The ABCDE Tool Helps Determine Whether A Mole is Suspicious
Do you ever wonder how to tell if a mole is cancerous or totally benign? Every once in a while, I’ll get a new text message from a friend who wants my opinion. They want my opinion on a new mole or freckle that they had never noticed before. For example, last week one of my friends from California sent me a message saying:
“Hey ms dermqueen, are freckles on palms or soles of feet a reason to be alarmed? Do they have to be removed?”
Of course every case is unique, but for the most part, the moles I encounter on a daily basis are characteristically benign.
What does benign mean?
First things first, benign growths are not able to turn into the types of cancer that can kill. Among lay people, benign means it’s not a good type of cancer. Benign growths will not invade or metastasize to other places.
How to Tell If A Mole Is Cancerous
Skin lesions have certain signs that point towards benign versus malignant behavior. Malignant growths are the bad type of cancer. They are the ones known to kill people. Dermatologists advise that you follow your ABCDE’s when checking your moles. (1) ABCDE was a tool invented to help dermatologists, other doctors, and regular people determine whether their mole was suspicious for cancer.
The ABCDE tool is a checklist of 5 items.
Is the lesion symmetrical? Can you divide it in half evenly?
Are the borders regular? Or are they jagged and haphazard?
Is the lesion all one color? Or is there variegation (several colors) within the lesion?
Is the lesion less than 6mm or 1/4 inch in its biggest diameter?
Has the lesion stayed the same? Or is it changing and evolving to become something different than it was before?
If the suspicious skin lesion you’re considering is symmetrical, has even borders, is all one color, is less than 6mm in diameter, and hasn’t changed for as long as you can remember it, then you’re most likely safe. If however, the lesion is not symmetrical, the borders are all over the place, the color changes within the lesion, it’s large, and/or it’s changed recently, then you should have your dermatologist check it out.
What will the doctor say about the mole?
The doctor will either send you on your merry way with a clean bill of health or decide that it’s suspicious enough to warrant a biopsy. A biopsy is a minor procedure done under local anesthesia where the doctor removes a skin sample. This small sample of skin is sent to a pathologist that specializes in skin lesions.
How to Keep Track of Your Moles
People have the most trouble with determining whether the mole has actually changed from when they last checked. Our brains are good at remembering the lyrics to the newest Beyonce single. However, they’re not so good at trying to remember if that mole in-between your toes was really that big last year.
A simple solution is to take a picture and save it on your phone or computer. To accurately track changes, you need to take the picture with a ruler next to the mole. This way, you can tell exactly how much it’s grown, if at all, by comparing the measurements from year to year. There is also a new technology called total body photography. Some dermatologists may offer this service.
I like to put the ruler flush against my skin so that it’s not pushing down or stretching the mole in any way. Then I take a picture, and voila! I have photographic evidence of how big my mole was at that point in time forever. My iPhone saves the date of the picture under information, but you can also write down the date on a piece of paper and take the picture with the date visible. I recommend you try to get the same angle and lighting every time so that you can actually compare in the future.
How often should I check for new moles, freckles, or growths?
You probably see your family practitioner or dermatologist at least once a year, right? The good news is that insurances now pay doctors that bill for a total body skin exam once a year. You can get ONE totally free, preventative total body skin exam once a year if you’re insured. If you want to check your skin yourself, you can try checking once a month. Patients are more likely to notice changes in their own body. The doctor only sees you once a year. A total body skin exam can be done more often if you have risk factors like family history, fair skin type, history of skin cancer, and history of sun exposure.
Find a partner to help exam your whole body.
You may need a total body skin exam buddy. I always recommend a sunscreen application buddy for hard to reach spots. This a great opportunity to find a buddy to help screen for cancers and suspicious moles. Don’t forget to look between your toes, in your scalp, in your genitals, and your back. Melanoma can start in really weird places like between the toes, in the vagina, on the back, and on your perineum (aka the place between your genitalia and your anus). Maybe ask your husband, or your mom, or the cute guy at the coffee shop for help. It’s not weird; it’s for your health! If you’re still squeamish about glaring your most private parts to someone else, employ the use of a hand mirror. As long as you’re checking every inch, it doesn’t matter how you’re doing it.
Don’t forget to look between your toes, in your scalp, in your genitals, and on your back. Melanoma can start in really weird places like between the toes, in the vagina, on the back, and on the perineum (the place between your genitalia and your anus). Ask your husband, or your mom, or the cute guy at the coffee shop for help. It’s not weird; it’s for your health! If you’re still squeamish about glaring your most private parts to someone else, employ the use of a hand mirror. As long as you’re checking every inch, it doesn’t matter how you’re doing it.
It’s not weird; it’s for your health! If you’re still squeamish about showing your most private body parts to someone else, employ the use of a hand mirror. As long as you’re checking every inch, it doesn’t matter how you’re doing it.
Did you know about using ABCDE to monitor your moles before this post? Did you learn how to tell if a mole is cancerous or not? Comment below on how often you’ll be checking your skin from now on!