judgement about a mole more accurate. It also means fewer harmless moles are cut out just to be safe.
How often you will be seen
There is no single schedule for everyone. Carriers of a known gene fault are usually seen more often than relatives where no gene was found. People with many moles may be seen more often at first, then less often once their skin is well known. Your dermatologist sets the interval for you. Ask for it in writing, so that a doctor nearer home can follow the same plan if you cannot travel to the city every time.
Surveillance is about finding change early. It does not stop melanoma from forming.Who it is for
Who is usually offered regular skin surveillance?
Most people never need it. It is offered where the chance of melanoma is clearly higher than usual.
Carriers of a melanoma gene fault
People who carry a fault in CDKN2A or CDK4 are usually advised to start regular checks earlier than anyone else in the family, and to keep them up for life. In some CDKN2A families, the question of pancreatic checks is raised too, and that is a separate conversation with a specialist.
Carriers of a BAP1 fault
Skin checks look for melanoma and for the small raised bumps typical of this gene. Because BAP1 is also linked to melanoma inside the eye, these families need regular eye examinations as well.
Usually includes
- Full-skin examination with dermoscopy
- An eye specialist examining the back of the eye
Close relatives with no gene found
Where melanoma runs in a family but testing found no fault, parents, brothers, sisters and children are still watched, based on the history rather than a result. A negative test in one relative does not remove the pattern the family has already shown.
People who have had melanoma
After one melanoma, the chance of a second, separate one is raised. Follow-up checks look at the whole skin, not only the scar.
Not sure whether this applies to you?
Ask an oncologistStart to finish
What happens at a skin surveillance visit?
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History and questions
The doctor asks about your family, any new or changing moles, and anything you have photographed since your last visit. Bring those photos.
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A full-skin examination
You undress to your underwear. The doctor looks at every area, including the scalp, the soles, between the toes, the nails and the inside of the mouth.
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Dermoscopy of chosen moles
Any mole that looks different, or has changed, is examined through the dermoscope. Some are photographed so they can be compared next time.
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A decision on each mole
Most are left alone. An uncertain one may be re-checked after a short gap. A worrying one is removed under local anaesthetic and sent for testing.
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The plan until next time
You leave with a date for the next visit and a reminder to check your own skin monthly, and to come back sooner if anything changes.
Words you may hear
The terms your dermatologist may use, in plain language
- Surveillance
- Regular, planned checks for someone who is well but at raised risk. It is not treatment.
- Dermoscopy
- Examining a mole through a lit magnifier that shows structures below the skin surface.
- Full-skin examination
- A head-to-toe check of every area of skin, including places you cannot see yourself.
- Excision biopsy
- Removing a whole mole with a small margin of skin and sending it to the laboratory for a firm answer.
- Histopathology
- The laboratory examination of that removed mole under a microscope. Its report gives the final word.
- Eye examination
- For BAP1 families, an eye specialist looking at the back of the eye after drops widen the pupil.
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What can wait for your next visit, and what should not
Usually fine to mention at your next visit
Book an appointment sooner
A mole that has looked the same for years
A mole that is growing or changing shape
Brown lines in several nails since childhood
A single new or widening stripe in one nail
A mole that itched once after a bite
A mole that bleeds or crusts without injury
A skin tag that catches on clothes
A firm raised lump that appeared quickly
A few new freckles after time in the sun
A dark patch on a sole that is spreading
Being straight with you
What this page cannot tell you
It cannot tell you whether a mole you are looking at is melanoma. That needs a dermatologist, the dermoscope, and sometimes a biopsy. It also cannot set your surveillance schedule, which depends on your family, your moles and any gene result.
It cannot interpret a gene report
If your family has had genetic testing, what your specific variant means is a question for the counsellor who ordered the test. That answer decides how closely you are watched.
Who this does not apply to
Most people do not need planned skin surveillance. One relative with melanoma late in life, a few ordinary moles and no other pattern is not a reason for regular specialist checks. Knowing your own skin and acting on change is enough. A dermatologist will tell you honestly if that is your situation.
Dermatologists trained in dermoscopy are concentrated in cities. If you travel from a district, ask for your visit notes and photos to take home.Commonly believed
Four things people tell us, and what is actually true
"Dermoscopy is a scan that needs an injection."
It is a magnifying lens with its own light. The doctor holds it against your skin. There is no injection, no radiation and no discomfort.
"Nothing was removed, so the visit was a waste."
A visit where every mole is left alone is the best result, not a wasted one. It also builds the record that makes the next visit more accurate.
"My check was clear, so I am safe for good."
A clear check describes your skin on that day. New moles can appear later, which is why the checks continue and why your own monthly look matters between them.
"Surveillance is only for people who have already had melanoma."
Its main purpose in a melanoma family is to watch relatives who are well. Finding a first melanoma early is exactly what it is for.
Questions we are asked
Common questions about skin surveillance
At what age should skin surveillance start?
It depends on the gene involved and the ages at which relatives were diagnosed. Gene carriers usually start earlier than other relatives. Your dermatologist or genetic counsellor will set a starting point for each person in the family.
Does dermoscopy hurt?
No. The dermoscope touches the skin lightly, sometimes with a drop of gel or oil. Nothing enters the skin. Only if a mole needs removing is a local anaesthetic injection used, and that is a separate step.
Which doctor should do my skin surveillance?
A dermatologist experienced in dermoscopy. Your oncologist or genetic counsellor can refer you. For BAP1 families, an eye specialist is also needed for the eye examinations.
What if a mole needs to be removed?
It is usually a short procedure under local anaesthetic, done in the clinic. The mole goes to the laboratory and the report comes back later. Most removed moles turn out to be harmless, and removal gives a firm answer.
Do I need to prepare for a visit?
Remove nail polish and make-up, and avoid body lotion on the day. Bring any photos you have taken of moles, and a list of anything new. Wear clothes that are easy to take off.
Can I ask for a female doctor?
Yes. A full-skin examination is intimate and it is reasonable to ask. Mention it when booking. You can also bring a relative to wait nearby during the examination.
Will my children need surveillance too?
Melanoma in childhood is very rare, even in these families. Children usually do not need formal checks. Good sun habits and a parent who notices change are enough until your counsellor advises otherwise.
Is skin surveillance covered by insurance?
Outpatient dermatology visits are often not covered, and policies differ widely. Ask your insurer in writing. If a mole is removed and melanoma is found, treatment costs are handled differently, so keep every report.
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
Medical Oncologist
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Sources
- National Cancer Institute — Genetics of Skin Cancer (PDQ) - Health Professional Version
- National Cancer Institute — Skin Cancer Screening (PDQ) - Patient Version
- National Cancer Institute — Common Moles, Dysplastic Nevi, and Risk of Melanoma
- MedlinePlus Genetics — 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
Total body photography and mole mappingHow photos make each visit more accurateFamily skin checks and self-examinationWhat to do at home between visitsFamilial melanoma explainedWhich genes put a family under surveillanceMelanoma in Indian skin: where it actually appearsThe hidden sites every check must cover
Talk to us
Does your family need regular skin checks?
Tell us who in your family had melanoma and whether anyone has been tested. We will arrange a specialist skin examination and explain what schedule makes sense. One helpline serves every CION centre.