When should you have moles checked? Should a doctor check all of your skin for cancer, or just individual moles? In this article, we discuss ways of deciding whether you should have a skin cancer check or a mole check, and when is the best time for a mole check.
Understanding skin cancer risks
Knowing your skin cancer risk helps you decide whether to have a general skin cancer check over your whole body, or just to have suspect moles checked individually.
Risk factors include:
- History of skin cancer, especially melanoma, but also basal cell carcinoma, squamous cell carcinoma and pre-cancerous conditions such as solar keratoses
- More than 100 moles, particularly if you have ever been diagnosed with a dysplastic mole
- Family history of melanoma
- Certain health conditions, mainly those affecting the immune system
- Certain treatments, such as radiotherapy and drug treatments that affect the immune system
- Very fair skin that burns easily and rarely tans
- A history of multiple peeling sunburns or solarium attendances when young
Causes of skin cancer
Skin cancer usually occurs because of damage to the DNA in skin cells caused by ultraviolet radiation. Ultraviolet radiation affects DNA both in large, intense doses (i.e. enough to cause a peeling sunburn) and also over many years at lower intensity.
Darker skin provides some protection: UV radiation is absorbed by pigment in the cells. Even fair skin can defend itself against some UV radiation by repairing damaged DNA, but the ability to repair DNA decreases as the skin ages.
Australia has a combination of factors that make the risk of skin cancer high:
- Potentially damaging levels of UV radiation on most days of the year
- A substantial proportion of fair skinned people in the population
- An ageing population
This means that for many people living in Melbourne, they are at risk of having skin cancer at any time and should consider regular skin checks.
Warning signs of skin cancer
Even if you have a relatively low risk of developing skin cancer, that doesn’t mean no risk. Skin cancers sometimes occur in young people or those with darker skin. Fortunately, most of the time it’s possible for people to identify their own skin cancers. Any mole or other spot showing skin cancer warning signs should be examined by a doctor experienced in skin cancer management.
Checking your moles at home
You don’t always need to visit a skin cancer clinic to detect cancer. The Cancer Council Australia recommends that people at lower risk should check their own skin at home and report any concerning moles or other spots to their doctor.
You should systematically check your skin, covering all areas. For more information, see our page about Screening your moles: checking your own skin for cancer.
What a benign mole looks like
A benign (normal, harmless) mole will usually like other moles on your body. Most normal moles look like they “belong together”, and fit into a pattern you can identify, e.g. all are a similar colour, shape or size.
Signs that a mole is normal and harmless can also be:
- The mole or spot is symmetrical, one colour throughout and its border looks the same all the way around
- The mole or spot has been present for a long time (years) without growing or changing
Signs your mole may be cancerous
Strictly speaking, moles and skin cancers are separate things. But people tend to use the word “mole” to refer to a wide range of lumps and spots on the skin that aren’t skin cancer.
If you are asking yourself “Is that mole skin cancer?” there are warning signs that can help you decide if it should be checked by a doctor.
Your “mole” may really be a skin cancer if:
- It’s an “ugly duckling” spot or lump that looks like it’s not related to your other spots
- It breaks the ABCD rule (asymmetry, border, colour, diameter)
- It’s an EFG spot (elevated, firm and growing)
- It’s a new dark or pigmented spot which first appeared after age 40
- It’s a pre-existing spot that’s changing: spreading out sideways, getting more elevated, changing colour or shape
These rules normally apply for melanoma, a potentially serious form of skin cancer which must be detected and treated as early as possible to avoid health complications.
The more common types of non-melanoma skin cancer (basal cell carcinoma and squamous cell carcinoma) may appear more like a skin rash that doesn't respond to treatment, or a sore that hasn’t healed or is still bleeding after several months.
If you have a spot that matches any of these criteria, you should have it checked by a skin cancer doctor.
Scheduling a skin cancer check with your doctor
A whole-body skin check or individual mole check is best performed by a doctor or nurse with experience in diagnosing and managing skin cancers.
In Australia, most general practitioners have some skin cancer experience and can be a good first contact if you have a spot of concern. Alternatively, skin cancer clinics often have special interest skin cancer doctors with clinical skills, experience, equipment and technology that may allow better detection of early skin cancer.
Dermatologists in Australia are skilled in diagnosing and managing skin cancers. To visit a dermatologist, you require a letter of referral from your GP, who will need to check the spot first.
Don’t wait to get your moles checked
Skin cancer prevention is important but preventing serious health issues due to melanoma and other skin cancers is also critical. Treatment of early skin cancers is almost always successful.
If your spot of concern is a melanoma, the difference between successful early diagnosis and treatment and serious health complications can be a matter of months.
New or changing “ugly duckling” spots should always be checked within a few weeks of being noticed.
If you have no moles of concern but risk factors for skin cancer, you should consider making a yearly skin check part of your health care routine.