Mole checks: which skin changes should you not ignore?

Most moles and other skin growths are benign. However, a new or changing growth can sometimes be an early sign of skin cancer. Regular self-examination helps you notice changes early, while a dermatologist makes the final assessment through a clinical examination and, if needed, dermoscopy.

The ABCDE rule: a simple guide for self-examination

A stands for asymmetry: one side does not match the other. B refers to borders: look for irregular, notched or unclear edges. C describes colour: several colours or uneven pigmentation may warrant examination. D is diameter, although a smaller growth can also matter. E means evolution: changes over time in size, shape, colour or sensation.

ABCDE is not a diagnostic test. A growth may not meet all criteria and still need examination. The “ugly duckling” rule is also useful: a mole that differs markedly from the others on your skin is worth showing to a dermatologist.

How to examine your skin

Examine your skin in good light about once a month. Remember your back, scalp, ears, feet, between the toes and under the nails. Use a mirror or ask someone close to you to help with areas that are hard to see. Dated photographs may help identify changes, but different lighting and distance can be misleading.

Particular attention is needed for people with many pigmented growths, repeated sunburn, intense UV exposure, fair skin or a family history of melanoma. A dermatologist determines the appropriate frequency of checks.

What does dermoscopy offer?

A dermatoscope allows the doctor to see magnified structures and pigment patterns that are not clearly visible to the naked eye. The examination is usually painless. Depending on the findings, the doctor may recommend monitoring, digital comparison, biopsy or surgical removal.

A suspicious pigmented growth should not be removed solely for cosmetic reasons without a dermatologist’s assessment. The medically safest approach must be determined first, with histological examination of tissue where needed.

Sun protection is everyday prevention

Avoid sunburn, seek shade around midday, wear protective clothing and use a suitable broad-spectrum sunscreen. Sunbeds are not a safe alternative to sunlight. Protection reduces UV damage but does not remove the need to examine existing changes.

When should you book a consultation?

Consider a consultation if:

· a growth enlarges or changes shape, border or colour;

· spontaneous bleeding, an ulcer or a scab appears and does not heal;

· a mole repeatedly itches, hurts or becomes tender;

· a new growth appears that differs from the others.

When not to wait

A rapidly changing, bleeding or non-healing growth should be examined as soon as possible. Self-examination and mobile apps do not replace a dermatologist’s diagnosis.