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By David Powell, MD

New patients are often surprised when I let them know that annual skin screenings are actually a thing, and more importantly that they should be participating – ANNUALLY. Skin cancer has been on the rise and is the 5th most common type of cancer, lucky for all of us its completely treatable if caught early. As dermatologist this is one of the fundamentals. Once you have had a suspicious lesion removed, most of my patients understand how important it is, but often until they do- they have NO idea. What even more shocking is, they tend to be fully covered by insurance, so getting screened costs you very little, mostly just time! Here are some guidelines and what to expect:

Skin checks should take place yearly starting at age 16. We recommend doing it the same time every year. If your workplace offers screenings on health days, go then! That’s such an easy service and then you don’t have to worry about it. Otherwise, these appointments last no more than 30minutes. In these appointments you will be asked to remove all your clothing and you will be checked from your scalp to between your toes. Some doctors, like me, like to use a dermatoscope to get an even closer look at some moles that might be straddling the line between suspicious and normal.

Follow the ABCDE’s of suspicious lesions. Call to make your appointment to get checked if your moles qualify for any of these parameters: Asymmetry (one half of the mole doesn’t match the other), Border irregularity, Color that is not uniform, Diameter greater than 6 mm (about the size of a pencil eraser), and Evolving size, shape or color.

As you get older and have increased sun exposure your risk profile only goes up! When the doctor (Me) finds a mole to be suspicious, we biopsy (cut a small piece of it) and send it to a specialized lab to be analyzed. Results take about two weeks. After which it will be classified into one of the following categories:

Actinic Keratosis – Pre-cancerous Cell

Squamous Cell – Most common form of Skin Cancer, and most treatable. Forms from uncontrolled squamous cells.

Basal Cell – Second most common form of skin cancer, formed from uncontrolled Basal cell growth.

Melanoma – Cancer that grows in the melanocytes, although less common this type has a higher risk profile.

Merkel Cell Carcinoma – A very rare, high risk factor cancer that has high rates of recurring and spreading.

The first three types (Actinic Keratosis, Squamous and Basal Cell) can be treated in office, the preferable one being Actinic Keratosis. Once you get to the final two categories, we will have to refer you out to a specialist for treatment. If you have been diagnosed with one of the top three, we no longer see you once a year, but instead screen you every 6 months. If you are diagnosed with Melanoma or Merkel, the time frame gets even shorter, then we like to see you every 3 months.

As you can tell from the list above it is preferable to be caught in the Actinic Keratosis stage, because at that point it hasn’t become cancer yet. Again, a really good reason to spend 30 minutes of your time in my lovely company once a year!

Skin cancer is a serious disease and should be taken just as seriously. I have been practicing for nearly 20 years and have seen it all. If you have a suspicious lesion or would like to get screened to have piece of mind you can schedule an appointment at my office – SBA dermatology (713)850-0240 – and come and see me.

You can also learn more on, a great website that provides free up to date educational materials on kkin cancer, skin cancer prevention and even detection.


Meet Dr. Powell

Dr. Powell has been practicing dermatology since 2001 and joined SBA dermatology earlier this year. He graduated from Tulane University School of Medicine in 1993 after receiving a full scholarship from the United States Navy. Dr. Powell completed his internship in Internal Medicine at Naval Medical Center, Portsmouth, Virginia and his United States Naval Flight Surgeon training at Naval Air Station, Pensacola, Florida. He served as the Senior Flight Surgeon at Naval Air Station, Dallas and Joint Reserve Base, Ft. Worth, Texas. After concluding his active duty service in the Navy, Dr. Powell returned to New Orleans and completed his dermatology residency at Tulane and Charity Hospital. He is certified by the American Board of Dermatology. Dr. Powell enjoys practicing all aspects of dermatology, including general, surgical, cosmetic, pediatric and geriatric. He has been recognized for excellence in a number of media outlets, including Texas Monthly Super Doctor (2013-2019) and in Ft. Bend Living Magazine as Best Dermatologist in Ft. Bend County (2013-2019). Learn more about Dr. Powell on our website here and here.