What is Dermoscopy?

by Hope Allen, PA-C

March 2023

At some point during a routine skin exam you’ve probably wondered some of the following questions, so let’s break them down!

What is that bright light they’re using to look at my skin?

Dermoscopy, (aka dermatoscopy, epiluminescence microscopy, or skin surface microscopy) is a technique that helps in the evaluation of suspicious skin lesions. A dermatoscope is the tool that is needed to perform this technique. Using a special type of light and magnification the dermatoscope helps your provider see microstructures and colors of the epidermis, the dermo-epidermal junction, and the papillary dermis, which is not visible to the naked eye. The dermatoscope reduces the skin surface reflection by using polarized light. The light reflected by the skin surface that is responsible for the glare of the skin is blocked by the cross-polarized filter. This makes the subsurface structures visible.

What do they see when they look through the dermatoscope?

Melanoma

A benign Seborrheic Keratosis (sign of wisdom)

Basal Cell Carcinoma

A benign nevus

Does using a dermatoscope improve diagnostic accuracy?

When they have done large studies comparing diagnostic accuracy with and without dermoscopy they’ve found that, “When used by specialists, dermoscopy is better at diagnosing melanoma compared to inspection of a suspicious skin lesion using the naked eye alone.” ***How accurate is dermoscopy compared to visual inspection of the skin for diagnosing skin cancer (melanoma) in adults? | Cochrane

Some features when visualized with dermoscopy can give more clues than others and there are formulas that clinicians study to help correlate various features to assist in making a decision on whether or not to biopsy. On average, providers who use dermoscopy biopsy less benign lesions when compared with providers who do not use a dermatoscope during skin exams.

Does a dermatoscope help in the diagnosis of rashes and hair loss?

Yes! The benefits of dermoscopy go far beyond diagnosing skin cancer. It can assist in finding warts, can assist in the diagnosis of many rashes, scalp disorders, and nail lesions or disorders.

Do I still need a biopsy if my provider used a dermatoscope?

The goal of dermoscopy is to help reduce the frequency of unnecessary biopsy and help clinicians find suspicious lesion that do not look concerning to the naked eye. It is not a diagnostic tool and a biopsy is still the gold standard to confirm any diagnosis.

Should I get a dermatoscope to use at home so I don’t need as many skin checks?

We do not advise this. Dermoscopy requires formal training to be effectively practiced. Interpreting dermoscopy takes thorough training and needs to be used within clinical context by clinicians who have studied dermatology and is not going to be helpful to the untrained eye.

If my provider doesn’t use a dermatoscope should I be worried?

Not at all. Some clinicians have not had enough specific training to feel comfortable using dermoscopy and that’s ok. A dermatoscope is one tool, but there is so much more that goes into a provider’s diagnostic decision making.

In summary, although a dermatoscope doesn’t beep when it finds a skin cancer (that would be nice!), it is an extremely helpful aid when it comes to diagnosing and detecting cancer and skin disorders.

Featured Products

Circadia Amandola Milk Cleanser

This conditioning almond milk cleanser contains Lactic and Mandelic Acids that gently exfoliate, hydrate and brighten damaged skin.

Benefits

• Non-foaming cleanser
• Gently removes dirt and debris
• Provides the mild exfoliating benefits of lactic and mandelic acids
• Skin brightening
• Hydrating properties

Circadia Lipid Replacing Cleansing Gel

This revitalizing cleanser effectively removes dirt, makeup and excess lipids without damaging the skin barrier.

Benefits

• Non-irritating foaming gel cleanser
• Slightly acidic pH
• Excellent professional cleanser that works well prior to microdermabrasion, chemical peeling, enzyme or oxygen treatment

Circadia Micro-Exfoliating Honey Cleanser

Micro-beads of natural beeswax gently cleanse and exfoliate, while absorbing excess oil. Leaves all skin types feeling fresh and revitalized.

Benefits

• Gently exfoliates, leaving the skin silky and smooth
• Naturally oil absorbing and hydrating at the same time
• Fragrance-free and sulfate-free
• Gentle enough to be used twice daily