Moles & Melanoma - Remember the ABCD of Melanoma

Early detection of the disease is vital, so it is important to regularly check your moles, record any differences that you may discover and consult a doctor immediately if you notice anything suspicious. Moles can be flat or raised, light or dark. Normally, they appear symmetric, with regular borders which fade gradually into the skin and display a single colour. These moles can change, but this normally occurs so slowly as to be unnoticeable. Most moles are normal and perfectly safe. See chart left for signs and characteristics to look out for.

Sun exposure can increase the number and appearance of moles and sometimes they can become cancerous.

The more moles you have on your body, the higher your risk of melanoma, people with more than 100 moles are at greater risk. Of course this doesn’t mean you will definitely get melanoma if you have lots of moles. But it does mean you should be careful about exposing yourself to the sun and you should keep an eye on all your moles, checking your skin regularly to spot any changes or new moles developing.
See section on SELF EXAMINATION BELOW.

You should consult your doctor if you develop any of the following signs as this may indicate a melanoma:

• Changing shape, particularly getting an irregular outline
  
• Changing colour- getting darker, becoming patchy or multi-shaded
  
• An existing mole getting bigger or a new mole growing quickly
  
• A mole starts to itch or become painful
  
• Bleeding or becoming crusty
  
• Looks inflamed

Itching, crusting, inflammation or bleeding are less common signs of melanoma but should not be ignored.

Research suggests that moles with 3 or more different shades of brown or black are particularly likely to be melanoma.

The chart above shows photographs of abnormal moles and melanomas and should help you to recognise what is not normal.
It is important to see your doctor if you notice any changes or unusual marks that have lasted more than a few weeks.

Precancerous moles are so easy to treat and can usually be removed under local anaesthetic. An early melanoma can be cured in this way. But if you leave them, the disease can spread and be more difficult to treat.

More advanced melanoma is not always easy to detect without further tests. However if you have an enlarged lymph gland in the area of a suspicious mole then you should definitely see a doctor as soon as possible.

If you have any doubt you should consult your doctor immediately.

Self Examintation

It is important that you check your skin regularly (the experts suggest once per month), especially if you are at higher risk of developing skin cancer. Those with a higher risk tend to have one or more of the following:

• Fair skin that burns in the sun
• Red or fair hair
• Lots of moles or freckles
• Have had a skin cancer before
• A family history of skin cancer, particularly melanoma
• Experienced sunburn, especially in childhood
• Have a history of sun exposure due to leisure pursuits or occupation

You should check your skin all over from the soles of your feet to your scalp (not forgetting your genital area and between your toes). Ask someone else to check the areas you cannot see yourself or stand in front of a full-length mirror and use a hand-held mirror to view the “difficult to see” areas.

Some people find photographs a useful tool when examining their skin. Take a set of photographs of your skin (eg front of upper body; back; front of legs; back of legs; arms and face) and then compare your skin each time against these photographs, paying particular attention to how the moles look compared to the surrounding moles.

If you have been diagnosed with a melanoma it can spread into the lymphatic system. You should therefore examine the lymph nodes nearest to the melanoma (eg if your melanoma was on your leg your should check the lymph nodes in your groin). The doctor or nurse will explain which lymph nodes you need to check. The aim is to detect any enlargement of the node and undertake investigations at an early stage.

Once you have had one skin cancer you are at more risk of developing another. Sometimes the changes occur in a mole that has been there a long time or at other times the changes appear in “normal” skin. If in any doubt about how to check you skin or lymph nodes, ask your GP, hospital doctor or nurse.