Moles: when to have them checked and what dermoscopy is

Yuna Shkhagosheva — dermatologist, cosmetologist, trichologist
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The ABCDE rule

A simple check used by dermatology societies. Be alert to:

• A — asymmetry: one half does not match the other;
• B — border: irregular, blurred or notched;
• C — colour: uneven, several shades within one lesion;
• D — diameter: over 6 mm, although melanoma can be smaller;
• E — evolving: change in size, shape or colour, or new itching, bleeding or crusting.

The last point is the most important. A changing lesion needs to be seen regardless of whether it meets the other criteria.

The ugly duckling sign

A person's moles tend to resemble one another, like relatives. A lesion that stands apart from the rest deserves attention even when it looks formally unremarkable. In practice this sign often outperforms the formal criteria.

What dermoscopy involves

The doctor examines the skin with a dermatoscope — a device combining magnification and polarised light that reveals sub-surface structures invisible to the naked eye. It is painless, needs no preparation, and takes time proportional to the number of lesions. Where there are many moles, digital mapping is used: images are stored and compared at the next visit, and comparison over time is what yields the most reliable information.

Who needs regular checks

• fair skin that burns easily;
• many moles, particularly more than 50;
• melanoma in a close relative or in your own history;
• childhood sunburns, or work or sport in direct sun;
• living in a high-sun region — and the UAE is one.

Everyone else can reasonably self-examine every couple of months and see a doctor about any change.

Why not to have moles removed at a salon

A pigmented lesion must be assessed by a doctor before removal, and the removed tissue must go for histology. Cosmetic removal by laser or freezing without a diagnosis destroys the very tissue that would have provided the answer: if it was a melanoma, time has been lost and no evidence remains. This is a matter of principle, not paperwork.

Where to be checked

At GMS examinations and dermoscopy are performed by a dermatologist who is a member of the European Academy of Dermatology and Venereology and works with dermoscopy and skin lesion removal. Dermatologist consultation AED 750. Consultations in English and Russian.

Guidelines referenced

• American Academy of Dermatology. ABCDEs of melanoma
• American Cancer Society. Signs and Symptoms of Melanoma

FAQ

Which moles are dangerous?

Be alert to asymmetry, an irregular or blurred border, several shades within one lesion, a diameter over 6 mm and above all evolution: change in size, shape or colour, or new itching, bleeding or crusting. A changing lesion needs to be seen even if it meets none of the other criteria, as does a mole that stands apart from the rest.

What is dermoscopy and does it hurt?

The doctor examines the skin with a dermatoscope, a device combining magnification and polarised light that reveals structures beneath the surface. It is painless and needs no preparation. Where there are many moles, images are stored and compared at the next visit — digital mapping.

How often should moles be checked by a dermatologist?

Regular checks are needed for fair skin that burns easily, more than 50 moles, melanoma in a close relative or your own history, childhood sunburns, work or sport in direct sun, and living in a high-sun region such as the UAE. Everyone else can self-examine every couple of months and see a doctor about any change.

This article is for information only and does not replace a consultation. If you have symptoms, see a doctor.

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