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ABCDE mole self-check

How to check your own moles: the ABCDE rule, the ugly-duckling sign that often works better, the raised nodular pattern ABCDE misses, the places people never look, and the changes that mean you book an appointment instead of taking another photograph.

This is a guide to noticing change, not a diagnostic tool. Nothing on this page can tell you whether a mole is harmless, and no photograph or app can. If a lesion is changing, bleeding, itching, or simply worrying you, book an appointment — that is what the appointment is for, and being wrong about it costs nothing.

ABCDE

The ABCD rule was devised in the mid-1980s as a way for non-specialists to describe suspicious pigmented lesions, and E was added later. It is promoted by dermatology bodies including the American Academy of Dermatology, and it is a checklist for describing what you see rather than a scoring system that produces an answer.

The ugly duckling

A person's moles tend to resemble each other, as if made to a house style. The ugly-duckling sign says: look for the one that breaks the pattern. It is darker, or bigger, or a different shape, or simply the one your eye keeps returning to when you scan an area. Many people find it easier and more reliable than ABCDE, because it requires no measurement and no memory of five criteria — and because a melanoma frequently stands out from its neighbours before it satisfies any individual letter.

The pattern ABCDE misses

Nodular melanoma grows upward rather than outward, and it often breaks all the assumptions the ABCDE rule is built on: it can be symmetrical, one uniform colour, small, and with a perfectly clean border. It is also faster growing, which makes missing it worse. The shorthand for it is EFG — Elevated above the skin, Firm to the touch, and Growing continuously for more than a month. A new raised, firm lump that keeps getting bigger over a few weeks deserves an appointment whatever it looks like, and whatever colour it is: nodular melanoma can be red or skin-coloured rather than brown.

The places people do not look

Self-checking concentrates on the parts of the body you can see in a mirror while standing up, which is not where all melanomas are. Work through the whole surface: the scalp, parting the hair; behind and inside the ears; the back and the backs of the legs, which need a second mirror or a second person; between the toes and the soles of the feet; and the nails.

Nails deserve their own sentence. A new pigmented band running lengthwise along a nail, particularly one that is widening, is darker at one edge, or where the pigment spreads onto the skin at the base of the nail, is a reason to be seen. Melanoma on the palms, soles and nails is the presentation that is proportionally most common in people with darker skin, where the disease is often found later precisely because it is not expected.

How to actually do it

• Once a month, in the same good light. Consistency is what makes change visible.
• Photograph anything you are unsure about, with a ruler or a coin in the frame for scale, from the same distance and angle. Look again in four to eight weeks.
• Ask someone to check your back, your scalp and the backs of your legs. These are the areas self-checking systematically misses.
• Do not wait for a lesion to satisfy every letter. One clear change is enough of a reason to book.
• Never use a mole-removal pen, cream or acid sold online. They scar, they can remove the surface of a lesion while leaving what matters behind, and they destroy the evidence a pathologist would have needed.

Who should be more careful

Risk is higher with fair skin that burns easily and tans poorly, with red or light hair and freckling, with a large number of moles or several atypical ones, with a personal or family history of melanoma, with a history of blistering sunburn — especially in childhood — and with any use of sunbeds, which are classified as carcinogenic to humans by the International Agency for Research on Cancer. People taking medicines that suppress the immune system are also at higher risk and should have that conversation with the team looking after them.

That risk profile is unusually common around the Baltic and in the Nordic countries, where fair skin, a long dark winter and a short, intense sunny season combine into exactly the intermittent, high-dose exposure pattern most associated with melanoma. Two weeks of holiday sun on skin that has seen none since September is the pattern, not the total annual hours. How much ultraviolet you are actually getting, and what that means for vitamin D, is a separate subject from this page.

When to book an appointment

• A mole that has changed in size, shape, colour or height over weeks to months.
• A lesion that bleeds, itches, crusts or is painful.
• A new raised, firm lump that keeps growing for more than a month, of any colour.
• The ugly duckling — the one that does not look like your others.
• A new or widening pigmented band in a nail, or pigment spreading onto the skin around it.
• A sore that has not healed in about four weeks, or a scaly patch that repeatedly bleeds.

What happens next is usually undramatic: a clinician examines the lesion, often with a dermatoscope, and either reassures you, arranges a review, or removes it for examination. Fear of the appointment is the main reason melanomas are found late, and it is worth naming for what it is.

Sources: EU Cosmetics Regulation (EC) No 1223/2009 and its annexes, as published in the European Commission's CosIng database, for every statement about what is permitted, restricted or banned · opinions of the Scientific Committee on Consumer Safety (SCCS) and safety assessments of the Cosmetic Ingredient Review (CIR) for the concentration positions · standard dermatology reference material for mechanism, tolerability and contact-allergy patterns · checked 2026-09-06. Deep links are deliberately omitted where a stable public URL could not be confirmed.

The ABCDE criteria are as promoted by dermatology bodies including the American Academy of Dermatology; the ugly-duckling sign and the EFG pattern for nodular melanoma are established descriptions in the dermatology literature; sunbeds are classified as carcinogenic to humans by the International Agency for Research on Cancer. No figure on this page is a diagnostic threshold.

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