How to be skin cancer savvy

Woman sunbathing wearing a hat and exclamation mark

“Is this mole a skin cancer, doctor?” is something I get asked a lot.

Woman sunbathing wearing a hat and factor cream to avoid skin cancerThere’s no doubt skin cancer is on the increase. But how do we tell if a mole is cancerous?

If you notice a new mole, or an existing one which is changing in shape, size or colour, then you need to speak to your GP.

It might be nothing (most times, moles are harmless). But worrying about it and trying to self diagnose isn’t going to help.

Doctors use what is known as the ABCDE method for examining moles:

A is for Asymmetrical – so the two halves of your mole look different

B is for Border – irregular, blurred or jagged edges

C is for Colour – where your mole has uneven colours of more than one shade

D is for Diameter – if your mole is wider than 7mm in diameter

E is for Enlarging – your mole has grown.

Please don’t panic, though, if you have some or all of these symptoms, as it still doesn’t automatically mean you have skin cancer. Your GP might be able to reassure you straight away, or if they’re not sure they’ll send you to a dermatologist for specialist advice.

To give you the facts, there are several types of skin cancer, but the three most common are basal cell carcinoma, squamous cell carcinoma and malignant melanoma.

The malignant melanoma is the most serious – to put it in perspective, only 1 in 20 skin cancers are melanoma, but it accounts for 3 out of 4 deaths due to skin cancer.

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The good news is that if melanoma is confined to the skin, picked up early enough and cut out, this often results in a ‘cure’.

Also, the treatment for advanced stage malignant melanoma has improved significantly over the past few years.

Your dermatologist may use a technique called dermatoscopy to help in telling if a mole is harmless or malignant. It’s a non-invasive procedure using a specialist piece of equipment called a dermatoscope to examine any skin lesions. This can reduce unnecessary surgery and also improves the diagnosis of actual melanoma, so it can be removed as
quickly as possible.

What causes skin cancer?

It’s been well established that sun exposure (or ultraviolet radiation from the sun) is the main cause of skin cancer. I ask about sun exposure over one’s lifetime, occupation, living abroad, recreational sun exposure and lifestyle.

Do you work outside – builders, bricklayers, gardeners get a lot more sun exposure. Have you lived abroad or are you a golfer? Do you enjoy cycling, walking, long distance running or play cricket?

Therefore, risk factors include:

  • Fair skin that burns easily
  • Sunburn, especially in childhood
  • Lots of moles
  • Past history or family history of a skin cancer
  • Using sun beds
  • Amount of sun exposure

So you really need to protect yourself in the sun. Here’s how:

  • Stay in the shade wherever possible, and certainly when the sun is at its strongest (usually between 11am and 3pm)
  • Keep well covered with sunglasses and a sunhat
  • Avoid using sunbeds
  • Regularly apply a high-factor sunscreen (don’t forget to
    reapply after you’ve been swimming)

As Dermatologists we spend an enormous amount of time seeing and thinking about moles and other forms of skin cancer. I have been using dermatoscopy for 15 years and most times moles are harmless.

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My advice – if you think you need to see a doctor – you need to see a doctor. Let the professional reassure you that the mole is ok. If it isn’t then you did the right thing seeing them.


About Dr Sandeep Varma

I am a Consultant Dermatologist and Dermatological Surgeon working for 11 years in Nottingham. As such I see all skin problems but I specialise in the early detection and treatment of skin cancer and in the diagnosis and management of Acne and Rosacea.