You notice a spot while getting dressed. Maybe it seems darker than you remember, looks different from your other moles or has started catching on clothing.
The next question is often: Should I get this checked?
Most moles are benign, and having moles does not mean there is something wrong with your skin. What matters is knowing what is normal for you and paying attention when a spot is new, changing or behaving differently.
A spot that is changing, looks unlike your other spots, repeatedly bleeds or does not heal should be assessed by a healthcare professional. You do not need to decide whether it is cancer before asking for help.
At Elevate Dermatology in Pickering, changing moles and other concerning lesions belong with our medical dermatology team. Our dermatologists can assess the lesion, consider its history and determine whether monitoring, further investigation or treatment is appropriate.
The ABCDE Signs of Melanoma
One useful way to remember changes that deserve attention is the ABCDE rule.
It is a screening guide - not a way to diagnose melanoma or rule it out at home.
| Letter | What to look for |
|---|---|
| A: Asymmetry | One half does not resemble the other |
| B: Border | Edges are uneven, poorly defined or irregular |
| C: Colour | Different colours appear within the same spot, or its colour changes |
| D: Diameter | A larger spot can be concerning, but melanoma can also be smaller than 6 mm |
| E: Evolving | A change in size, shape, colour or behaviour over time |
A - Asymmetry
Look at the overall shape of the mole.
If you were to draw a line through the middle, would the two halves look reasonably similar?
Asymmetry means one half of the spot does not match the other.
Not every asymmetrical mole is melanoma, but noticeable asymmetry is one feature worth paying attention to.
B - Border
Look at the outside edge of the mole.
A typical mole often has a relatively smooth, clearly defined border. A mole may deserve closer attention when its edges become:
- Irregular
- Notched
- Scalloped
- Blurred or poorly defined
A change in the border of a mole you have had for some time is also worth mentioning.
C - Colour
Moles do not all have to be exactly the same colour. They may be brown, tan, pink or other shades depending on your skin and the type of mole.
What can be more important is variation in colour within an individual spot, particularly when that appearance is new or changing.
A concerning lesion may contain multiple shades, including combinations of brown, black or tan and, in some cases, areas of red, white or blue.
D - Diameter
A diameter greater than approximately 6 mm - roughly the size of a pencil eraser - is one feature included in the ABCDE rule.
However, 6 mm is not a safe cut-off.
Melanomas can be smaller than 6 mm. A small spot that is changing or has other concerning features should not be ignored simply because it has not reached a particular size.
E - Evolving
Of all the things you can watch for, change matters.
A mole may warrant assessment if it begins changing in:
- Size
- Shape
- Colour
- Surface
- Elevation
- Sensation
This is one reason knowing your own skin is useful. A photograph taken at one point in time cannot always show whether a lesion has been evolving over several weeks or months.
Do not wait for every ABCDE feature to appear. A small lesion can deserve evaluation, and a concerning change may be more informative than any single measurement.
The American Academy of Dermatology’s ABCDE guide includes additional examples and illustrations.
Warning Signs Beyond the ABCDE Checklist
The ABCDE rule is useful, but not every concerning skin lesion looks like a dark, irregular mole.
Pay attention to a mole or other spot that:
- Repeatedly bleeds
- Crusts
- Itches
- Becomes painful or tender
- Develops a sore that does not heal
- Looks noticeably different from your other spots
- Changes over time
A persistent scaly area, repeatedly crusting or bleeding growth, or sore that does not heal can also warrant assessment.
Skin cancer can appear in different ways, so these signs do not automatically mean that a lesion is cancerous. They are reasons to have the area appropriately assessed rather than trying to diagnose it yourself.
The Canadian Cancer Society describes additional signs and symptoms of skin cancer.
“It Has Always Been There” Doesn’t Mean You Should Ignore a Change
Many people have moles that remain stable for years.
If a longstanding mole begins changing, however, the fact that you have had it for a long time does not make the new change irrelevant.
Consider having a mole assessed if you notice that it has recently:
- Become larger
- Changed shape
- Developed different colours
- Started bleeding or crusting
- Become persistently itchy or uncomfortable
When monitoring your skin, the comparison is not only between one mole and another. It is also between what a particular spot looked like before and what it looks like now.
When describing a change to your healthcare provider, try to be specific. “This spot has enlarged since March” is more useful than simply saying, “I have an odd mole.”
What Is a Mole?
Moles are growths formed by clusters of pigment-producing cells. Their appearance varies, and some changes can occur over a person’s lifetime.
A raised mole is not automatically dangerous, and a flat spot is not automatically harmless. Context and examination matter.
People also commonly use the word “mole” to describe freckles, sun spots, skin tags and other growths. These are not all the same thing.
If you are unsure what a spot is, describing its location, how long it has been present and how it has behaved is more useful than trying to diagnose it yourself.
Learn more about moles from the American Academy of Dermatology.
How to Check Your Skin
Getting familiar with your skin can make it easier to notice changes.
Use good lighting and a mirror to look at areas you can see, and consider a hand mirror or help from someone you trust for areas that are more difficult to inspect.
Don’t limit your check to obvious areas such as your face and arms. Include areas that are easier to overlook, such as:
- Scalp
- Back
- Palms
- Soles of the feet
- Around and underneath the nails
- Between the toes
The goal is not to diagnose melanoma at home. It is simply to recognize something new or different so it can be assessed when appropriate.
A simple body map or dated photographs can also help you remember where a lesion was and what it previously looked like.
If you photograph a spot, consider taking both a wider image that shows its location and a closer, in-focus image. Consistent lighting can make photographs easier to compare over time.
A photograph can support the history you provide to your healthcare professional, but it should not delay assessment of a concerning change.
The American Academy of Dermatology provides additional guidance on checking your skin.
