How to Tell If Your Mole Is Abnormal

Learn the Signs of an Abnormal Mole of Freckle

Examining a mole. Credit: Bartek Tomczyk / Getty Images

How can you tell if your mole or freckle is abnormal?  Let's take a look at the answer to this common question.

Abnormal Moles and Freckles

Health experts recommend that we check our skin every month for signs of skin cancer and melanoma, but how do we know if a mole or freckle is normal or abnormal?  If you ordinarily have a lot of moles, how can you monitor them?

Ultimately, a dermatologist is the only person who can differentiate between a normal and abnormal mole, but there are some ways to tell at home whether a mole may be abnormal.

Keep in mind that regardless of whether or not a mole has any of these signs, if you are worried, make an appointment.  In addition, if you have risk factors for melanoma, including a family history of the disease, you may wish to make an appointment.  It's thought that 55% of melanomas have a genetic connection.  If you have a lot of moles, some dermatologists even take yearly photos in order to monitor these more closely.

Finally, it's important to point out a few important facts.  Though melanomas are certainly more common in fair skinned people, those with even the darkest skin colors have developed melanomas.  And even though you may associate melanomas with sun exposure, they are not uncommonly found in regions that have never been exposed to the sun.

The ABC Rule

The ABC's of skin cancer is a tool to help you identify abnormalities when examining your moles. Each letter represents an abnormal characteristic, including asymmetry, border, color, diameter, and evolution.

  These are general signs to watch for, and not all melanomas are asymmetric, with irregular borders and a non-uniform color.

When you're done learning the signs to watch for, make sure to check out this skin cancer gallery to see photos of melanomas showing each of these characteristics.  When you're done with those, here are some more pictures contrasting normal moles and melanomas.

The ABCD mneumonic is as follows:

  • Asymmetry:  Normal moles or freckles are completely symmetrical. If you were to draw a line through a normal spot, you would have two symmetrical halves. In some skin cancers, spots will not look the same on both sides. 
  • Border:  The borders or edges of a melanoma may be irregular, jagged or blurry.
  • Color:  Normal moles are uniform in color. Moles are considered to be abnormal when they are more than one color or shade. This can include lightening or darkening of the mole.  The classic example of a melanoma is considered "red, white, and blue."  While this is classic, it is not exceptionally common.  It is common, however, for melanomas to vary in color over the whole of the mole.
  • Diameter:  If a mole is larger than a pencil eraser (about 1/4 inch, or 6mm), it is considered to be abnormal. This includes moles that do not have any other abnormalities (color, border, asymmetry.)
  • Evolving or Elevation: The letter E is used in different ways by different dermatologists. Evolution refers to any changes in the symmetry, borders, colors, and diameter of an existing mole.  Elevation refers to a mole that is elevated on the skin, or has different regions with different degrees of elevation.
  • Funny Looking:  While not often listed in the ABC's of melanoma, some doctor have added the level F for funny looking.  Melanomas can have a look that is not really funny looking, but simply looks abnormal and not like a spot that should be found on the skin.

In summary, normal moles are typically small, have well-defined borders, are symmetrical, are brown and uniform in color, and are round.

Melanomas can have one or all of these abnormalities, or again, may not.  If your gut tells you that a mole is abnormal, it doesn't have to have any of these characteristics - make an appointment with your doctor and have it checked out.  As a final note on signs and symptoms, some people with melanomas have said that they have a vague sensation at the location of the mole.  It may feel dry or itchy, or you may simply be aware of a mole in a way we aren't ordinarily aware of our skin.

If You Have An Abnormal Mole

First, don't panic. It is prudent that you have your mole checked out by your doctor or, preferably, a dermatologist. What you may think is abnormal may look completely normal to the trained eye of a medical professional. Second, you should know that not all abnormal moles are cancerous. Sun exposure is not the only cause for moles to become abnormal. Hormonal changes during puberty and pregnancy can cause benign skin changes, too.

In contrast, and again if your mind is telling you that something could be wrong, make sure to see your doctor.  And if your mole is deemed nothing to worry about and you're still worried, get a second opinion.  Melanoma is most treatable when it's small.

Sources:

American Academy of Dermatology. Melanoma. Accessed 04/16/16. https://www.aad.org/public/diseases/skin-cancer/melanoma

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