How to Delicately Talk to Clients When You See an Abnormal Lesion

Promoting early detection of a client’s abnormal lesion starts with an important conversation, writes Mary-Ann McCall.

Has there ever been a time when an abnormal lesion makes you do a double take, but unsure how to tell your client? Turning a calm and soothing treatment into a serious conversation can be daunting.

As a dermatology nurse and dermal clinician, Jennifer Hookham has navigated through these conversations. She advises the best way to start the exchange is by simply asking, “Have you had a skin check before?”

The fundamental question places the topic back on skin health. To ensure that clients are not caught off guard, Jennifer recommends having brochures in clinics or having the information sent to clinics before appointments. This way, the client knows they are in a supportive environment.

Still, clients can be hesitant. There’s a fear of the unknown of what can come from a skin check. “Some people are genuinely scared of melanoma or skin cancer,” Jennifer says, and in cases like these, clinicians need to understand their fears and reluctances but reassure them that it’s the safest approach.

“In the majority of cases, most lesions are benign but because we are treating it’s really important that we have done everything in our power to make sure that we are working safely,” Jennifer says.

What happens if a client wants to ignore your advice? “For the ones who don’t respect that, and they just don’t want to go down that pathway, then maybe they’re not the client for you,” Jennifer assures. “Because you don’t want to do anything that jeopardises your professionalism or your ethics.”

These conversations are lifesaving. At least 2 out of 3 Australians will be diagnosed with skin cancer, so the importance of early detection is also a duty of care. “It’s an education component of our consultation, and it’s implying the fact that skin checks are really important and they need to be done by a skin cancer qualified professional so they know what they’re looking for,” Jennifer states, also indicating that there could be further consequences if abnormal lesions are ignored during treatments.

“Because there are studies that have shown that if you do irradiate over a lesion that you have assumed is a pigmented lesion that’s benign, and they turn out to be a melanoma in situ, or a lentigo maligna, then that’s an issue.”

Thanks to initiatives like Spot a Spot from TAFE NSW, clinics can confidently navigate these discussions with clients and identify abnormal lesions. Certificates from Dermoscopy courses offered by Health Cert, Dermatology Australasia, and the Skin Cancer College Australasia provide skin therapists with advanced skills for thorough lesion identification.

Levelling up the initial consultation builds client trust in your capabilities as a skin professional. But it all begins with the first step: if you see something, say something.

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