Who May Need Closer Surveillance?
Your personal risk factors can influence recommendations for skin examinations and follow-up.
Factors that may be relevant include:
- A personal history of skin cancer
- A family history of melanoma
- Many or atypical moles
- Significant UV exposure
- Previous severe sunburns
- Certain medical conditions or treatments
Having darker skin does not eliminate the need to assess a changing lesion, and having relatively few moles does not mean a new growth should automatically be ignored.
Risk factors help inform the overall assessment, but a specific concerning change can deserve attention on its own.
The Canadian Cancer Society outlines melanoma risk factors.
What Happens When a Mole Is Assessed?
Assessment usually begins with the lesion itself and its history.
Useful information can include:
- How long you have noticed it
- Whether it has changed
- What type of change occurred
- Whether it bleeds, crusts, itches or hurts
- Whether you have noticed other new or unusual spots
- Whether you have had previous skin cancers or biopsies
The clinician will examine the area and determine whether additional assessment is appropriate.
A dermoscope - a handheld instrument that provides light and magnification - may be used to examine structures that are difficult to see with the naked eye.
Depending on the findings, an examination may lead to reassurance, monitoring, further assessment or a recommendation for biopsy.
Does a Biopsy Mean I Have Skin Cancer?
No.
A biopsy is a way to obtain tissue for laboratory examination when more information is needed. The biopsy itself does not establish a cancer diagnosis.
The type of biopsy or tissue sample recommended depends on the lesion and the clinical question.
If a biopsy is recommended, your healthcare team can explain what is being done, wound care instructions and how results and follow-up will be communicated.
The Canadian Cancer Society explains how melanoma is diagnosed.
Does Every Mole Need to Be Removed?
No.
Many moles are benign and do not require removal.
There is also an important distinction between medical assessment and cosmetic removal.
A mole may require medical assessment because it is:
- New
- Changing
- Symptomatic
- Bleeding
- Otherwise clinically concerning
In other situations, a mole may be benign but someone may still want it removed because of its appearance, because it catches on clothing or jewellery, or because it is repeatedly irritated.
Assessment comes first when a lesion is unexplained or concerning.
At Elevate Dermatology, our dermatologists can assess medical concerns involving moles and other skin lesions. If a mole is benign and you are interested in removal for cosmetic reasons, our team can also discuss whether cosmetic removal may be appropriate for that particular lesion.
Do not attempt to remove an unexplained pigmented lesion yourself or treat it cosmetically in place of appropriate medical assessment.
Preparing for a Mole Check
You do not need to arrive knowing what the spot is.
A few pieces of information can make your assessment more useful:
- Where the spot is located
- When you first noticed it
- What has changed
- Whether it bleeds, crusts, itches or hurts
- Dated photographs, if available
- Previous biopsy or skin cancer history
- Relevant family history
If you have several spots that concern you, make a short list so they are not forgotten during the appointment.
When Should You Get a Mole Checked?
Consider bringing a mole or other skin lesion to the attention of a healthcare professional when you notice:
- A new or changing spot
- Asymmetry
- An irregular or poorly defined border
- Multiple or changing colours
- Increasing size
- Bleeding or crusting
- Persistent itching, pain or tenderness
- A sore that does not heal
- A spot that looks noticeably different from your other moles
You do not need to decide for yourself whether a change is serious before asking about it.
If something on your skin has changed or simply does not look right to you, documenting what you have noticed and seeking an appropriate assessment is more useful than trying to diagnose the lesion from photographs online.
Medical Mole Assessment in Pickering
At Elevate Dermatology in Pickering, our dermatologists assess medical skin concerns, including changing moles and other lesions that may require further evaluation.
If you are contacting our clinic about a changing, bleeding or non-healing lesion, make that concern clear so our team can help you understand the appropriate booking pathway.
If a mole has already been assessed as benign but you are interested in removing it for cosmetic reasons, that can be a separate conversation.
Learn more about our medical dermatology services or contact our Pickering team to discuss the appropriate next step.
Frequently Asked Questions
Can a small mole be melanoma?
Yes. The 6-mm point in the ABCDE guide is not a safe cut-off. A lesion can warrant assessment even when it is smaller than a pencil eraser, particularly when it is changing or has other concerning features.
What if a mole has been there for years?
A longstanding mole can still deserve assessment if it changes. Tell your healthcare provider both how long it has been present and what is different now. An earlier photograph may help document the change.
Should every adult have a yearly mole check?
There is not one examination schedule that is appropriate for everyone. Your personal history, family history, number and type of moles and other risk factors can influence the follow-up your healthcare provider recommends.
Regardless of your usual schedule, a new concerning change should be brought to medical attention when it appears.
Can I send a photograph instead of having it examined?
Photographs can be useful for documenting change or communicating a concern, but they have limitations. Lighting, focus and the inability to examine the lesion directly can prevent reliable assessment.
Ask your healthcare provider whether photographs are useful in your situation and whether an in-person examination is required.
Should I worry if a mole catches on clothing?
Friction can irritate a benign growth, but recurrent bleeding or other changes should still be discussed. Tell your healthcare provider whether bleeding occurs only after obvious irritation or also happens without an identifiable injury.
Does a skin examination hurt?
Visual examination of the skin and examination with a dermoscope are generally non-invasive. If a biopsy or other procedure is recommended, your healthcare provider can explain that procedure separately, including what to expect.
A Clear Next Step for a Changing Mole
If you have noticed a new or changing mole, start with what you know: what changed and when did you first notice it?
You do not need to determine whether it is melanoma yourself.
For a changing mole or persistent lesion, medical assessment comes before cosmetic treatment. You can speak with your primary care clinician or contact Elevate Dermatology to clarify the appropriate pathway for your concern.
For additional information, see:
