Examine a Mole

A mole is a brown to black growth on skin that develops when pigmented skin groups into clusters. Moles are mostly flat, but can also be elevated. They are usually round or have a regular shape. These commonly appear in the first few decades of life and, for most, continue to grow until about the age of 40. The presence of normal moles is not a concern, but atypical moles may be related to skin cancer. If you know the characteristics of the different types of moles and understand what to look for, you can examine your moles and figure out if you need to seek a medical opinion.

Steps

Examining Moles In-Depth

1. Look for atypical moles. The main way to tell if a mole is atypical is to know the difference between them and normal moles. Atypical moles, also known as dysplastic nevi, are most commonly seen on the chest and back. These moles are usually greater than 6 mm in diameter and have more than two shades of brown or black on them. They look different than normal moles because their margins are irregular and, in most cases, they have a raised center, which is called a "fried-egg” appearance.
   • Atypical moles have a greater chance of forming a cancer.
   • Normal moles are usually smaller than 6 mm, do not have more than two shades of color in them, and have regular and well-defined outlines on the skin. At times, normal moles may turn into atypical moles if they have unusual multiplication of the pigmented cells.
   • Freckles are different from moles. They are not from an increase in pigment producing cells. To make freckles, some of the pigments produced by the skin group together to form granules and cause the characteristic ‘freckling’ of skin. Freckles are usually lighter and smaller than moles, are flat, and are very common on the face, chest, and upper arms.
2. Find the right time to examine your moles. To detect skin cancer earlier, it is necessary to perform a regular self-examination. You should do a thorough and complete body examination once every month. Though there is no set age when you should start examining yourself, it is suggested that you should start examining yourself at the age of 25.
   • It is easiest to examine yourself after you shower. You will already be naked and you can get to every part of your body.
3. Create the best environment for self-examination. The best place to examine yourself is a room with plenty of light. You will need both a full length mirror and a handheld mirror. You should also have a ruler or tape measure and a journal handy to measure your moles and record your findings.
   • If you find a mole you want to keep an eye on, you may want to have a camera handy to keep track of its appearance.
   • For self-examination, the American Society for Dermatological Surgery (ASDS) has created the Skin Self Examination (SSE) kit. This kit provides a document which can be printed and used as a journal and also includes instructions on performing a self-examination.
   • The American Academy of Dermatology has a body map that can help you mark the location of any moles about which you want to consult your doctor.
4. Perform a self-examination. Performing a thorough skin self-examination for moles is an easy process, but it takes time. You need to remove your clothes and stand in front of a full-length mirror. Visually examine your body for the location of your moles.
   • Inspect your entire body, including your face, ears, neck, front and back of your arms, under your arms, chest, sides, abdomen, and both sides of your legs in the mirror.
   • You also need to check your hands, palms, fingers, finger and toenails, ankles, the bottom of your feet, and in between your toes.
   • Don't forget to check the skin of your buttocks and genitals as well.
   • Women must also examine beneath the breasts.
   • Though it seems odd, you should also look at your scalp. For ease of examination of the scalp, use a comb or a blow dryer to move your hair. If it is difficult to examine the scalp, you could ask someone else to help you.
   • The handheld mirror can be used to view areas that cannot be seen on the full-length mirror.
5. Examine a found mole. As you examine your body, you will likely find moles. When you come across moles, you need to examine them. Take the ruler and measure how big they are. In your journal, write down the appearance, location, and size of the moles, as well as the date you examined each one.
   • You should also take pictures to help check for changes over time.

