Total-body skin checks and mole mapping: who benefits and what the evidence says

A total-body skin examination involves a clinician looking at the whole skin surface, often with a dermatoscope. Mole mapping adds systematic digital photography of the body and dermoscopic images of selected lesions, stored for comparison at later visits. Some services use software to flag change. The idea is to detect new or changing lesions earlier and to avoid removing stable benign moles.

• A previous melanoma or other skin cancer.

• A large number of moles, or many atypical (dysplastic) moles.

• Close relatives with melanoma, particularly several or at a young age.

• Certain genetic variants associated with melanoma.

• A weakened immune system, for example after transplant.

• A history of heavy sun exposure, sunbed use or severe sunburn.

For people at high risk, regular surveillance by trained clinicians is part of specialist dermatology practice and can detect melanomas early, often at a thin stage. For the general population, studies have not shown a clear reduction in melanoma deaths from routine screening, and the National Screening Committee has not recommended it. A risk is overdiagnosis: lesions that would never have caused harm are found and removed, with associated cost, scarring and anxiety.

Private mole mapping can offer reassurance and detect change, particularly for people with many moles. It may be less useful for people with few moles and low risk. Costs vary and often recur with annual or six-monthly reviews, so ask about the total over time. Check that the examiner is trained in dermoscopy, how images are stored and compared, what happens if a lesion changes and whether histology will be arranged for any removal.

A good service gives you a baseline set of images, a written plan for review intervals, clear thresholds for removal or referral and a way to contact them between visits. It also teaches you to check your own skin, since melanomas can appear between visits. Keep copies of your images and reports.

Monthly self-checks, sun protection and prompt attention to any new or changing lesion are the core of prevention. A one-off check can be reasonable if you are worried, but it should not create false reassurance. Your GP can advise whether your risk profile warrants specialist follow-up.

Ask what the service includes, how often you will be reviewed, what each review costs and what happens if a lesion changes. Ask whether the examiner is a dermatologist or a trained clinician and whether they use dermoscopy. Ask how images are stored and whether you can obtain copies. Ask how the service decides when to remove a lesion and whether histology is included. Be wary of long prepaid packages for people at low risk, and consider whether your GP could advise first.