When a mole needs checking

Almost everyone has moles, and almost all of them are entirely harmless. The purpose of checking isn't to worry about each one — it's to notice the small number that change.

Change matters more than appearance

A mole that has looked the same for twenty years is far less concerning than one that has visibly altered over a few months, even if the second looks less dramatic. If you notice a mole becoming larger, darker, patchier in colour, raised where it was flat, or ragged at the edge, that's worth showing to a dermatologist.

Signs worth acting on

• Asymmetry — one half doesn't match the other
• Border — edges that are ragged, notched or blurred rather than clean
• Colour — more than one shade, or an unusual black, red or blue tone
• Diameter — larger than about 6 mm, roughly a pencil eraser
• Evolving — any change in size, shape, colour or sensation

The last of these is the most important. A mole that itches, bleeds without being knocked, or crusts and doesn't heal deserves attention regardless of how it scores on the others.

What a check involves

A dermatologist examines the mole with a dermatoscope — a magnifier with its own light source that reveals structures beneath the surface, invisible to the naked eye. Most examinations end with reassurance. Where there is doubt, the mole is either photographed for comparison at a later date or removed and examined under a microscope.

Photos can triage, not replace

A clear photo of a single mole is often enough to say whether it needs a closer look, which is why a photo review is a sensible first step. But dermoscopy and a full-body examination cannot be done through a camera. If a mole warrants proper assessment, the honest answer is an in-person visit — and you should expect to be told that plainly.

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If a mole has changed recently, don't wait to see whether it changes further. Getting it looked at early is straightforward, and the reassurance is usually immediate.