Mole and Skin Self-Check: ABCDE Rules, Photos and Where to Look
A full skin self-check takes ten minutes, once a month, in good daylight with a hand mirror and your phone camera. This guide adds what the ABCDE rules skip: a body map so nothing gets missed, a photo method so you can prove a change, and the places melanoma hides on brown skin, which are not the sunny spots at all but the palms, soles, nails and mouth.
Quick facts
- How often: once a month, same date, plus a proper look after any summer or a new sunburn.
- Kit: daylight or a bright white lamp, a full-length mirror, a hand mirror, your phone, a ruler or coin.
- Order: face and scalp, front, sides, back, arms and hands, legs and feet, then the hidden spots.
- Two rules: ABCDE for any single mole; the “ugly duckling” for one that looks different from all its neighbours.
- Skin of colour: check palms, soles, between toes, under nails, and inside the mouth. That’s where melanoma most often starts on brown and black skin.
- See a dermatologist within 2 weeks for: a changing, bleeding, itching or new dark streak or spot, anywhere.
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What the ABCDE rules cover, and what they miss
ABCDE is the mole test: Asymmetry, Border irregularity, Colour variation, Diameter over 6 mm, and Evolving (changing). The existing post on the ABCDE check and why home mole removal is dangerous explains each letter, so we won’t repeat it. Use it for any single mole that catches your eye.
It misses three things. First, the whole body: no rule scores a mole you never look at. Second, the “ugly duckling”: a spot that fails no single letter but simply looks different from every other mole on you, rounder, darker, redder, raised where the rest are flat. Third, ABCDE was built on pale skin, where melanoma usually grows on sun-exposed areas. On brown skin the commonest type, acral melanoma, starts on palms, soles and under nails, where there’s little sun and where nobody checks. Those gaps are what the monthly method below fills.
Skin self-check step by step, with the body map
Do this undressed, in daylight or under a bright white light, not a warm yellow bulb that hides colour. Work top to bottom, front then back.
- Face and neck (1 minute). Face the mirror. Check forehead, nose, cheeks, lips and the rims and backs of both ears. Then the front and sides of the neck.
- Scalp (1 minute). Use a comb or hairdryer to part the hair in 2 cm strips from front to back, with the hand mirror angled at the wall mirror. Or ask a family member or your barber to look.
- Chest, belly and sides (1 minute). Women lift each breast to check the fold underneath. Turn side-on for the flanks.
- Back and buttocks (1 to 2 minutes). Back to the wall mirror, hand mirror in front. Shoulders, upper back, lower back, buttocks. Melanomas here are often found late, so ask someone to look.
- Arms and hands (1 minute). Each arm front and back, armpits, then the palms, the backs of the hands, between the fingers, and every fingernail. Look at the nail itself for a brown or black stripe running from base to tip.
- Legs and feet (2 minutes). Sit down. Front and back of each thigh and calf, groin, then each foot: the top, the sole, the heel, between every toe, and each toenail. Use the hand mirror for soles.
- Mouth and hidden areas (30 seconds). Inside the lips and cheeks, the gums, under the tongue. Genital skin. A dark flat patch in any of these is worth a doctor’s look.
- Photograph anything you’ll want to compare (2 minutes). Method below. Then note the date on your body map.
The monthly photo method that actually shows change
“Evolving” is the most important letter and the hardest to judge from memory. A photo solves that, but only if next month’s photo is taken the same way. Three rules make photos comparable.
Same light, same distance, with a scale. Take the picture in daylight near a window, never with flash, which flattens colour. Put a 1-rupee coin or a ruler beside the mole, in the same frame, so size can be read. Hold the phone about 15 cm away, straight on, not at an angle. Then take one wider shot from about 50 cm showing where on the body it is. Keep them in one album, oldest first.
Make a body map once. Draw two simple outlines of a body, front and back, on a page or in a notes app. Mark each mole you’re tracking with a number. Next to the numbers, write the size in mm and one word on colour. That turns “I think that’s new” into “number 7 was 4 mm in June and is 6 mm now”.
Compare side by side, not from memory. Put last month’s and this month’s photos next to each other on the screen. Look for growth, new colour, a new bump or a blurred edge. Anything that clearly changed over one to three months should be seen.
Where melanoma hides on brown skin
People with darker skin get melanoma less often than pale-skinned people, but when they do it’s found later and does worse, mostly because nobody looks in the right places. On South Asian, African and East Asian skin the commonest melanoma is acral: on the palms, the soles, under the nails, and sometimes in the mouth. Sun has nothing to do with these sites, so sunscreen doesn’t protect them.
