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A new, changing, noticeably different, itchy, painful, bleeding, oozing, or nonhealing spot deserves a clinician’s attention. Use the ABCDE pattern—asymmetry, border, color, diameter, and evolving change—to decide which spots to show a dermatologist, but do not use it as a diagnosis or wait for every warning sign. Melanoma can be smaller than 6 millimeters and may appear as a new spot rather than inside an old mole.
Self-examination and dated photographs can help you notice change. Only a clinical examination and, when indicated, laboratory examination of removed tissue can establish whether a spot is melanoma.
When a mole change warrants an appointment
Arrange an appointment with a dermatologist if a spot is:
- new in adulthood;
- different from your other moles or spots (the “ugly duckling” pattern);
- changing in size, shape, color, texture, or elevation;
- itchy, tender, painful, bleeding, or oozing;
- developing a hard, lumpy, dry, or scaly surface; or
- a sore that does not heal, or one that heals and then returns.
The American Academy of Dermatology Association (AAD) gives the same practical advice: “If you notice any new spots on your skin, spots that are different from others, or spots that are changing, itching or bleeding, make an appointment to see a board-certified dermatologist.” A family doctor can assess an unusual mole and refer you when a dermatologist is not directly available.
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These signs do not prove cancer. They identify a spot that should be assessed rather than watched indefinitely at home. The evidence available for this guidance supports making an appointment, not a universal number of hours or days to wait. If a spot is accompanied by a separate, severe or rapidly worsening medical problem, contact a clinician who can judge your circumstances.
Use the ABCDE pattern as a recognition aid
ABCDE helps you describe what you see and decide which spots to show a professional. It is a prompt for assessment, not a screening test that can declare a mole benign or malignant.
| Letter | What to look for | How to interpret it |
|---|---|---|
| A — Asymmetry | One half does not look like the other half. | Unequal halves are more concerning than a spot whose shape is broadly balanced, especially when the difference is new. |
| B — Border | Edges are irregular, scalloped, ragged, blurred, or poorly defined. | An uneven edge is a reason to arrange an assessment; a sharply outlined edge does not by itself prove that a spot is safe. |
| C — Color | Color is uneven or several colors occur in one spot, such as tan, brown, black, white, red, blue, gray, or pink. | Variation within one lesion matters more than a particular “bad” color. Compare the spot with its earlier appearance and with your other spots. |
| D — Diameter | The spot is large, or its size is increasing. | Melanomas are often more than 6 mm when diagnosed, but they can be smaller. Six millimeters is not a safe cutoff for ignoring a changing spot. |
| E — Evolving | The spot changes in size, shape, color, surface, height, or sensation. | Change over time is often the most useful clue. A lesion does not need to show every ABCDE feature before you seek advice. |
The National Cancer Institute (NCI) notes that some melanomas show only one or two ABCDE features. The AAD also says a melanoma may be smaller than 6 mm. Do not wait for a spot to become large or to collect all five letters.
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Warning signs that can sit outside a neat checklist
A new or “ugly duckling” spot
Look for a mark that stands out from the rest of your moles, even if it is small, symmetrical, or missing another ABCDE feature. Your own pattern is an important comparison: a spot that looks unlike your other spots or unlike its previous photographs merits professional review.
Surface and sensation changes
A mole that becomes raised, firm, lumpy, dry, scaly, sore, itchy, tender, or painful has changed in a way worth reporting. Bleeding, oozing, repeated crusting, or a wound that will not heal also warrants an appointment. Do not dismiss a spot because it is not painful; melanoma and other skin cancers may have no pain.
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Change in an existing mole versus a new lesion
Many melanomas begin as a new unusual area rather than a pre-existing mole. For that reason, inspect clear skin as well as familiar moles. A normal-looking description cannot rule out melanoma, and a stable photograph cannot guarantee that a lesion is harmless.
Check places people commonly miss
Nails, palms, and soles
Melanoma can occur under a fingernail or toenail, on the palms, on the soles, or elsewhere on the body. During an examination, look for a new or changing dark streak, band, patch, or spot in these areas. A band of pigment that widens, changes color, becomes irregular, or affects the surrounding skin should be shown to a clinician.
All skin tones need complete checks
Melanoma can affect people of every skin tone. NCI reports lower population-level risk in the United States for Black and Hispanic people than for White people, but also describes later-stage diagnosis patterns among people with darker skin. Group statistics cannot determine an individual’s risk and should not be used as reassurance. Include the palms, soles, nails, and less visible skin in every check.
Areas that are hard to see
Use a full-length mirror, a hand mirror, or another person’s help for the scalp, back, buttocks, backs of the legs, and other obscured areas. A handheld mirror is simply a viewing aid; it cannot diagnose a lesion. Ask someone you trust to help if you cannot see an area safely.
How to examine your skin systematically
A consistent routine makes it easier to notice what is genuinely new. The AAD provides a free body mole map that you can use to record spots. Follow any examination schedule recommended by your dermatologist; the sources do not establish one universal frequency that fits every person.
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- Choose good conditions. Examine in bright, even light. Remove makeup, nail polish, and anything else that hides the skin or nails.
- Start with the front. Check your face, neck, chest, abdomen, arms, hands, fingers, and the fronts of your legs. Include the spaces between fingers and toes.
- Turn to the sides and back. Use mirrors or assistance to inspect your sides, back, buttocks, backs of your arms, backs of your legs, and scalp.
- Inspect acral sites. Look at the palms, soles, nail beds, and under the nails for new or changing pigment or spots.
- Describe each notable spot. Record its body location, approximate size, shape, colors, surface, and symptoms. Note whether it differs from your other spots.