Detecting Melanoma

1. Look for melanoma. If you have a mole that is atypical, it is possible that it might be melanoma, a type of skin cancer. Melanoma arises from melanocytes, the skin cells that produce melanin, which gives skin its color. Melanocytes also produce moles. Since moles have many of these cells, melanomas can develop in moles. However, melanoma does not always come from existing moles.
   • Melanoma can come from any area of your skin. They are most common on the back, legs, arms, and face, although they can occur anywhere.
   • You are ten times as likely to get melanoma if you have more than five atypical moles than someone who has none.
   • When you perform your thorough examination of your moles, differentiate between atypical and normal moles so you can check the atypical ones for melanoma. Early detection of skin cancer improves its outcome and increases survival.
   • Feel the mole to check if it is elevated. You should keep track of changes in size, shape, color, elevation, or any new symptom such as bleeding, itching, or crusting over the mole. This is done with successive examinations. Therefore it is very important to keep a journal of your examination findings.
2. Learn the “ABCDEs” of melanoma. This is a handy acronym to help you learn how to identify characteristics of melanoma. Use the following reminders to help you distinguish between benign and potentially cancerous moles.
   • “A” is for asymmetry. Benign moles are usually symmetrical. In other words, if you draw a line through the middle of the mole, the two halves will look similar in size and shape. If you see an asymmetrical mole, have it examined by a doctor.
   • “B” is for border. Benign moles usually have smooth borders. Melanoma lesions may have irregular borders that look like they have jagged or notched edges. If you notice any whitish or opaque growth on the mole with edges of the growth rolling in and curling, the mole may be melanoma. This effect occurs in cancer as the skin cells rapidly multiply.
   • “C” is for color. Benign moles are usually the same color throughout the mole (generally brown). A melanoma lesion may have multiple colors in the same mole. Moles that are black or red may also be at risk for being melanoma.
   • “D” is for diameter. Benign moles are usually 6mm or less in diameter (about the size of an eraserhead). You can use a ruler or tape measure to measure your moles. If your mole is more than 6mm in diameter, consult with your doctor.
   • “E” is for evolution. This is the most important factor to keep in mind is whether your moles undergo any changes from what’s “normal” for you. If your mole changes in size, shape, or color, see your doctor.
3. Consult a doctor. If your mole exhibits any signs of the atypical characteristics of a mole, or if you notice any changes that seem unusual for your skin, you should consult a doctor. If you catch it early, the severity of the melanoma is much less than if you find it at a later stage. This is especially true if a family member has been diagnosed with skin cancer.
   • If you have more than 100 moles, you should see a doctor to make sure there is not some other problem. They can also do a more extensive examination of your moles, which is helpful because your doctor has a better idea of what to look for.
   • If you have a lot of moles on your back, you may want a doctor to examine those. Since you cannot look at those up close, the doctor may be better equipped to notice melanoma.
   • If you have received prior radiation therapy for other cancers as a child, you should get checked by a doctor. Radiation therapy can induce skin cancer.
4. Know what to expect from a doctor's examination. When you go to the doctor with an atypical mole, s/he will perform a thorough examination of the skin. S/he may take total body photographs in order to keep track of your moles. Physicians often use dermatoscopes or microscopes to obtain a magnified image of the mole.
   • If an atypical mole or melanoma is suspected, a skin biopsy will be done. In this procedure, a thin layer of skin is removed using a scalpel blade.
   • At times, the entire mole is removed by incising the skin. The removed tissue is sent to a laboratory for analysis, which takes a few days. Your physician will then inform you about the results.
   • Further treatments may be carried out, depending on the results. Your physician may refer you to a dermatologist for more examination.
5. Be aware of the risk factors. Melanoma has some risk factors that should be taken into consideration. Skin cancer is at a high risk of recurrence, so make sure you are extra cautious if you have been diagnosed with skin cancer in the past. Common risk factors include:
   • pale or less pigmented skin
   • exposure to UV rays, even via tanning beds
   • past sunburn
   • older age
   • skin previously damaged by radiotherapy treatment,
   • any condition that suppresses the immune system, such as AIDS
   • medications or medical treatments, such as chemotherapy, that suppress the immune system
   • a family history of melanoma
   • If you fit any of the risk factors for melanoma, you should perform self-exams often and let your doctor examine your skin periodically as well.

Preventing Skin Cancer

1. Wear sunscreen whenever you go outside. Even if it’s a cloudy day, your skin can still absorb damaging UV rays from the sun. Apply a sunscreen with at least an SPF factor of 30 to avoid sunburns, which may increase your risk of melanoma.
   • Look for a “broad-spectrum” sunscreen that blocks both UVA and UVB rays.
   • Apply about a palmful or shot-glass full of sunscreen lotion to all exposed skin.
2. Stay in the shade. When you can, stay in the shade outdoors. If you have to be outdoors, stay out of the sun during “peak hours,” usually between 10 AM and 2 PM.
   • Wear protective clothing, such as lightweight long-sleeved shirts and pants, long-sleeved swim shirts or rash guards, hats, and sunglasses when you’re outside.
3. Avoid tanning. Tanning can cause skin cancer, including melanoma. Avoid tanning beds and tanning booths.
   • If you want to look tan, experts recommend that you use a sunless tanner instead. Look for a product that contains dihydroxyacetone, or DHA.

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