Melanoma

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Skin Exam

Having regular and thorough skin exams by a doctor or other trained healthcare professional can help find skin cancer early.

Who should have a skin exam

Everyone should have their skin examined as part of a yearly health checkup.

People who are at higher than average risk of developing skin cancer may need to be examined more often than people with average risk. If you have a higher than average risk, talk to your doctor about a personal plan for skin exams. You may be at higher than average risk if you have:

  • a personal history of skin cancer
  • a strong family history of melanoma (one or more first-degree relatives with the disease)
  • familial atypical multiple mole melanoma (FAMMM) syndrome
  • CDKN2A gene mutation
  • xeroderma pigmentosum
  • basal cell nevus syndrome

You may also be at higher risk if you are receiving immunosuppressive therapy after an organ transplant or PUVA therapy.

How a skin exam is done

The healthcare professional will systematically examine the entire skin surface for any signs of skin cancer. Make sure that you take off all makeup before you have a skin exam.

About 85% of non-melanoma skin cancers develop on areas of the body that are often exposed to the sun. But 20% of melanomas occur on skin that isn’t always exposed to the sun. That is why it is important to check all of your skin.

When looking at a mole, or nevus, the healthcare professional looks at some specific features to tell if it is normal or might be melanoma. They use the following systems to help them assess a mole.

ABCDE rule

The ABCDE rule helps healthcare professionals assess different features to tell a normal mole from a melanoma.

  • A is for asymmetry, or if one half of the mole is not the same as the other half.
  • B is for border irregularity, which means the edge of the mole is ragged or blurred.
  • C is for colour variation, or if the mole has different colours such as shades of tan, brown, black, blue, red, white or pink.
  • D is for diameter, or the size of mole, which includes if the mole has grown or if any mole is bigger than 6 mm (the size of a pencil eraser).
  • E is for elevation, or if the mole is raised above the skin and has an uneven surface, and also for evolving, which means a mole is growing or changing, itching or bleeds.

7-point checklist

The 7-point checklist is another system healthcare professionals use to help tell a normal mole from a melanoma. This checklist focuses on changes in size, shape and colour of a mole. If a mole has 2 or more major feature changes, the healthcare professional may suggest you have further tests.

Major features

change in size

change in colour

change in shape

Minor features

diameter greater than 7 mm

change in sensation, such as itchiness, tenderness or pain

oozing or crusting

bleeding or inflammation

What happens if a change or abnormality is found

If the healthcare professional notices a change, they will decide if you should have further tests. They may order a biopsy to check any suspicious area.

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