A mole that looks new, changing, or different from your others deserves attention. Most moles are benign, and common moles only rarely become melanoma. Melanoma can develop within an existing mole, but it can also appear as a new spot on otherwise normal skin.
That is why knowing when to get moles checked matters. Finding melanoma before it has spread is associated with substantially better outcomes, but no examination can guarantee a particular result.
The ABCDE Rule: A Screening Guide, Not a Diagnosis
Dermatologists use the ABCDE criteria to help decide which moles deserve a closer look. These are warning tools rather than diagnostic rules. No single feature can determine whether a lesion is melanoma.
A is for Asymmetry
Many common benign moles are round or oval and relatively symmetric, but symmetry alone cannot confirm a mole is benign. Asymmetry can make a lesion more suspicious, especially when it is new or changing, but asymmetry does not by itself diagnose melanoma.
B is for Border
A ragged, scalloped, notched, or poorly defined border may warrant evaluation, especially when it differs from your other moles or is evolving. A visual border cannot show whether or how far any abnormal cells have spread.
C is for Color
Uneven or multiple colors within one mole can be a warning feature. Suspicious lesions may show areas of brown, tan, black, red, white, blue, or gray. Color alone cannot distinguish melanoma from a benign spot or show how deeply a lesion has grown.
D is for Diameter
A diameter greater than about 6 millimeters can raise concern, especially alongside other warning signs or continued growth. Size alone does not determine whether a mole is benign or malignant. Melanomas can be smaller than 6 millimeters.
E is for Evolution
Change over time is an important feature to watch. Even so, a melanoma can be present when no change has been noticed or documented.
A new or evolving mole should be assessed promptly, particularly if the change is progressive or unexplained. Changes can have benign causes, so an examination is needed to determine the appropriate next step.
Some melanomas are small, symmetric, uniformly colored, pink, red, or skin-colored. When in doubt, let a clinician look.
Other Moles You Should Get Checked
Beyond the ABCDE features, certain symptoms and patterns make an appointment reasonable. None of these diagnoses melanoma on its own, and many have benign causes.
- A mole that bleeds spontaneously, crusts, scabs, ulcerates, or does not heal without a clear cause.
- Itching, tenderness, or pain that is persistent, recurrent, or unexplained, especially with visible change. These symptoms are not specific to melanoma.
- An “ugly duckling,” meaning one mole that looks clearly unlike your other spots.
- A new or unusual mole at any age, particularly one that changes or appears later in adulthood. Age is one part of risk assessment, not a diagnostic cutoff.
- A growing bump, a pink or red lesion, or a sore that keeps returning, since concerning spots are not always brown moles.
- A widening or changing dark band in a fingernail or toenail, pigment extending onto nearby skin, or nail splitting.
When you check your own skin, include the scalp, back, buttocks, palms, soles, the spaces between your toes, and your nails.
Who Has Higher Melanoma Risk
Risk factors are associations, not predictions. Having one or several does not mean you will develop melanoma, and having none does not rule it out.
Risk rises with numerous or atypical moles, a personal history of melanoma or other skin cancer, and a relevant family history. UV exposure, indoor tanning, a history of severe blistering sunburns, and fair, sun-sensitive skin also contribute. Some forms of immunosuppression are associated with increased skin cancer risk, with follow-up individualized to the condition and medication.
Large or giant congenital moles in children can carry increased melanoma risk and may warrant specialist follow-up. Risk and management vary with size, location, associated lesions, and symptoms, so not every congenital mole carries the same risk.
Melanoma can occur in every skin tone. Overall incidence is lower in people with highly pigmented skin, but the risk is not zero.
Acral melanoma develops on the palms, soles, or nails and can occur in anyone. It accounts for a greater share of the melanomas diagnosed in people with highly pigmented skin, and diagnosis may come at a later stage. These areas deserve attention during self-checks and office visits.
How Often Should You Get Moles Checked?
There is no established universal annual screening schedule for every adult. For asymptomatic adults without a personal or family history of skin cancer, the United States Preventive Services Task Force finds the evidence insufficient. It does not recommend for or against routine clinician visual screening in that group.
That statement does not apply to suspicious lesions or to people already under high-risk surveillance. Insufficient evidence is also not a recommendation against screening. Whether and how often to have routine examinations should be individualized based on your history, mole pattern, other risk factors, and clinician judgment.
A suspicious lesion is different. A mole that is new, changing, bleeding, ulcerated, or nonhealing warrants a prompt appointment, not a wait for a routine visit. Our office determines timing based on the lesion’s features, rate of change, symptoms, and your risk history.
Between visits, monthly self-examination is a commonly suggested practical interval, particularly for higher-risk patients, though it is not a proven universal schedule.
Evidence-based sun protection also helps reduce risk. Avoid indoor tanning, seek shade, wear protective clothing, and use a broad-spectrum, water-resistant sunscreen with SPF 30 or higher. Sunscreen reduces UV exposure but does not eliminate melanoma risk or replace skin awareness.
What Happens at a Mole Check
At Advanced Dermatology and Aesthetic Medicine, Dr. Monica Rani, MD, FAAD and Dr. Stavonnie Patterson, MD, FAAD evaluate moles in our South Loop office.
A visit starts with your history and an examination of the area of concern. With your consent, a complete skin examination can include the full visible skin surface, scalp, nails, palms, and soles.
We may use dermoscopy, a noninvasive adjunct that can improve lesion assessment when used by trained clinicians. It does not provide perfect accuracy or replace a biopsy when a lesion remains suspicious.
For selected patients at elevated risk, clinical photography or sequential imaging may help with comparison over time. Evidence for these monitoring tools continues to develop, and imaging does not replace examination or biopsy.
When melanoma or another skin cancer is suspected, a skin biopsy and pathology review are usually needed to establish the diagnosis. Microscopic examination of biopsied tissue is the standard method for a definitive melanoma diagnosis.
Safety Considerations
A skin biopsy is performed in our office after the area is numbed with local anesthetic, and the injection may briefly sting or burn. The procedure creates a small wound and may cause bleeding, scarring, pigment change, or infection, although serious complications are uncommon.
Some biopsy results are indeterminate. These may need expert pathology review, additional sampling, or removal of more tissue.
If melanoma is diagnosed, a wider excision is the recommended next treatment step. Whether lymph node evaluation or other staging is needed depends on the pathology findings and your clinical situation.
Evaluation itself can carry downsides, including anxiety, scars, and procedures that turn out benign, which your dermatologist will weigh with you.
Concerned About a Mole? We Can Help
It is reasonable to contact a clinician whenever a mole concerns you. After an examination, your dermatologist can determine whether monitoring, a photograph, a biopsy, or no further action is the appropriate next step.
Knowing your usual skin pattern and reporting a new or changing spot supports earlier assessment. Even so, not every melanoma is visible or recognizable to patients, and a later diagnosis is not the patient’s fault.
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Frequently Asked Questions
There is no single evidence-based screening interval that fits everyone. Whether to schedule routine examinations, and how often, depends on your history, mole pattern, other risk factors, and clinician judgment.
If you have many or atypical moles, or a personal or family history of skin cancer, ask us what fits you.
Do not rely on unsupervised observation instead of an initial evaluation. After examining the mole, a dermatologist may recommend biopsy, reassurance, or structured photographic or dermoscopic monitoring, depending on the level of concern.
One feature is still a reasonable prompt to be seen. Some melanomas show only one or two ABCDE features, and any mole that concerns you deserves an assessment.
An examination, sometimes with dermoscopy, can identify which lesions look suspicious. When melanoma is suspected, a biopsy with microscopic review is the standard way to establish the diagnosis.
