A mole is a common skin growth composed of melanocytes, the cells that produce the pigment melanin. These spots, which range in color from tan to dark brown, are typically benign and appear on the skin during childhood and early adulthood. While most moles remain harmless, some can evolve into melanoma, the most serious form of skin cancer. Understanding the difference between a normal mole and a suspicious lesion is important because early detection significantly increases the likelihood of successful treatment.
Using the ABCDE Method for Self-Screening
The most widely used guideline for monitoring moles at home is the ABCDE method, which outlines five characteristics that can signal a need for professional evaluation. The letter A stands for Asymmetry, meaning one half of the mole does not match the other half. A normal mole is generally symmetrical and uniform; if you were to draw a line through the center of a suspicious mole, the two sides would appear different in shape or color.
The letter B represents Border irregularity, where the edges of the mole are uneven, notched, or scalloped. Benign moles typically have sharp, continuous outlines, but a melanoma often exhibits ragged or blurred edges. C is for Color variation, describing a mole that contains multiple colors or shades within the same lesion. A benign mole is usually a single shade of brown, but a concerning lesion may display shades of black, brown, tan, white, red, or even blue.
D stands for Diameter, noting that a mole larger than 6 millimeters (approximately the size of a pencil eraser) should be examined. While some melanomas can be smaller, size is a significant consideration, especially if a mole is growing. E is for Evolving, which refers to any change in a mole over time. This includes changes in size, shape, color, elevation, or the development of new symptoms such as bleeding, itching, or crusting. Any mole that exhibits one or more of these ABCDE characteristics must be brought to the attention of a dermatologist immediately.
Factors That Increase Your Need for Professional Screening
While self-monitoring is valuable, certain risk factors necessitate regular professional skin examinations. Individuals with a personal history of melanoma or other types of skin cancer, such as basal cell or squamous cell carcinoma, require professional checks. The risk also increases if you have a first-degree relative—a parent, sibling, or child—who has been diagnosed with melanoma.
Another risk factor is the presence of numerous moles on the body, particularly if the count exceeds 50 to 100. Having atypical moles also increases risk; these moles often share features with melanoma, such as irregular borders or varied color, but are benign lesions themselves. Individuals with fair skin, light hair, and light-colored eyes are more susceptible, as their skin produces less protective melanin.
A history of severe, blistering sunburns, especially those occurring in childhood or adolescence, also raises the risk of developing melanoma. Exposure to ultraviolet (UV) radiation from the sun or from indoor tanning beds is a significant contributor to risk. For high-risk individuals, such as those with a history of melanoma or many atypical moles, an annual full-body skin examination by a dermatologist is recommended. Those with lower risk factors may be advised to perform monthly self-checks and see a professional less frequently, based on their doctor’s guidance.
What to Expect During a Dermatologist Examination
A professional skin examination usually begins with the dermatologist taking a detailed medical history, focusing on your risk factors and any changes you have noticed on your skin. The core of the visit is a full-body skin check, where the doctor systematically examines the skin from head to toe, including the scalp, palms, soles of the feet, and between the toes. You will be asked to wear a gown, and the examination typically takes 10 to 20 minutes.
The dermatologist uses a specialized handheld device called a dermatoscope to inspect any moles or lesions that appear unusual. This instrument uses light and magnification, allowing the doctor to see deeper structural patterns within the skin that are invisible to the naked eye. This detailed view helps the clinician distinguish between a benign mole and a potential skin cancer.
If a lesion is suspicious, the next step is a biopsy, which is a procedure performed in the office. The area is first numbed with a local anesthetic, and a small sample or the entire lesion is removed using a specialized blade. The tissue sample is then sent to a laboratory for microscopic analysis to determine if cancer cells are present, providing a definitive diagnosis.