The signs to know:
- A dark stripe in a nail that runs from the cuticle to the tip, is wider than about 3 mm, is widening, has blurred or uneven edges, or has spread dark pigment onto the skin fold around the nail.
- A new dark flat patch on the sole or palm, especially with irregular edges or uneven colour, or one that has started to thicken, crack or bleed. It’s often mistaken for a callus.
- A sore between the toes or on the heel that doesn’t heal in 3 to 4 weeks.
- A dark patch inside the mouth or on the gums that’s new or growing. Many brown-skinned people have harmless flat pigment in the mouth; a new or changing one is different.
On darker skin, non-melanoma skin cancers and even melanoma can also look pink, red, brown or grey rather than black, and can show up as a shiny bump, a scaly patch or a sore that keeps reopening. “Not black, so not cancer” is a mistake.
A mole or spot is changing in size, shape or colour; a mole has become raised, itchy, crusted or bleeds; a dark stripe has appeared in a nail or is widening; a new dark patch has appeared on a palm, sole or in the mouth; any sore on the skin hasn’t healed in a month; or one spot looks unlike all the others on you. A home check finds the suspect; it can’t say what it is. Only a dermatologist’s exam, and sometimes a biopsy, can. Never cut, burn, thread, tie or apply any acid, paste or “mole-removal” cream at home, however small the mole. If a lesion is a melanoma, home removal can drive it deeper and hide it from the pathologist.
What a normal mole looks like, so you don’t panic
Most adults have somewhere between 10 and 40 moles, and a few new ones appearing through the 20s and 30s is normal. A typical benign mole is one even colour, round or oval, with a sharp edge, smaller than a pencil eraser, and unchanged year to year. Moles on brown skin are often darker and can be quite black; colour alone isn’t the signal, change is.
Other harmless things people mistake for danger: freckles that darken every summer and fade in winter; rough “stuck-on” patches after 40 (seborrhoeic keratoses); tiny red dots (cherry angiomas); skin tags; and dark flat patches on the face after pregnancy or sun (melasma). For melasma, the post on judging a sunscreen by its label covers what to buy.
How to lower the risk between checks
Sun still matters on brown skin, for skin cancers on the face, ears, neck and arms,. Shade, a cap or dupatta and a broad-spectrum sunscreen are the basics. Feet and hands need their own attention: wear proper footwear outdoors, look at your soles when you bathe, and don’t ignore a “callus” that’s dark or that bleeds. With a family history of melanoma or a very large number of moles, ask about a yearly dermatologist check. This check belongs with the rest of the Skin & Beauty routines.
Mole and skin self-check questions people ask
Can dark-skinned people get melanoma?
Yes. It’s less common than on pale skin, but it’s found later and is often more serious because it starts in places nobody checks: palms, soles, under nails and in the mouth. Sun protection doesn’t cover those sites; looking does.
Is a black line in my nail dangerous?
Sometimes. Faint stripes in several nails are common and usually harmless on brown skin. A single stripe that’s new, wider than about 3 mm, widening, blurred at the edges, or spreading onto the skin around the nail should be seen by a dermatologist promptly.
Is a new mole in adulthood always a worry?
No. New moles appearing into the 30s are common. A new mole after 40, a new one that grows fast, or one that looks unlike your others deserves a check.
Do moles that itch or bleed always mean cancer?
No, a mole rubbed by a bra strap or belt can itch or bleed. But a mole that itches, crusts or bleeds without being rubbed, or does so repeatedly, should be examined.
Can I remove a mole at home if it’s small?
No. Home removal by cutting, thread, acid, garlic or creams causes burns, scars and infection, and if the mole was a melanoma it can hide the diagnosis. A dermatologist removes it properly and sends it for testing.
What does a dermatologist do if a mole looks suspicious?
They look with a dermatoscope, a lit magnifier. If it still looks suspicious they remove it under local anaesthetic, a short clinic procedure, and send it to a laboratory.
Should children have their moles checked?
Children get new moles as they grow and it’s normal. Melanoma in children is very rare. A mole in a child that’s growing quickly, bleeding, very irregular or looks unlike the others should still be shown to a doctor.
How big is 6 mm, the ABCDE size limit?
About the width of a pencil eraser, or a bit less than a 1-rupee coin. It’s a rough guide that counts alongside the other letters.