By now, most people are well aware of the damage they're potentially causing to their skin when they expose themselves to the sun’s UVA and UVB rays. Many of us are even aware of the staggering statistics, like that one in five Americans will develop some form of skin cancer during their lifetime. Recent years have also seen the proliferation of apps meant to help diagnose funny looking moles, with an aim toward detecting potential skin cancer early on. These apps (like SkinVision and SpotCheck) first appeared about three or four years ago, and most of them involve snapping a photo of your mole, and either screening it with computer analysis, or sending it to a licensed dermatologist.
In theory, these apps make sense: they're intended as an easy way to maintain skin health without having to cram an IRL dermatologist appointment into a busy schedule the second we notice something is a little "off." But dermatologists have begun to voice their concerns that the apps may actually be deterring patients from seeking real-life medical care when they need it. We asked to some of the top dermatologists out there for their take.
Can iPhone Apps Actually Lead to Incorrect Diagnoses?
Dr. Snehal Amin, the Director of Manhattan Dermatology & Cosmetic Surgery, cites a 2013 study that evaluated this exact question. According to the study, three of four smartphone applications incorrectly classified 30 percent or more of melanomas as "unconcerning," he explains. He goes on to explain how a dermatologist might react differently than an app: "When a dermatologist is unsure about the nature of a particular skin spot, they biopsy it. A skin biopsy is a quick and nearly painless procedure and it is 99 percent accurate. I've had two myself (with good results). A photo with your iPhone lens is definitely not as accurate as a pathologist's microscopic analysis," he says.
Dr. Julie Russak of Russak Dermatology Clinic isn't totally against the use of dermatological apps. If, for example, you already have a standing relationship with your doctor, certain conditions can easily be treated and followed up on virtually, like an acne flare-up or a cosmetic treatment, she says. But if it's a new skin condition, she advises that it's always best for the doctor to see it in person. She also points to the fact that most apps probably aren't as comprehensive as they should be. "You couldn't possibly do a full-body skin cancer check virtually. There are simply some things you just cannot do, and an app shouldn't be intended for that."
We asked the dermatologists if they could recall any stories of patients using apps and later visiting their practices, and Dr. Amin recalled that he'd had a patient who was an executive at one of the melanoma diagnostic device companies. "She came in saying the mole on her torso felt abnormal but their own device called it 'normal' several times. She was right, because with the skin biopsy, I found a severely abnormal mole; thankfully it wasn't skin cancer."
Apps May Actually Have a Selfie Effect – In a Good Way
Mole-checking apps can have some positive effects, according to experts. "If a phone app helps you look at your skin periodically, then you're much more likely to notice something changing or strange on your skin," says Amin. "If this app helps you check the back of your legs or your mid-back, that could help doctors to find more skin cancers earlier." So he's not completely against using the apps; he's just against using them in place of actual visits to the doctor.
And Amin also notes that these apps may help to save lives by helping with early detection. "Catching skin cancer early does save lives, and only 15 percent of Americans actually go for their annual skin cancer screening," he says. "These apps can help patients become more aware of their skin spots and can be used in conjunction with their annual dermatologist visits to catch skin cancers earlier."
Russak echoes this sentiment, adding that apps could help to open up the conversation between doctor and patient, enabling the patient to feel more comfortable with the subject.
What Will Future Apps Bring?
The data may show that our current mole-checking apps aren't entirely reliable, but experts remain hopeful that improvements are coming. Amin is currently consulting with a few companies that are working on automated skin cancer detection, and he says that he's excited about what's coming to the market soon for patients. "The software has gotten smarter, and now some apps don't rely on your built-in iPhone lens, but have an attachable device with LED lights or polarized light. Soon we may even have a laser microscope (confocal microscopy device) that you can attach to your phone," he says.
Dr. Neil Sadick of Sadick Dermatology is also hopeful about the implications of technological advances with these apps; he agrees that telemedicine is a promising field.
What You Should Do If You’re Concerned Now
If you're currently concerned about a strange-looking spot or are considering using an app because of a hectic schedule, keep in mind that current technology has its limits, so a doctor's trained eye is still your best bet.
Amin estimates that one out of every 10 of his patients has tried out an app, but when you include Google, he jokes, it's 10 out of 10. "The dermatologist's eye is sharper than your 12 megapixel smartphone, and scheduling an appointment is quicker than downloading an app, and can save your life."