- Take dated reference photographs. Photograph a spot from the same distance and angle, with a ruler or another consistent size reference if useful. Keep the original date with the image. A photograph documents appearance; it is not a diagnostic test.
- Show changes to a clinician. Bring the mole map and photographs to your appointment. Do not postpone an appointment while collecting a perfect series of images.
When helping another person, describe what changed and when you first noticed it rather than offering a diagnosis. The useful question is whether the spot needs examination, not whether a photograph “looks cancerous.”
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A clinician can examine the lesion, ask about its history, compare it with surrounding spots, and decide whether tissue should be removed. The NCI states: “The only way to diagnose melanoma is to remove tissue and check it for cancer cells.” Depending on the lesion, a clinician may remove all of it or a portion for laboratory examination.
Do not cut, burn, freeze, scrape, or apply home remedies to a suspicious mole. Those actions can injure skin, obscure the lesion, delay diagnosis, and make a later examination more difficult. Do not rely on an online image comparison, an app, or a home photograph to label a spot as safe or cancerous.
A visual examination can identify a reason for further evaluation, but only tissue examination can establish melanoma. A result that looks reassuring in a photograph does not replace an in-person assessment when the lesion is new, evolving, symptomatic, or unlike your other spots.
Normal moles vary, especially during childhood
Common moles are often round or oval, fairly even in color, and stable, but normal moles do not all look identical. They may be flat or raised and can differ in shade and size. A description that sounds typical cannot rule out melanoma.
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Children’s and adolescents’ moles may grow as the child grows, and some may become lighter or darker. That context is different from a new or changing mole in an adult. Adults should take a new mole or a change in an existing one seriously and ask a clinician to assess it rather than assuming that normal childhood behavior applies.
A dysplastic nevus is an atypical mole, not a diagnosis of cancer. NCI reports that about one in 10 Americans has at least one dysplastic nevus. Having one does not mean melanoma is present, but a larger number can change risk context and may justify a personalized monitoring plan.
Risk information that needs careful interpretation
Population figures provide context, not an individual risk calculator. NCI reports the following US estimates and research-based figures:
| Figure | What it describes | Important qualification |
|---|---|---|
| 2.9% (1 in 34) | Lifetime risk of being diagnosed with melanoma for White people in 2017–2018. | A population estimate for the cited period, not a prediction for one person. |
| 0.1% (1 in 1,000) | Lifetime risk reported for Black people in 2017–2018. | Population-level data; it does not eliminate the need to examine changing spots. |
| 0.5% (1 in 200) | Lifetime risk reported for Hispanic people in 2017–2018. | Population-level data; it does not account for every individual factor. |
| About 10 times higher | Estimated melanoma risk for someone with more than five dysplastic nevi compared with someone with none. | An estimate attributed by NCI to cited research and reviewed on its page in 2022; a dysplastic nevus is not itself melanoma. |
| 99,780 new cases | NCI’s estimate of new US melanoma cases for 2022. | A dated 2022 estimate, not a current incidence count. |
Family history, number and type of moles, prior skin cancers, immune status, UV exposure, and other factors can affect a person’s situation. A dermatologist can combine those details with the appearance and evolution of a lesion to recommend an appropriate monitoring plan.
Common mistakes that delay useful care
- Waiting for 6 mm. Size is one clue, not a pass/fail threshold. A melanoma can be smaller.
- Waiting for every ABCDE letter. Some melanomas show only one or two features.
- Checking only existing moles. Many melanomas begin as new unusual spots.
- Ignoring symptoms because the spot is small. Itching, bleeding, pain, oozing, or a nonhealing sore matters at any size.
- Checking only sun-exposed skin. Include nails, palms, soles, scalp, back, and other difficult-to-see areas.
- Assuming darker skin prevents melanoma. Risk differs between groups, but melanoma still occurs in every skin tone and may be diagnosed later.
- Trying to remove the spot yourself. Cutting, freezing, burning, or treating it with household products can cause harm and delay the correct diagnosis.
- Using a photograph as proof. Images help document change but cannot establish whether a lesion is benign or malignant.
A practical decision path
If the spot is new or unlike your other spots
Record its location and appearance, then arrange a dermatology appointment. Do not wait for it to develop a larger diameter or additional ABCDE features.
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If an existing spot is evolving
Bring dated photographs, if available, and describe the first change you noticed—such as widening, darkening, a new uneven edge, a raised surface, or a change in sensation. Arrange an assessment rather than relying on continued home observation.
If it itches, bleeds, hurts, oozes, or will not heal
Contact a dermatologist or family doctor for evaluation. Mention repeated bleeding, crusting, recurrence after apparent healing, or any rapid change in your description.
If it is under a nail or on a palm or sole
Include the location when requesting the appointment. These sites can be overlooked, and a changing streak or patch deserves the same professional attention as a changing spot elsewhere.
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If you cannot access a dermatologist directly
Start with a primary-care or family doctor. NCI notes that a family doctor may refer someone with an unusual mole or other skin concern.
What the major health agencies emphasize
“A change in your skin is the most common sign of skin cancer.”
Centers for Disease Control and Prevention, Symptoms of Skin Cancer, updated and reviewed June 17, 2026.
The AAD’s ABCDE guidance focuses on new, different, changing, itching, or bleeding spots and advises an appointment with a board-certified dermatologist. Its melanoma guidance also highlights unusual new spots, symptoms, nail involvement, palms, soles, and regular self-examination.
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NCI’s mole guidance explains why appearance alone cannot settle the question: “The only way to diagnose melanoma is to remove tissue and check it for cancer cells.” Use self-checks to notice and communicate change, then let a qualified clinician decide whether examination or tissue removal is needed.
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