Has a mole changed colour, grown larger or developed irregular edges? These are changes that deserve a dermatologist’s attention. A preventive skin examination helps detect suspicious moles and other skin lesions early. We have put together an overview of what to expect, what to look for at home and when to book an appointment with a dermatologist.

When checking your skin, you may not be able to see every important detail with the naked eye. A dermatologist therefore uses a dermatoscope – a special illuminated magnifying instrument that can magnify a mole up to ten times. This allows the doctor to assess its structure and colour more closely. Some devices also allow the doctor to save images on a computer and compare them at a follow-up appointment.

What to Expect at a Preventive Check-Up

The dermatologist examines your skin from head to toe, both front and back. They use a dermatoscope to take a closer look at any moles or other lesions that appear unusual. If they find suspicious changes, they will recommend removal and discuss the next steps with you.

An annual preventive skin check is advisable, ideally after summer. However, you do not have to schedule it for autumn. If you notice a change in a mole or another suspicious skin feature, contact a dermatologist without waiting for your regular check-up.

Five Letters to Help You Check Your Skin

You can also examine your skin regularly at home, for example once a month. The ABCDE rule can help you know what to look for. Each letter stands for a feature to check:

  • A – Asymmetry: the mole has an uneven shape.
  • B – Border: its edges are irregular or poorly defined.
  • C – Colour: it contains several colours, has uneven colouring or changes colour over time.
  • D – Diameter: it measures more than approximately 5–6 millimetres across.
  • E – Evolution: it changes in size, colour or how much it rises above the surrounding skin.

Do not limit your check to areas you can easily see. Examine your heels, the soles of your feet, your palms and your nails too. Use a mirror to check the back of your body, or ask someone close to you for help.

When to See a Dermatologist

A change in a mole’s colour or size is not the only reason to see a dermatologist. Pay attention to new growths and areas of skin that do not heal.

See a dermatologist if:

  • you notice any of the changes described in the ABCDE rule,
  • a very dark mole appears,
  • a new skin growth appears and gets bigger, even if it is the same colour as your skin,
  • an area does not heal for more than three months or shows no improvement after two to three weeks of treatment,
  • you notice a dark mark under a nail that does not grow out with the nail.

A suspicious skin lesion does not have to be dark. Even melanoma may lack dark colouring. When examining your skin, look for growth and other changes as well as colour.

What If the Doctor Recommends Removing a Mole?

The doctor first numbs the area with a local anaesthetic and then cuts out the mole. They also remove a margin of surrounding skin that appears healthy. If necessary, they close the wound with one or more stitches.

Specialists in a pathology laboratory then examine every removed mole under a microscope. This histological examination identifies the type of lesion and whether it is benign, malignant or borderline.

The surrounding margin of skin plays an important role. It helps specialists assess whether the doctor has removed the entire suspicious lesion, both across its width and into its depth. If they find suspicious cells in this margin, the doctor may recommend removing more tissue. The histology results also help guide further treatment.

Make Skin Checks a Regular Part of Your Calendar

Checking your skin once a month and seeing a dermatologist once a year can form part of your regular routine. If you notice a suspicious change between check-ups, arrange an earlier appointment. Detecting suspicious moles and other skin lesions early can save lives.

Source: Dr Věra Němečková, Preventive Skin Examination.