If you’ve ever stood in front of the mirror, spotted a mole you don’t remember seeing before, and thought “I’m sure it’s nothing”, you’re not alone. Almost every patient who comes to see us about a mole starts the conversation the same way, half apologising for wasting our time. They never are. In over twenty years of medicine, in general practice, in hospital dermatology clinics and now in my own clinic, I’ve learned that the patients who catch something early are almost always the ones who trusted their gut and got it looked at.
Skin cancer, and melanoma in particular, is one of the few cancers you can genuinely see coming if you know what to look for. That’s the good news. The slightly less good news is that most people don’t check their skin regularly, and even when they do, they’re not always sure what counts as normal and what doesn’t. This blog is here to help with that.
Minor Surgery at Health & Aesthetics
What Makes A Mole Worth Checking?
Most of us have somewhere between ten and forty moles by adulthood, and the overwhelming majority are completely harmless. Moles are simply clusters of pigment cells, and having a lot of them doesn’t automatically mean anything is wrong. What matters isn’t the number, it’s whether any one of them stands out from the rest.
We often tell patients to think of it as the “ugly duckling” test. Look at your moles as a group. Most people have a pattern, a sort of family resemblance between their own moles. The one that doesn’t fit that pattern, the one that looks different from its neighbours, is the one worth a closer look. It doesn’t need to be dramatic. Sometimes it’s just a mole that’s slightly darker, slightly more irregular, or simply new.
Dermatologists also use a simple checklist called ABCDE, and I still use it every single day in clinic:
- Asymmetry: one half doesn’t match the other
- Border: edges that are blurred, notched or irregular rather than smooth
- Colour: uneven shading, or more than one colour within the same mole
- Diameter: generally more than 6mm, roughly the size of a pencil eraser, although melanomas can be smaller
- Evolving: any change in size, shape, colour or texture over weeks or months
No single one of these means “cancer”. But if a mole ticks more than one box, or has changed noticeably, it’s worth having a professional look at it rather than watching and waiting.
Changes In Size, Colour, Shape
This is the part patients often get wrong, understandably. A mole that has always been slightly irregular and hasn’t changed in ten years is usually far less concerning than a mole that looked completely ordinary six months ago and has since changed shape. Change over time is one of the strongest signals we look for, which is exactly why “Evolving” sits in the ABCDE list.
Practically, this means it helps enormously if you know your own skin. I would encourage every patient, especially anyone who is fair-skinned, has a family history of melanoma, or has had significant sun exposure or sunburn in the past, to take photos of their moles every few months. It sounds unglamorous, but a simple photo on your phone is one of the most useful diagnostic tools you own, because it turns “I think it might have changed” into something we can actually compare.
Colour changes deserve a special mention. A mole that develops several different shades within it, particularly if one of those shades is very dark, almost black, or has patches of red, white or blue, should be checked promptly. Bleeding, crusting, itching or a mole that simply feels different to the touch are also signs we never wave away.
Should I Be Concerned?
Honestly, in the vast majority of cases, no. Most moles that patients bring to me turn out to be entirely benign, and we say that not to be dismissive but because it’s genuinely reassuring and true. The purpose of a mole check isn’t to send you home terrified, it’s to give you a clear, professional answer so you can stop wondering.
That said, we would rather see ten patients with nothing to worry about than miss the one who has something that needs treating. Melanoma is one of the few cancers where early detection makes an enormous difference to outcome. Caught early, while it’s still confined to the top layers of the skin, it’s highly treatable. Left unchecked, it can spread. That difference is entirely about timing, which is why I always say there’s no such thing as a silly reason to get a mole checked.
What Happens During A Mole Check?
A mole check is quick, painless and, frankly, far less daunting than most people expect. We use a dermatoscope, a handheld magnifying device with polarised light, which lets us see the structures within a mole that are completely invisible to the naked eye. This is the same technology used in hospital dermatology departments, and it dramatically improves accuracy compared with a visual check alone.
During your appointment, we examine any moles you’re concerned about individually, but also look more broadly across your skin, because it’s not unusual for a patient to come in about one mole and for us to find something else worth keeping an eye on elsewhere. Where a mole looks entirely reassuring, we will tell you so, and often we will photograph it for comparison at a future visit. Where something looks less straightforward, we will discuss the options, which usually means a referral for a biopsy so the mole can be examined properly under a microscope. This is not a diagnosis of cancer, it’s simply the safest way to be certain either way.
When To Seek Medical Advice
You don’t need a special occasion or a dramatic symptom to book a mole check. If a mole has changed, if something ticks a few of the ABCDE boxes, if you’ve noticed bleeding, crusting or persistent itching, or if a mole simply looks or feels different from the rest, that’s reason enough. The same goes if you’re someone who burns easily, has a family history of skin cancer, or has spent a lot of time in the sun over the years, whether from holidays, outdoor work or, years ago, sunbeds.
If you have been putting off getting a mole looked at because you’re worried you’re overreacting, please don’t be. That instinct to check is exactly the right one, and it’s the reason early skin cancers get caught. If you’d like a professional mole check, do get in touch with the clinic and we will arrange a time that suits you.
