Recognizing the early signs of melanoma — and getting yourself to a doctor as soon as possible if you see anything suspicious — is vital.
That’s because the earlier the diagnosis, the better the prognosis. For melanoma treated early, before it has time to spread, the five-year survival rate is over 98 percent.
Once the cancer has spread, treatment is more complicated and recovery a lot less certain.
Dermatologists recommend examining your skin once a month, looking for any abnormal spots or growths that might signal melanoma or another type of skin cancer.
The ABCDEs of Melanoma
Dermatologists use an acronym, ABCDE, to describe the differences between a benign (harmless) mole and a malignant one.
- A is for asymmetry. Most benign moles are symmetrical: If you draw a line through the middle, the halves match. Asymmetry, on the other hand, is a warning sign for melanoma.
- B is for border. A benign mole has smooth, even borders; a malignant mole may have scalloped, notched, or otherwise irregular edges.
- C is for color. Most benign moles are a single color, usually some shade of brown. Malignant moles might contain several different shades of brown, tan, or black, or they might be red, white, or blue.
- D is for diameter. Malignant moles are usually bigger in diameter than benign ones. They tend to be larger than the eraser on a pencil (about ¼ inch) but may be smaller if caught early.
- E is for evolving. Benign moles usually stay the same. Malignant ones can morph in size, color, shape, elevation, or other characteristics. (2)
Some melanomas don’t neatly fit into the ABCDE categories. See a doctor if you have any of the following warning signs:
- A sore that does not heal.
- Spread of pigment from the border of a spot into the skin around it.
- Redness or a new swelling beyond the border of the spot.
- Change in sensation, such as itchiness, tenderness, or pain.
- Change in the mole’s surface: oozing, bleeding, scaliness, or the appearance of a bump or lump. (3)
Searching for Ugly Ducklings
If the ABCDE approach seems complicated, dermatologists have come up with a simpler way to identify a suspicious mole: Ask yourself whether it’s an “ugly duckling” that looks different from all the other moles around it.
It might be larger and darker, for instance, or it might be a small red mole surrounded by bigger brown moles. For a person who has few other moles, any change in a spot or growth makes it an ugly duckling.
Researchers at the Mayo Clinic in Arizona who evaluated this method found patients were able to use it more effectively than the ABCDE approach. (4)
Skin Self-Exams: A How-to Guide
Once you know what to look for, you need to start looking.
Together with yearly skin checks by a doctor, regular self-examination is critical for catching melanoma and other types of skin cancer early.
According to the Skin Cancer Foundation, monthly self-exams should be sufficient for most people, but they recommend checking with your doctor to make sure you don’t need to look more frequently.
Once you’ve done a few self-exams, they get easier and faster. You should be able to complete it in 10 minutes. (5)
You’ll need a bright light, a full-length mirror, a hand mirror, two chairs or stools, a blow-dryer, and a pencil.
You’ll also want a body map (downloadable from the Skin Cancer Foundation) to record the location, size, and color of each mole, freckle, birthmark, and any other spot or growth. This will help you monitor these lesions for changes.
Here’s how to do the exam:
- Look closely at your face, paying extra attention to your nose, lips, mouth, and ears — front to back. Use the hand mirrors (one or both) if necessary.
- Examine your scalp, using a mirror and a blow-dryer to move hair out of the way. Get a friend or family member to help if possible.
- Scrutinize your hands: the palms and backs, between the fingers, and underneath the fingernails. Move up your wrists to your forearms, examining the skin front and back.
- Facing the full-length mirror, examine your upper arms (including your underarms) starting at the elbows.
- Check the neck, chest, and torso. Women should lift their breasts to see the undersides.
- Facing directly away from the full-length mirror, use the hand mirror to examine the back of your neck, shoulders, upper back, and any part of the back of your upper arms you weren’t able to see before.
- Using both mirrors, examine your lower back, buttocks, and backs of both legs.
- Sit down and take turns propping each leg on the other chair or stool. Use the hand mirror to examine the genitals. Scan the front and sides of both legs, thigh to shin, as well as the ankles, tops of feet, between the toes, and under the toenails. Scrutinize the soles of the feet and heels. (6)
Why Having a Skin-Check Partner Is a Smart Move
Researchers are finding that when it comes to spotting melanoma, two sets of eyes are better than one.
In a study at the Northwestern University Feinberg School of Medicine, researchers recruited patients who’d previously been treated for melanoma, and who were thus at increased risk for developing a second melanoma.
Each patient brought in a partner — a spouse, family member, or friend. Half the partners were trained to identify suspicious lesions.
The researchers discovered that the patient-and-trained-partner duos spotted more early-stage melanomas than pairs who were simply reminded to do regular self-exams. Being trained with a partner to do skin exams appeared to promote more frequent performance of self-exams and helped people pick up melanomas accurately. (7)
Editorial Sources and Fact-Checking
- Melanoma. American Academy of Dermatology.
- Do You Know Your ABCDEs? Skin Cancer Foundation.
- Signs and Symptoms of Melanoma Skin Cancer. American Cancer Society. May 20, 2016.
- Muneeb Ilyas, Costello CM, Zhang N, et al. The Role of the Ugly Duckling Sign in Patient Education. Journal of the American Academy of Dermatology. December 2017.
- If You Can Spot It You Can Stop It. Skin Cancer Foundation.
- Step by Step Self-Examination. Skin Cancer Foundation.
- Robinson JK, Wayne JD, Martini MC, et al. Early Detection of New Melanomas by Patients With Melanoma and Their Partners Using a Structured Skin Self-Examination Skills Training Intervention: A Randomized Clinical Trial. JAMA Dermatology. September 2016.