What Causes Moles On Face In A Person With A History Of Melanoma?

Posted on Thu, 21 Jan 2016

Question: I am 67 years old and have had skin cancers on my face, one of which required a Mohs procedure over ten years ago. Although I am more careful now to wear a hat and sunscreen and limit outdoor time during the sunniest hours (I live in often XXXXXXX Northern California), I continue to develop a variety of moles (some of which itch and/or peel off at times) and other skin irregularities. My father had a melanoma which was successfully treated when in his 70s. I have read in various places that I should be seen by a dermatologist annually because of my history and I have asked for referrals from two different primary care physicians but they have turned me down and settled for cursory exams by themselves. Why are they so reluctant? Should I be satisfied with this? Is there some way to present my situation so that they would be more likely to refer me to a skin specialist for a more thorough check-up?

Answered by Dr. Bonnie Berger-Durnbaugh (23 minutes later)

Brief Answer:
About referrals:

Detailed Answer:
Hello XXXXXXX

Negotiating the medical system can be frustrating. Depending on the type of insurance plan you have, they may refuse a primary care doctor's referral for things that they consider a primary care doctor can do.

I think your request to see a dermatologist for a thorough skin survey is reasonable and I do not think you should be satisfied with a cursory exam. The doctor should be looking everywhere, even in remote places, and thoroughly. I would be very assertive and adamant that you want to see a dermatologist for a very thorough skin survey because you have a primary relative who had melanoma. That would be the argument I would make. And that you do not feel comfortable with anything less.

Are you able to refer yourself or does your insurance require that you first go through primary care?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Bonnie Berger-Durnbaugh (1 hour later)

My insurance requires that I go through primary care in order to be referred to a dermatologist. Thank you for your input.

Answered by Dr. Bonnie Berger-Durnbaugh (2 hours later)

Brief Answer:
Good luck to you.

Detailed Answer:
Sometimes being very persistently assertive can get people past the primary practice "gate keeper". Any thing you can provide that might be beyond the primary cared doctor's expertise might get you a referral.

Good luck to you - I hope it works out.

Best regards,
Bonnie Berger-Durnbaugh, MD

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar