What exactly am I looking for?
When looking at any mole or lesion on your body, you should see whether they are symmetrical , have a uniform colour and border, and do not change dramatically over the course of a few months. Most marks on our skin are usually uniform and symmetrical. However, some people do have asymmetrical moles, but they have several of the same type of moles, i.e. are asymmetrical in the same way.
If you have a solitary mole or lesion on your skin that stands out from the crowd, check if it is:
A. Asymmetrical – if you divided the lesions into 4 quadrants and the 4 quadrants are different from each other, you should get the area checked.
B. Borders – the borders of the mole should be regular and you should be able to draw a definite line around the edge. The line should be smooth and not scalloped. If borders fade out into the skin, you should get the area checked.
C. Colour – most lesions have one or two colours of different shades. Brown is a most common example, however some lesions can have a tinge of blue, grey or black. If you see these colours you should seek medical advice.
D. Diameter – lesions that are greater than 7mm in diameter are usually considered high-risk. This is true if you have solitary lesions above 7mm, but if you have many moles that are all large then it is quite difficult to monitor based on size alone. On another note, if you have lots of small moles and then one solitary 5mm lesion, this also needs to be examined as this stands out from your normal type of mole.
E. Evolution – how a mole changes over time is important. You can only be accurate with how that mole is evolving if you are monitoring them closely, and the best way to do this is with photographs.
To summarise, when it comes to a mole that you are not sure about, if in doubt check it out.
How often should I check my moles?
At OneWelbeck Skin Health & Allergy, we recommend checking moles two to three times a year and comparing to a set of baseline photographs. For those of you who are tech savvy, you do not necessarily need a particular phone application to do this. All you need is good photography on your mobile phone, and store the images in an encrypted folder. If you’d like some more help in archiving your images there are a range of apps that are both free and paid-for that can help you do this.
The free apps include MoleCare, available on the NHS website, and MySkinSelfie, which is run by Newcastle University. The paid-for apps include CompariSkin, Miiskin, and SkinVision – these have more features and sometimes access to a dermatologist, which requires extra in-app payment.
Protecting your skin
Research has shown that using a sunscreen with an SPF of 30 usually only gives you around an SPF of 10 to 15 as people rarely apply it to the thickness required. Therefore, we always recommend an SPF of 50 and assume you will only actually use an SPF of 20.
You should always use a high SPF with a 5-star UVA rating, which can also be represented on packaging by having UVA within a circle or the words ‘broad spectrum’. This means that the UVA is a high proportion of the UV-B within the sunscreen and therefore gives you better protection against both UVB and UVA sunrays. The key to sunscreen is not the type of sunscreen that you have, but rather the way you use it. Apply it frequently, i.e. hourly when in direct sunlight, and every half-hour when swimming or sweating. This would mean that you are constantly getting the right amount of protection.
When should I see my GP about a mole or lesion?
If you are worried about a mole that has become symptomatic (itching, bleeding or painful) then you must see your GP. Equally, if you feel that a mole is changing according to the ABCDE criteria mentioned earlier, it is important to see your GP.
If you are over the age of 20 and have a new mole or lesion that does not go away within a month, you should get this checked. Remember that not everything that is dark or pigmented on your body is skin cancer. Non-melanoma skin cancer is very important and is often simply a pinkish or scaly lesion that is new and often doesn’t have any symptoms such as itching or bleeding.
In general, GPs are excellent at diagnosing skin cancer and would usually refer you on to a dermatologist for confirmation or further management. However, if you find it difficult to see a GP face-to-face with current Covid-19 restrictions, most dermatologists both NHS and private have large face-to-face consultation clinics.
Remember: it is your skin and your body, and you are the best person to see and know what is on your body and how it is changing. But if you do not look, you will not know. If you do not record, you may not remember.
Close monitoring of your skin is just as important as a regular breast examination for females and a regular scrotal examination for men.
At OneWelbeck Skin Health & Allergy we offer a full mole check service performed by our expert dermatologists, so don’t hesitate to get in touch today to find out more.
Written by Dr Dev Shah, Consultant Dermatologist and Skin Surgeon at OneWelbeck Skin Health & Allergy. He leads the skin cancer and Mohs unit at Buckinghamshire NHS Trust, and leads both NHS and private skin cancer multi-disciplinary meetings.