Skin Self Examination

For those at high risk of melanoma or those with a pervious history of any type of skin cancer, regular skin self examination is advised every 3 months (or every season as a prompt to memory).

Skin self examination can be performed alone or with the help of your spouse or partner. Good lighting is necessary and for solo examination a full length mirror and hand held mirror for checking the more difficult to see areas. Don’t forget to look at the palms and soles, under the nails, between the fingers and toes, armpits, groins, genitalia in both sexes and under the breasts in women.

The information below relates to detection of the common varieties of melanoma skin cancer. Please see Types of Skin Cancer for information about non melanoma skin cancers.

Be on the lookout for anything you think is new or different. You can use the ABCDE(FG) rule or look for any of the changes listed below.

What To Look For:

A – Asymmetry of Shape and Structure. One half doesn't match the other half (not just asymmetry of the border but also the colour and structure within the lesion.)

B – Border Irregularity.  The edges are ragged, blotched, or blurred.

 

C – Colour Variability.  The pigmentation is not uniform. Shades of tan, brown, and black may be present and red, white, grey and blue may add to the mottled appearance.

 

D – Diameter Increasing. Traditionally this criteria was used to select lesions with a width greater than six millimetres (about the size of a pencil eraser). We know however that tiny melanoma only 1-2 mm are diagnosed so any growth of a mole should be of concern.

 

E – Elevated. A mole that is of different elevations/contours or ANY mole that has changed from flat to elevated is of concern.

F – Firm.  A lesion that is firm to hard to feel, and also ones that are friable (easily damaged) are more likely to be malignant. Whilst many common benign moles are raised, soft and “wobble” like jelly with pressure.

G – Growing. Signs of growth either slow or rapid should raise concern. Slow growth is more difficult to detect and high risk patients may have “total body photography” performed to facilitate detection of slowly changing lesions.

Important changes that may occur in an existing pigmented skin lesion include:

Change in colour. Especially multiple shades of dark brown or black; red, white and blue; spread of colour from the edge of the lesion into surrounding skin.

Change in size. Especially sudden or continuous enlargement.

Change in shape. Especially development of irregular margins.

Change in elevation. Especially sudden elevation of a previously flat pigmented lesion.

Change in surface. Especially scaliness, erosion, oozing, crusting, ulceration, bleeding.

Change in surrounding skin. Especially redness, swelling, and “satellite” areas of pigmentation.

Change in sensation. Especially itching, tenderness, and pain.

Change in consistency. Especially softening and friability, or increasing firmness.

If you notice any suspicious spots or changes make sure you have it checked by a doctor experienced in skin cancer diagnosis as soon as possible.