Skin cancer knowledge, attitudes, and practices among non‐medical skin care professionals: A narrative review of cross‐sectional and interventional studies

Abstract

Background Skin cancers are the most common malignancies in the United States. Total body skin examination by a physician, especially a dermatologist, is the gold standard for detecting suspicious lesions that may require further evaluation. Non‐medical professionals (NMPs) including massage therapists, estheticians, hairdressers, and cosmetologists have the unique opportunity to frequently examine their client's skin outside of a clinical setting. By evaluating their knowledge of and comfort with evaluation of suspicious lesions, multiple studies have gauged the utility of patient encounters with NMPs for skin cancer detection. Several studies have also focused on assessment of intervention strategies for assessing and improving NMPs ability to detect suspicious lesions and to refer for physician evaluation when necessary. Aims To conduct a narrative review of skin cancer knowledge, attitudes, and practices among NMPs. Patients/Methods A systematic search of the databases yielded 16 studies for review. A total of 8 cross‐sectional studies examined the knowledge and attitudes of NMPs toward skin evaluation, and 8 studies assessed interventional strategies for improving NMPs’ ability to assess skin lesions for consideration of physician referral. Results This review finds that NMPs are open to the idea of examining the exposed body surfaces relevant to their work with clients and are willing to refer for physician evaluation when needed. Multiple interventional strategies have demonstrated success with educating NMPs on the importance of skin surveillance and the characteristic physical examination findings associated with skin cancers. Conclusion Strengthening the readiness of NMPs to examine their client's skin offers an opportunity to reduce time to skin cancer diagnosis, improve patient outcomes, and lower healthcare‐associated costs of skin cancer treatment.

Examining the Role of Estheticians in Skin Cancer Surveillance

“…Data regarding whether nonmedical professionals can screen accurately are lacking [11]. There is concern that training may cause overconfidence, leading to over-referral for benign lesions.…”

“…For example, "health-related" knowledge may encompass many topics including cosmetics or acne. Revisions to this wording may help further define comfort when Data regarding whether nonmedical professionals can screen accurately are lacking [11]. There is concern that training may cause overconfidence, leading to over-referral for benign lesions.…”

“…Estheticians are trained skincare professionals, and involving estheticians in skin cancer screenings has great potential as they are more numerous than dermatologists, see their clientele regularly, and might provide a more cost-effective screening. Few studies have investigated potential barriers preventing estheticians from participating in lesion detection or examined the efficacy behind educational curriculums for lesion detection in nonmedical professionals [11]. Our goal was to develop an education course to train nonmedical professionals to recognize concerning lesions, to assess the baseline knowledge of estheticians toward skin cancer detection, and to determine the effect that our curriculum has on lesion detection.…”

“…Previous studies have shown that skin cancer screenings are important to identify lesions early; however, data are lacking to establish recommendations for the general population due to concerns regarding risk-to-benefit ratio and overtreatment [2,3]. Formal skin cancer education among nonmedical professionals is variable [4][5][6][7][8][9][10], and the accuracy of skin cancer screening by nonmedical professionals is largely unknown [11]. In addition, there are potential risks to promoting skin cancer screening by nonmedical professionals.…”

Stylists saving lives: A program to educate hairstylists in the early detection of skin cancers

“…A recent systematic review identified 16 studies done among non-medical professionals evaluating the knowledge of skin cancers among massage therapists, aestheticians, and hairdressers. 2 Roosta et al studied hairdressers' knowledge regarding melanomas. They noted that while almost 70% were likely to refer a client to seek medical attention, only 12% felt confident in their ability to identify these lesions.…”