Key takeaways: 

• Cancerous moles may be asymmetrical, have an irregular shape or border, contain multiple colors, grow larger than other moles, or generally evolve over time.
• Skin cancer may also appear as a spot or growth.
• Schedule an appointment with a dermatology provider as soon as you notice any changes in a mole, spot, or growth on your skin.
• On average, early detection and prompt treatment is associated with survival rates of >99%, according to the American Cancer Society.

Most moles are harmless, but sometimes, a changing mole, spot, or other type of growth can be a warning sign of skin cancer, including melanoma, basal cell carcinoma (BCC), or squamous cell carcinoma (SCC). Know the signs of a cancerous mole, like the ABCDE rule, which looks at asymmetry, border, color, diameter, and evolution, and when to see a dermatology provider. The good news is that when detected early, skin cancer is highly treatable.

Regular moles vs. cancerous moles

A cancerous mole typically looks different from other moles, but if you don’t know what to look for, you might miss it. Cancerous moles may be larger, have an irregular shape or border, contain multiple colors, or change in appearance over time.

It's important to remember that these characteristics don't automatically mean a mole is cancerous. Leigh Ann Pansch, NP, DOCS Dermatology provider, explains, “Atypical moles, seborrheic keratoses, sunspots, angiomas, and other noncancerous growths can [also] have irregular borders, multiple colors, or an unusual texture.” 

That said, any new or changing mole or growth should still be evaluated. A dermatology provider, such as our network of Ohio clinicians at DOCS Dermatology, can examine a suspicious spot and determine whether it needs additional evaluation.

The ABCDEs of cancerous moles

The ABCDE rule is a useful tool for recognizing potential warning signs of melanoma.

• A is for asymmetry: One half of the mole doesn't look like the other half. A harmless mole is often more symmetrical, while melanoma may have an irregular or uneven shape.
• B is for border: The edges of the mole may be irregular, jagged, blurred, or poorly defined rather than smooth and even.
• C is for color: A concerning mole may contain multiple colors or uneven shades. Look for combinations of brown, black, red, white, blue, or pink.
• D is for diameter: Melanomas are often larger than 6 millimeters across, about the size of a pencil eraser. However, melanoma can be smaller, so size alone shouldn't determine whether a mole is concerning.
• E is for evolving: Any mole that changes over time deserves attention. Changes in size, shape, color, texture, or symptoms such as bleeding or itching can be warning signs.

“Of these, E for evolving may be the most important. A mole that has been stable for years is generally less concerning than one that has recently begun changing. I also teach patients to look for the ‘ugly duckling’—a spot that looks different from the rest of their moles,” says Pansch.

If you notice any of the above symptoms, schedule an appointment with a dermatology provider for an evaluation. When melanoma, the most dangerous form of skin cancer, is caught early and hasn’t had the chance to spread, the 5-year survival rate is more than 99%.

Get your mole or spot evaluated by a DOCS Dermatology provider.

Types of cancerous moles and other skin cancers

Melanoma is most associated with new or evolving moles, while BCC and SCC may show up as other types of spots or growths. Be aware of any new or evolving spots on your skin, beyond moles alone.

Melanoma

Melanoma may develop in an existing mole or appear as a new spot on otherwise normal skin. There are several types of melanoma, including superficial spreading melanoma, nodular melanoma, lentigo maligna melanoma, and acral lentiginous melanoma. Because melanoma can spread to other parts of the body, early detection and treatment are especially important.

Basal cell carcinoma

Basal cell carcinoma is the most common type of skin cancer. It often develops on areas of skin that receive frequent sun exposure, such as the face, neck, ears, and arms. BCC may appear as a pearly or flesh-colored bump, a pink or reddish growth, or a sore that repeatedly heals and returns. Some basal cell carcinomas may also look like a scar or a shiny, translucent patch. While BCC rarely spreads to distant parts of the body, it can damage nearby tissue if left untreated.

Squamous cell carcinoma

Squamous cell carcinoma develops in the squamous cells that make up the outer layer of the skin and can appear as a rough, scaly patch, a firm red bump, or a sore that does not heal. SCC may also develop from a precancerous growth called actinic keratosis. Like BCC, squamous cell carcinoma is most common on areas of skin frequently exposed to the sun. Although many SCCs are treatable, some can grow deeper into the skin or spread, making early diagnosis important.

When to see a dermatology provider for a mole

Consider scheduling an appointment with your dermatology provider if you notice a mole that is changing or looks significantly different from your other spots. Don’t wait for your next skin-check appointment.

Schedule an appointment if a mole, spot, or growth…

• Changes in size, shape, or color
• Develops an irregular border
• Contains multiple or unusual colors
• Begins bleeding or crusting
• Becomes persistently itchy, painful, or tender
• Appears suddenly and looks unusual
• Looks different from your other moles—the “ugly duckling” sign

You don't need to wait until a mole has multiple warning signs before having it evaluated. If something on your skin looks unusual or simply concerns you, it's reasonable to have a dermatology provider take a closer look.

If your dermatology provider suspects that a mole could be skin cancer, they may recommend a skin biopsy. During a biopsy, a small sample, or sometimes the entire suspicious lesion, is removed and examined under a microscope by a pathologist.

Is there a DOCS Dermatology provider near me?

Regular full-body skin examinations are also an important part of skin cancer prevention and early detection, even if you don’t have any specific concerns. Your dermatology provider can spot abnormalities you may miss or that aren’t visible to you. 

It’s typically recommended to get a full-body skin check once per year, but your provider can recommend an appropriate screening schedule based on your individual risk factors, including your history of sun exposure, previous skin cancer, family history, and number and type of moles.

DOCS Dermatology has 39 locations across Ohio, including in the greater Columbus, Cleveland, Cincinnati, and Dayton areas.

Next steps after a cancerous mole or other skin cancer is diagnosed

If melanoma or another type of skin cancer is diagnosed, treatment will depend on the type and stage of skin cancer and may include surgical removal of the cancerous tissue, such as curettage, excision, or Mohs surgery. For melanoma, additional treatment may be recommended depending on whether the cancer has spread beyond the original site.

At your next follow-up appointment, Pansch advises, “Bring a written list of questions and consider bringing another person with you. Ask what type and stage of cancer you have, what treatment is recommended, what alternatives are reasonable, whether additional testing is needed, what the expected recovery will be, and how often you should be examined afterward.” 

She also notes that seeking a second opinion is reasonable, especially for an uncommon, aggressive, recurrent, or advanced skin cancer.

The bottom line

“The important takeaway is that ‘suspicious’ does not mean ‘cancerous,’ but it does mean ‘worth checking.’ If a lesion is new, changing, bleeding, painful, persistently itchy, or noticeably different from your other spots, schedule an examination rather than trying to diagnose it at home,” says Pansch.

The ABCDE rule is a helpful starting point, while regular skin checks and professional evaluation by a dermatology provider can offer a more comprehensive picture of your skin health.

New or changing mole? Talk with a DOCS Dermatology provider.