Skin Cancer Screening in Coral Gables: What to Expect at Your First Appointment

Florida has one of the highest skin cancer rates in the country, and Miami's year-round UV exposure accelerates the accumulation of damage that leads to it. Annual full-body skin checks are the most effective early-detection tool available — yet many patients skip them for years simply because they're unsure what the appointment involves.

Here is exactly what to expect at your first skin cancer screening at Miami Skin Center.

Before you arrive: how to prepare

Don't apply nail polish before your appointment. Melanoma can occur under fingernails and toenails, and nail polish can obscure pigmentation changes that would otherwise be visible.

Remove or avoid heavy makeup. The face, ears, and neck are common areas for skin cancers, particularly basal cell carcinomas on the nose and cheeks. Makeup on the day of your exam makes these areas harder to assess.

Wear your hair down if possible. The scalp — especially in areas with thinning hair — is a frequently missed site for actinic keratoses, squamous cell carcinoma, and basal cell carcinoma.

Bring a list of any spots you're concerned about. You know your own skin better than anyone. Write down any moles, patches, or lesions that have changed, appeared recently, or that you've been watching. This helps focus the exam on your highest-priority areas.

Write down your skin cancer history, if any. Prior diagnoses, biopsies, and family history are all relevant. If you've had any previous skin cancers removed, know the type (basal cell, squamous cell, melanoma) and the location.

What happens during the exam

The full-body skin check at Miami Skin Center is performed by Dr. Puyana — not a medical assistant or nurse practitioner. You will change into a gown and the exam covers:

• Face, ears, neck, and scalp — including the hairline and behind the ears
• Chest, abdomen, back, and shoulders
• Arms, hands, and fingers — including under the fingernails
• Legs, feet, and toes — including the soles of the feet and between the toes
• Genitals and buttocks — you may decline this portion, though it's clinically important; melanoma can occur on any skin surface

Dermoscopy: precision for ambiguous lesions

Dr. Puyana uses dermoscopy — a handheld device with magnification and polarized light — to examine lesions that are difficult to assess with the naked eye. Dermoscopy significantly increases diagnostic accuracy for distinguishing benign lesions from early melanomas and other skin cancers, reducing unnecessary biopsies.

The appointment typically takes 15–30 minutes for a thorough full-body exam.

What happens if something is found

If Dr. Puyana identifies a lesion that warrants further evaluation, you have several options discussed at the appointment:

• Monitoring — documenting the lesion with photography and re-examining in 3–6 months, appropriate for borderline lesions
• Biopsy — a quick in-office procedure (local anesthesia, small punch or shave sample) that provides a definitive pathology report. Most biopsies take 5–10 minutes and results return within a week
• Treatment — if an actinic keratosis or other clearly benign but precancerous lesion is identified, same-day treatment (liquid nitrogen, topical prescription) may be recommended

A biopsy result is not a diagnosis of cancer — it is a test. Most biopsied lesions are benign.

How often should you be screened?

The American Academy of Dermatology recommends annual full-body skin exams for adults, and more frequent exams for patients with:

• Personal or family history of skin cancer
• Fair skin, light eyes, or history of frequent sunburns
• More than 50 moles
• Immunosuppression (organ transplant, HIV, certain medications)
• History of significant outdoor exposure or tanning bed use

In Miami, given the UV intensity and outdoor lifestyle, annual screening is appropriate for virtually all adults.

Bottom line

A skin cancer screening is a 15–30 minute appointment with the potential to catch a cancer at its most treatable stage. There is no threshold of sun history or skin type that exempts you from risk in South Florida. If you haven't had a full-body skin check this year, this is the year to schedule one.