Melanoma is a serious form of skin cancer that starts in the cells that give skin its color. It can spread to other parts of the body if not addressed promptly.

"Melanoma is an extremely common cancer," says dermatologist Jesse Hirner, MD. "When detected early, it's treated with a minor skin procedure, and we're able to cure it the vast majority of the time. But when detected late, it's more difficult to deal with."

Unfortunately, patients who have had melanoma once are at higher risk of getting it again. 

"Some of these patients are more likely than not to have another melanoma in their life," Dr. Hirner says. "Close monitoring is really important."

The good news is that the Nebraska Medicine Dermatology team is using new technology to help catch melanoma early, when it's easiest to treat.

What is total body photography?

Total body photography is a way to monitor your skin for changes that might be cancer. It's not just taking photos – it's a complete system to track any changes in your skin over time.

"Total body photography is full head-to-toe photography usually done once a year," Dr. Hirner says. "Our platform, called FotoFinder, includes highly magnified imaging underneath the surface of the skin to allow us to better diagnose early skin cancer."

The system takes detailed pictures of your whole body (with underwear left on). You'll get these pictures taken once a year so doctors can spot new moles or changes in existing ones.

How it works

The technology includes the following features:

• 100x magnified views under the skin’s surface.
• Computerized tracking of all the spots on your body.
• Artificial intelligence (AI) that helps identify suspicious spots.
• Images that can be viewed by all your doctors through your electronic medical record.

"Total body photography allows us to know in really detailed ways about changes to people's skin," says Dr. Hirner. "It allows us to detect new spots and changes in existing spots more reliably than if we're only relying on our memory and the patient's memory."

Is total body photography right for you?

It's important to understand that total body photography is not for everyone. Nebraska Medicine offers this service specifically for people at high risk for melanoma.

You might be a good candidate if you:

• Have had melanoma before.
• Have a strong family history of melanoma.
• Have a genetic condition that increases your melanoma risk.
• Have been identified by a doctor as high-risk.

"Screening low-risk patients would be an unnecessary cost to them,” Dr. Hirner says. “We're really focused on patients who are at high risk of developing a melanoma."

If you're not sure if you qualify, talk to your doctor. They can help determine if this screening would be beneficial for you.

Does insurance cover it?

Insurance coverage for total body photography is improving, according to Dr. Hirner.

"In Nebraska, we anticipate about half of patients will get insurance coverage for it," he says. ""Just five years ago, it was never covered by insurance. We're seeing increases in coverage as data demonstrates more usefulness."

The Nebraska Medicine team will work with your insurance provider before your appointment to let you know about any potential costs.

The role of artificial intelligence

The FotoFinder system uses AI to enhance the skin examination process beyond what the human eye can detect.

"AI has a lot of promise in early detection of melanoma,” Dr. Hirner says. “Certain AI models actually perform better than a dermatologist."

However, the final decision about whether to remove a suspicious spot always involves both you and your doctor. AI is just a helpful tool in the process.

A team-based approach 

Nebraska Medicine offers a Multidisciplinary Melanoma Clinic, where several specialists work together to create the best treatment plan for each patient.

The team includes:

• Medical oncologists (cancer doctors).
• Dermatologists (skin doctors).
• Surgical oncologists (cancer surgeons).
• Mohs surgeons (specialized skin cancer surgeons).

"By having everybody in clinic together, it allows for real-time communication," Dr. Hirner says. "That close coordination is really valuable."

For complex cases, the team meets weekly to discuss treatment plans. This includes even more specialists, like radiation physicians and pathologists who study tissue samples.

Next steps

If you think you might be at high risk for melanoma, talk to your doctor about whether a referral to the Nebraska Medicine Multidisciplinary Melanoma Clinic is right for you.

Remember that regular skin checks – both at home and with your doctor – remain an important part of skin cancer detection, whether or not you qualify for total body photography.