Most people have at least a few moles, freckles, bumps or other marks on their skin. Many of these spots are harmless and may remain unchanged for years. Others can appear with age, sun exposure, hormonal changes or irritation.
Although noticing a skin growth does not automatically mean something is wrong, it is important to pay attention to new or changing spots. Skin cancer and other medical skin conditions can sometimes resemble an ordinary mole, sore or irritated patch. A dermatology provider can examine the area and determine whether it should be monitored, treated or tested.
Use the ABCDE guide to watch your moles
The ABCDE guide is a useful way to recognize changes that may need professional evaluation:
- A — Asymmetry: One half of the mole does not resemble the other half.
- B — Border: The edges appear irregular, blurred, scalloped or poorly defined.
- C — Color: The spot contains multiple colors or develops an uneven distribution of brown, black, red, white, blue or other shades.
- D — Diameter: The mole is larger than approximately 6 millimeters, although concerning spots can also be smaller.
- E — Evolving: The mole changes in size, shape, color, elevation, texture or symptoms.
The “E” for evolving is especially important. A spot that looks different from your other moles or begins changing deserves attention, even when it does not meet every part of the ABCDE guide.
Other warning signs to watch for
Not every concerning skin growth looks like a dark or irregular mole. Some skin cancers and precancerous growths appear as a pink bump, a rough patch, a sore that repeatedly crusts or an area that simply does not heal.
Schedule a dermatology appointment when you notice:
- A new growth that continues to enlarge
- A sore that does not heal or repeatedly opens
- Bleeding or crusting without a clear cause
- A spot that becomes painful, tender or persistently itchy
- A shiny, pearly, scaly or rough area that does not go away
- A mole that suddenly becomes raised or changes texture
- A dark streak beneath a fingernail or toenail that was not caused by an injury
- Pigment extending beyond the border of a mole
- A spot that looks noticeably different from the others around it
Dermatologists sometimes refer to the last example as the “ugly duckling” sign. Most of a person’s moles tend to share similar characteristics. A spot that stands apart in color, shape or size may warrant a closer look.
Can skin cancer occur in people with darker skin?
Yes. People of every skin tone can develop skin cancer. Although certain types are more common in people with lighter skin, no one is completely protected.
On darker skin, suspicious changes may be more likely to occur in areas that receive less sun exposure, including the palms, soles, nails or inside the mouth. This is one reason a complete skin check should include more than the face, shoulders and arms.
How to perform a skin self-check
Regular self-checks can help you become familiar with what is normal for your skin. You do not need to diagnose anything yourself. The purpose is simply to identify changes that can be brought to a dermatology provider’s attention.
Choose a well-lit room and use both a full-length mirror and a handheld mirror. Examine:
- Your face, ears, scalp and neck
- Your chest, abdomen, sides and back
- The fronts and backs of your arms and legs
- Your hands, palms, fingernails and spaces between your fingers
- Your feet, soles, toenails and spaces between your toes
- Areas beneath skin folds
- The genital and buttock areas
A comb or hair dryer can make it easier to check the scalp. You may also ask a partner or family member to look at areas that are difficult to see.
Taking a clear photograph can help you compare a spot over time. Try to use similar lighting and distance each time. Photographs are useful for tracking changes, but they should not replace an examination when a growth is already concerning.
When should you make an appointment?
There is no need to wait until a spot becomes painful or dramatically different. Contact a dermatology provider when you notice a new, unusual or changing area — especially if it continues to evolve over several weeks.
You may also benefit from periodic professional skin examinations if you have:
- A personal or family history of skin cancer
- Numerous moles or several unusual-looking moles
- A history of significant sunburns
- Frequent occupational or recreational sun exposure
- Previous indoor tanning exposure
- A weakened immune system
- A spot you cannot monitor easily on your own
Your provider can recommend an examination schedule based on your individual risk factors.
What happens during a dermatology evaluation?
Your provider will first ask how long the spot has been present and whether it has changed, bled, itched or caused discomfort. The area may be examined with magnification or a specialized handheld instrument that provides a closer view of structures beneath the surface.
Many spots can be identified through examination alone. When the diagnosis is uncertain or a growth appears suspicious, a small sample may be taken for laboratory testing. This is called a skin biopsy.
A recommendation for biopsy does not mean that a growth is necessarily cancerous. It simply allows the tissue to be examined more closely so that an accurate diagnosis can be made.
Protect your skin between appointments
Sun protection can help reduce additional ultraviolet damage. Choose a broad-spectrum, water-resistant sunscreen with an SPF of at least 30, apply it to exposed skin and reapply as directed — especially after swimming or sweating. Protective clothing, sunglasses, hats and shade provide additional protection.
Avoid intentionally tanning outdoors or in tanning beds. A tan is a sign that ultraviolet radiation has affected the skin, even when there is no visible sunburn.
Do not ignore a changing spot
Most moles and skin growths turn out to be benign, but appearance alone cannot always confirm what a spot is. An evaluation can provide reassurance when a growth is harmless and help ensure that a concerning condition is addressed promptly.
If you have noticed a new, changing or uncomfortable spot, schedule an appointment for a professional skin evaluation.