Dear Sharon,

Surprisingly, it doesn't take long for a board certified dermatologist to perform a complete skin examination to screen for skin cancer. A multicenter study reported in the April issue of the respected dermatology journal, Archives of Dermatology [Arch Dermatol. 2008;144:509-513.] found that experienced dermatologists take an average of 1 minute and 10 seconds to perform a complete skin examination. If dermoscopy, a method of skin examination with use of a noninvasive optical instrument, is added, the complete skin examination takes an average of 2 minutes and 22 seconds. So the bottom line is not how long your dermatologist takes, but whether you feel comfortable that he or she checked you all over. The examination should include not only your skin but also your scalp, hair, mouth and nails. If you feel that the examination was not through and your dermatologist was not responsive when you stated this, then I do suggest you consult another dermatologist. Perhaps you can get a word-of-mouth recommendation from someone who is happy with their dermatologist. Besides freezing with liquid nitrogen, treatment options for actinic keratoses include heat treatment (electrodesiccation) and prescription creams such as Efudex (5-fluorouracil) and Aldara. I prefer Aldara because some studies have shown it to be more effective than Efudex. Aldara contains the active ingredient, imiquimod, which specifically stimulates your skin's immune system to destroy the actinic keratoses. It tends to cause less skin irritation than Efudex and, unlike Efudex, it does not cause sun sensitivity.

Hope this helps!

Dr. Hema