How to check your moles — and when to see a doctor

Even if no abnormalities are detected at your skin cancer check-up, a new skin cancer can develop at any time. Learning how to check your moles and skin between professional examinations can help you notice new or changing spots earlier.

Checking your skin regularly helps you become familiar with what is normal for you. When you know your usual pattern of moles and freckles, it becomes much easier to spot something new, changing or unusual that may need medical attention. If you notice a suspicious spot, it’s best to have it assessed during a professional skin examination.

For patients with many moles, full-body mole mapping can help track subtle changes over time.

How to check yourself for skin cancer

Self-checks complement professional assessment. Use a system so you:

• Examine your skin systematically, covering all areas.
• Know what factors suggest that a mole might, in fact, be a melanoma or other skin cancer.

Step-by-step guide to checking your skin

This process (adjusted from the Cancer Council), becomes more manageable and takes less time as you become used to your skin:

1. Make sure there is good light in the room.
2. Have a mirror available to help you see hard-to-reach areas. Even better: use both a hand-held mirror and a wall-mounted mirror.
3. Undress completely (or undress one part of your body at a time as you work through all areas).
4. Check your face and scalp. It may be easier to check your scalp if you use a comb to part your hair.
5. Check your neck and shoulders. Don’t forget to check your shoulders from the top using a mirror.
6. Check the front and back of your arms, including your armpits.
7. Check the front and back of your hands, including between the fingers and under the fingernails.
8. Check your chest and abdomen; you may need to lift your breasts to see underneath them.
9. Check around the genitals; you may need to use a mirror to check underneath.
10. Stand with your back facing a wall-mounted mirror, and use a hand-held mirror to examine your back from top to bottom. Alternatively, you could have a family member, partner or friend check for you.
11. Check the front and back of your legs.
12. Check your feet, including the soles and between your toes.

Video guide to checking your skin

SCAN your skin: look for spots that are sore, changing, abnormal or new.

• The more SCAN features a mole has, the higher the risk of skin cancer. For example, if a spot is sore and changing and new, it’s at a higher risk than one that is sore but not changing or new.
• Most people stop developing new moles after 40, and new moles that appear after this age are more likely to be skin cancers.
• A doctor should check any spots or moles of concern.
• The more you check your skin, the better you will know what is normal for you and be able to detect changes more easily.

What to look for when checking your moles

When you check your moles for skin cancer, you don’t need to do it the same way a skin cancer doctor does. The doctor needs to examine each mole to gather information and decide if it might be cancerous. The “ugly duckling” method allows you to examine your skin from a distance and determine if there is a mole that doesn’t resemble other moles.

Be suspicious of any new or changing moles that look different from moles elsewhere on your body.

Spots that break the pattern of the other spots are known as “ugly ducklings.” Identifying them is one of the quickest and easiest ways for non-medical people to locate skin cancers.

“Be suspicious of any new or changing moles that look different from moles elsewhere on your body.”

The ABCDE rule and EFG signs

Research has shown that the ugly duckling rule for detecting suspicious spots helps non-trained people find skin cancers with higher accuracy than the better-known ABCDEFG rule.¹

The ABCDEFG rule for moles:

• Asymmetry: The two sides of the spot don’t match.
• Border: The edge/border of the spot is irregular. It might be clear in one area and indistinct in another.
• Colour: The spot has many different colours (not just shades of one colour).
• Diameter: Melanomas can be smaller than 6 mm. A small spot can still need assessment.
• Evolving: A change in size, shape, colour or symptoms matters.
• EFG = elevated, firm, growing: Any raised lump that has a firm consistency and is growing is suspicious.

These signs help you notice concerns; a spot does not have to meet every sign to need assessment.

How to recognise “ugly ducklings”

If you use the MoleScope app to take and record photos of your spots, it can help you check for the ABCD signs.

Checking for melanoma and basal cell carcinoma

Melanomas are important to detect as early as possible because they can spread to other parts of the body if left untreated. Early detection significantly improves outcomes. A melanoma will usually be either a new or changing spot that is asymmetrical. Other features such as an irregular border or multiple colours are often, but not always present. Melanomas are most common in areas that have been badly sunburnt or received intense UV radiation exposure during youth, but less commonly they can occur in areas of the body that have not been exposed to the sun.

Basal cell carcinoma is the most common form of skin cancer. It usually tends to develop in areas that get UV radiation repeatedly over many years, such as the face and ears. It can appear as a pink or red lump or scaly area. Sometimes they are detected because they show up as a sore that takes many months to heal.

Monitoring your mole with photography

You can monitor your own moles by taking a series of photographs over time. This can be a useful way of detecting changes in size or shape – sometimes an early sign of skin cancer.

Spot Check Clinic patients have access to the online MoleScope/DermEngine system which records the location and appearance of atypical spots detected during examination. You can log in to MoleScope to view these photos and assess changes. If you wish, you can take your own photos and add them to your MoleScope records.

The MoleScope app lets you view and organise images. A compatible dermoscopic attachment can record finer detail, but is not required to take ordinary monitoring photographs. Uploads are not monitored as requests for assessment, and we no longer offer remote spot reviews. Arrange an appointment for a concern.

Learn more about photographing your moles.

When to have a mole checked by a doctor

You should have your mole checked by a doctor if it is:

• A new or changing spot with any of the ABCDE characteristics.
• A new or changing “ugly duckling” spot that looks different from your other moles.
• It is elevated, firm and growing.
• It’s bleeding, ulcerated, crusted or a persistent open wound that does not heal.

While checking your own skin is useful for noticing change, a professional skin examination using dermoscopy allows doctors to examine suspicious spots much more closely than is possible with the naked eye.

If you are unsure about a spot or notice a new or changing mole, a professional skin examination with dermoscopy is the most reliable way to determine whether it may be a skin cancer.

Your doctor can advise which spots to watch and how often you should have a professional skin check, based on your skin and medical history. Do not wait for your next routine check if a spot changes or concerns you. Book a spot check for a specific concern, or a full body skin check when a broader examination is needed.

References

1. Ilyas M, Costello C, Shang N et al 2017. The role of the ugly duckling sign in patient education. J Am Acad Dermatol, Dec;77(6):1088-1095.