Moles, also known as nevi, are extremely common skin growths that develop when pigment-producing cells, called melanocytes, grow in clusters instead of being spread evenly throughout the skin. Most adults have between 10 and 45 moles that typically appear during childhood and adolescence. While the vast majority of these growths are harmless, any mole has the potential to become cancerous, which is why regular monitoring is important. Early detection of melanoma, the most serious form of skin cancer, dramatically increases the chances of successful treatment.
Recognizing Moles That Need Attention
Regular self-examination is the first step in monitoring your skin for changes that might indicate a health concern. When performing these checks, you should look for the “ugly duckling” sign, which is any mole that looks noticeably different from the others on your body. This visual comparison helps identify a lesion that stands out in size, shape, or color.
To systematically assess individual moles, medical professionals recommend using the ABCDE method, an acronym that describes five features of suspicious growths:
- Asymmetry: One half of the mole does not match the other half. Benign, or non-cancerous, moles are generally symmetrical.
- Border irregularity: The edges are uneven, scalloped, or poorly defined, contrasting with the smooth edges of a typical mole.
- Color variation: Involves multiple colors or uneven shading within a single spot, such as shades of tan, brown, black, white, red, or blue.
- Diameter: Most melanomas are larger than 6 millimeters, roughly the size of a pencil eraser.
- Evolving: Refers to any change in a mole’s size, shape, color, or elevation. A spot that starts to itch, bleed, or looks different should be examined by a healthcare provider.
Healthcare Professionals Who Perform Checks
Once a suspicious mole is identified, Primary Care Physicians (PCPs), such as family doctors, are appropriate for routine screenings and initial assessment. PCPs are trained to perform visual skin checks and can often use a dermatoscope, a magnifying device, to look closely at a mole’s subsurface structure.
If a PCP identifies a suspicious lesion or if you have a high risk for skin cancer, such as a strong family history or numerous atypical moles, they will typically refer you to a dermatologist. Dermatologists are skin specialists who possess specialized knowledge and tools for complex cases and full-body examinations. They are the practitioners best suited to diagnose and manage skin cancers, especially melanoma.
Specialized skin cancer clinics also offer comprehensive screening services, often utilizing advanced imaging techniques like total body photography for high-risk patients. These clinics offer a focused approach to detection. Community health centers or foundations sometimes offer free or low-cost screening events for initial evaluation by a trained professional.
What Happens During a Professional Mole Check
A professional mole check typically begins with a discussion of your medical history, focusing on family history of skin cancer, sun exposure habits, and any changes you have noticed. You will be asked to undress and wear a gown so the provider can perform a thorough visual examination of all skin surfaces, as melanoma can appear in areas not exposed to the sun.
The provider will use a handheld dermatoscope to examine any moles or lesions on your skin. This tool uses magnification and specialized light to reveal subsurface features invisible to the naked eye. This non-invasive procedure helps the clinician distinguish between a benign growth and one that might be cancerous.
If a mole appears suspicious after dermoscopy, the next step is usually a skin biopsy to obtain a definitive diagnosis. This minor procedure is performed in the office using a local anesthetic to numb the area. Depending on the lesion’s size and location, the provider may perform a shave biopsy (removing the top layers of the skin) or a punch biopsy (removing a small, cylindrical plug of tissue).
The tissue sample is then sent to a laboratory where a dermatopathologist examines the cells under a microscope. Results generally take one to three weeks, as the sample requires preservation, slicing, and staining before detailed analysis. If the results indicate melanoma, the healthcare team will develop a treatment plan, which may involve further surgery.