Is It Skin Cancer? How to Tell a Harmless Mole from a Melanoma

By STACEY COLINO | iVillage Canada – Fri, 22 Jun, 2012 1:00 PM EDT

Know Your ABCDEs
Melanoma is the deadliest form of skin cancer but it can be hard to identify. The ABCDE guide helps. If your mole fits the characteristics below, call your dermatologist pronto:
Asymmetry—if the mole could be folded in half, the two halves wouldn’t match
Border irregularities—the mole’s borders are uneven or blurred
Color variations—the mole has mixed shades of tan, brown, black or other hues
Diameter—the spot is bigger than a pencil eraser
Evolution—its appearance has changed in some way 

“Skin cancer is highly curable when it’s found early,” says iVillage skin expert Doris Day, M.D., a clinical assistant professor of dermatology at New York University. “Keep an eye on your skin and look for changes.” Still, not every mole or mark is dangerous. Here are some more tips to tell the difference.


Don’t Make a Mountain Out of a Mole
A mole is simply a cluster of pigmented cells, creating a spot that can be flesh-colored, pink or very dark brown. Some moles are raised off the skin’s surface, and some sprout hairs, but neither is a bad sign in itself. Moles can usually be left alone but should be monitored for changes. If a mole appears suspicious (based on the ABCDE characteristics) or it becomes easily irritated, your dermatologist can numb the skin and remove it by cutting or shaving it off, explains Dr. Day. It will often be sent for evaluation to make sure it’s normal.


A Serious Sign of Sun Damage
An actinic keratosis (AK) is a rough, red or brown, flat, scaly patch on the skin’s top layer—and it’s considered precancerous. “These occur in sun-exposed areas and you can often feel them before you can see them,” Dr. Day says. If left untreated, it can turn into squamous cell carcinoma, another form of skin cancer that can also spread but isn’t as deadly as melanoma. Dermatologists typically recommend using a topical cream (like Aldara or Efudex) to destroy the precancerous cells, or treating AKs with other treatments like liquid nitrogen, laser or photodynamic therapy that can destroy abnormal cells on the surface. 

Just a Mysterious Mark or Melanoma?
A seborrheic keratosis can be flesh-colored, light brown or tan, and it may have a waxy or scaly, wart-like appearance. “Sometimes a seborrheic keratosis can have variations in color and be confused with a melanoma,” Dr. Day says, so it’s important to get them checked out. These common growths, which can range in size, are benign. However, if they become itchy, red, irritated or inflamed or if they’re unsightly, they can be gently scraped off the skin’s surface or frozen off with liquid nitrogen.

Nothing to Do With Your Liver
A lentigo (or liver spot) is a flat, brownish blotch caused by long-term sun damage. They may be unsightly, but they’re benign. “They only occur in sun-exposed areas—for some people it takes a lot of sun exposure; for others, very little,” Dr. Day says. Lentigos can be left alone, but if they bother you for cosmetic reasons, your dermatologist may recommend applying a tretinoin cream (such as Retin-A) and a topical bleaching cream. You can also have them removed with a chemical peel, liquid nitrogen or zapped with a laser, Dr. Day says. Wear a sunscreen with an SPF of 30 or higher to prevent more from developing (not to mention, to protect your skin).

Melasma, not Melanoma
As if pregnancy doesn’t bring enough changes, some women develop brown patches on their faces during the nine-month stretch, often called the mask of pregnancy (melasma). While its exact causes aren’t known, there are genetic, sun-related, and hormonal components so melasma can also happen if you’re taking oral contraceptives, Dr. Day says. “The longer you’re on the Pill, the greater your risk.” Fortunately, melasma is harmless. Sun exposure can darken the patches though, so wear sunscreen with an SPF of 30 or higher every day, and stay in the shade as much as possible. Sometimes, melasma fades after childbirth or going off the Pill. If it doesn’t, a prescription-strength bleaching cream (such as hydroquinone), a chemical peel, or intense pulsed light treatment can help.