Our skin changes continuously throughout life, and most of us have various moles and pigment changes. The majority of these are benign and do not require treatment. Still, it is important to pay attention to skin changes, as some can develop into skin cancer or its precursors. Early detection of skin cancer is crucial, because the earlier an abnormal change is identified, the better the chances for effective treatment.
Risk Factors for Skin Cancer and the Most Common Types of Skin Cancer
Ultraviolet (UV) radiation from the sun significantly increases the risk of skin cancer, which is why protecting the skin from UV exposure is important. Having many moles, fair skin, and hereditary factors can also increase the risk of developing skin cancer.
The most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma.
Basal cell carcinoma is the most common form of skin cancer. It usually grows slowly and is often found on sun-exposed areas of the skin. Basal cell carcinoma is divided into three groups based on its growth pattern: nodular, superficial, and morpheaform (scar-like) basal cell carcinoma. If left untreated, it can grow into deeper tissues beneath the skin, but it usually does not spread (metastasize) to other parts of the body.
Squamous cell carcinoma is the second most common type of skin cancer. It often appears on the lips, face, or ears. Unlike basal cell carcinoma, squamous cell carcinoma can spread to nearby lymph nodes.
Melanoma is one of the fastest-growing cancers in prevalence in Western countries. It is the most dangerous form of skin cancer because it can spread to lymph nodes and other internal organs. Melanoma often appears as a new or changing pigmented lesion. Many people think melanoma always develops from an existing mole, but in reality, only some melanomas arise from pre-existing moles. Often, melanoma appears as a new change on previously healthy skin.
The sun leaves marks on the skin over the years — some visible, some invisible. That is why protecting your skin is not just an aesthetic choice; a small action today may help protect your skin decades from now.
When Can a Mole Be Concerning?
A mole or other skin change should be examined by a doctor if it changes in any way. Pay particular attention if a mole:
- changes color, darkens, or has uneven pigmentation
- grows rapidly
- develops irregular or asymmetrical borders
- begins to cause symptoms, such as bleeding
- looks clearly different from your other moles
Especially a so-called “ugly duckling” mole—one that looks different from the others—can be an important warning sign. If any lesion appears noticeably different from your other skin changes, it should be examined.
The ABCDE Rule Helps Assess Mole Changes
One of the best-known ways to recognize suspicious moles is the ABCDE rule:
- A – Asymmetry: the two halves of the mole do not match
- B – Border: the borders are irregular, jagged, or poorly defined
- C – Color: the mole has uneven pigmentation or multiple colors
- D – Diameter: a size over 6 mm may raise suspicion, but smaller changes can also be significant
- E – Evolving: the mole grows, changes color or shape, or starts causing symptoms
These guidelines help identify situations where medical evaluation is recommended. When changes are detected early, treatment outcomes are usually good.
When and How Is a Skin Lesion Removed?
Removal of skin lesions is a common procedure in a plastic surgeon’s practice. If there is suspicion that a mole or other skin lesion may be malignant, it is surgically removed and sent for pathological examination. A skin lesion may also be removed if its location causes practical discomfort or cosmetic concerns.
The removal is performed under local anesthesia, and the procedure is usually quick and well tolerated. A mole or skin lesion can either be removed completely, or a punch biopsy may be taken to collect a tissue sample for examination. Laser removal may be suitable for certain benign lesions, but it does not allow for tissue analysis. If a mole has concerning features, it should always be removed surgically so that appropriate tissue samples can be properly examined.
Safety is always the top priority during removal, but especially in visible skin areas, preserving tissue, scar placement, and aesthetic outcomes are also carefully considered.
When Should You Seek an Evaluation?
It is advisable to seek a doctor’s evaluation with a low threshold if a mole or skin change:
- changes color
- grows
- becomes asymmetrical
- bleeds or ulcerates
- looks different from your other moles
- appears for the first time in adulthood and changes rapidly
It is important to identify changes early, as treatment options are generally very good when detected in time.