Melanoma and your moles: Know what's new

Skin cancer is highly treatable if caught early. But do you know how to spot melanoma, the deadliest form of skin cancer? Many people have heard of the ABCDE rule, which is to look for changes in a mole.

ABCDE melanoma – signs of melanoma

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• Asymmetry – The shape of one half of the mole looks different than the other half
• Border – The borders or edge of the mole look ragged or blurred
• Color – The mole has uneven coloring, with shades of black, brown, gray or other colors.
• Diameter – The size of the mole is greater than 4 mm or ¼ inch
• Evolving – The mole is changes in size, shape, color, or there's a new mole.  

It's especially important to pay attention to new moles.  

A recent review of published research on melanoma skin cancer has confirmed what many skin doctors and cancer specialists already knew: Most melanomas (an estimated 70 percent) start as a brand new lesion, not in an existing mole.  

That means you really need to know your skin. All adults should get in the habit of doing a monthly skin check, so they know where their moles are and what looks normal. That makes it much easier to notice a new or changing mole.   

What does melanoma look like?

Melanomas can vary a lot in how they look, and detecting them at an early stage can be critical and greatly increase your chances for cure. Generally, it is a good idea to follow the ABCDE signs to identify melanoma. However, you may find only one or two of these signs, and some moles may not fit the ABCDE rules. 

Many of us will develop moles throughout our lifetimes. Most of the time, they are merely harmless clusters of pigmented cells. If the mole is the same color and solid throughout, it shouldn’t be anything to worry about. But keep an eye on moles that have different shades of the same color or different colors. Most melanomas are black or brown, but they can be almost any color: skin-colored, pink, red, purple, blue or white.

When the melanoma is more advanced, the texture of the mole looks different as well; the skin surface may look broken or scraped. So watch out for moles that change appearance, especially with redness, scaling, bleeding, or oozing. Normal moles are round or oval, with a smooth edge, and usually within one-quarter inch (six millimeters) in diameter. Bigger moles can be a bad sign. However, size is not definitive proof of cancer. Be especially watchful for new moles.

If you see any of the ABCDE signs, notice a new pigmented lesion (even if it doesn't have the characteristics described above) or a mole that's changed, you should talk with your doctor. Don't wait until your next annual physical to bring it up—make an appointment soon. The only way to be sure is to remove tissue and check it for cancer cells. If you do have a melanoma, a doctor can remove it before it has a chance to spread. 

Melanoma risk factors include:

• A personal or family history of melanoma
• Fair skin
• Blue eyes
• History of sunburns
• Having a large number of moles (more than 50).

Reduce your risk of melanoma and other skin cancers by protecting your skin from the sun: 

• Wear a broad spectrum (UVA/UVB) sunscreen every day
• Wear a hat, sunglasses and other sun-protective clothing
• Seek shade when outside between 10 a.m. and 4 p.m.
• Avoid tanning and tanning beds.