Can You Trust Skin Cancer Apps

Human error plays a big role

The technology is not perfect, but neither is the user. Ever snapped a bad photo? That's the risk here. Human error can play a crucial role in accuracy. Bad lighting, a slightly blurry image or a photo taken at an awkward angle could distort the size, shape or color of the mole or lesion, leading to a misdiagnosis.

"It's like everything else in medicine – there are false negatives, false positives and user errors," Dr. Doolittle says.

Worst case scenario, let's say a person accepts the app's assessment of a "low-risk" mole and doesn't follow up with a doctor. The false sense of security can be dangerous if he or she actually has an aggressive form of melanoma. Left unchecked, the cancer can spread in a matter of months.

"It can happen," Dr. Doolittle says. "I've seen patients who didn't have moles or lesions that looked anything like melanoma, but they turned out to be melanoma."

As a rule, skin cancer tends not to look like its "neighbors." Smartphone apps may not be programmed to make such comparisons.

For example, amelanotic melanomas have no color. They appear as pink or tan spots and can be very dangerous. Apps based on color and pattern recognition won't pick them up.

That's why doctors look at people instead of apps. A trained eye, how the spot feels and how it appears under a microscope are very important when ruling skin cancer out. Dermatologists will also use a dermoscope, a special noninvasive, handheld microscope that lights up the skin pigment network, giving doctors a much better view of what's going on underneath the skin.

Apps are conversation starters

Dr. Doolittle says smartphone apps may have a bright future, but only as a first step in early detection. He wants users to see the app for what it is – a conversation starter between patient and doctor, not a replacement for your dermatologist.

"There's no question these apps will raise awareness and encourage people to point out moles or unusual skin findings to their doctors – even if they are going in for a routine exam," Dr. Doolittle says.

Dr. Doolittle says the smartphone apps could be most helpful to those people who may not be getting regular skin cancer screenings. Apps do not take the place of being evaluated in person. If you have a spot, it's best to have it checked by a doctor.

Still, it's an exciting development

Despite the limitations of smartphone app technology, Dr. Doolittle agrees the potential is exciting.

"Anything that can catch skin cancer farther 'upstream' is going to turn into a cure," Dr. Doolittle says. "A melanoma doctor has to believe image recognition technology and smartphone apps are a positive thing, assuming all the appropriate studies are done before it is released to the general population."