The clues are sometimes subtle but may be enough to get you evaluated and diagnosed when the cancer is still treatable.
This article explains the differences between moles and melanoma and some of the signs and symptoms that warrant an immediate investigation by a dermatologist.
Also known as beauty marks, moles are not usually present at birth but begin to appear during childhood and the teen years. They can either develop on the skin (in the layer known as the epidermis) or under the skin (in the layer called the dermis).
Most moles never cause any problems, but a person who has more than 50 of them has a higher risk of developing melanoma, the most aggressive form of skin cancer.
Early signs of melanoma are changes in the size or appearance of a mole. At later stages, the lesion may get crusty, form ulcers, or bleed. Melanoma usually does not cause pain.
Melanoma is the most dangerous type of skin cancer, affecting more than 230,000 people globally and causing over 50,000 deaths each year. In the United States, males are around 1.5 times more likely to get melanoma than females.
When identified early, melanoma is highly treatable. When it spreads (metastasizes), the five-year survival rate is around 30%. This means that three out of 10 people will survive for at least five years.
Asymmetry: An irregular shape Border: Ragged, notched, or blurred edges Color: Different colors or shades within the mole Diameter: Diameters over 6 millimeters (though melanoma can come in any size) Evolving: Changes in size, shape, color, or appearance
Although most moles are benign, certain types carry a higher risk of developing melanoma. Between 2% and 8% of the White population in the United States have moles that are dysplastic.
Dysplastic moles are not cancer but can become cancerous over time. Unlike normal moles, dysplastic moles are larger than 6 millimeters, irregular in shape, and tend to have uneven coloration, with dark brown centers and lighter, uneven edges.
People with dysplastic moles and a family history of melanoma are at high risk of developing melanoma before the age of 40.
One is to draw a line through the center of the lesion and see if the two sides match. If they don’t and the colors also appear uneven, see a dermatologist.
Also, look at the borders. Are they starting to fade and dissolve into the surrounding skin? This is another telltale sign. Any noticeable change to a mole is worth getting checked out.
No matter which color, the one feature that characterizes moles is that the color is consistent. You won’t see two or three different colors in a mole, but you may with melanoma.
It is worth noting that moles can change in color without becoming cancerous. For example, moles on the face will often start out brown and get lighter over time. Moles can also raise or flatten (though will typically remain the same size).
Another clue that a person has melanoma is the so-called “ugly duckling sign.”
By and large, the moles on people’s bodies will all look the same. However, if you step back and look at them in their entirety, there may be some that stand out as being different, either in terms of color, size, or shape. These “ugly ducklings” may be an early sign of melanoma.
Despite these differences, the vast majority of moles have smooth borders that are clearly separated from the surrounding skin. The color of the mole will also be even rather than mottled.
An uneven border is one of the telltale signs of melanoma. By contrast, moles tend to have smoother, more even borders.
It is worth noting that around 20% to 30% of melanomas develop from existing moles, while 70% to 80% arise on seemingly normal skin. In either case, melanoma tumors will commonly have jagged, uneven borders that set them apart from other benign skin conditions.
The challenge, of course, is recognizing the changes. Unless you do a regular self-examination, you may not even notice a mole has changed unless it is bleeding or has caused a skin ulcer. This is especially true if you have lots of moles.
Another challenge is monitoring changes on parts of the body you can’t easily examine, such as the back. A friend or mirror can certainly help, but a better option may be to have a regular, full-body check-up with a dermatologist.
The Skin Cancer Foundation is among the organizations that endorse once-yearly skin exams.
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The ABCDE rule is based on the fact that melanoma tumors tend to be asymmetrical, have ill-defined borders, be unevenly colored, be larger than 6 millimeters in diameter, and change over time. These early signs can help spot melanoma early when it is still highly treatable.
In addition to doing regular self-exams at home, an annual, full-body checkup with a dermatologist is often recommended.
