Anytime you hear about skin cancer, you always hear the same advice — contact a health care provider if you notice anything unusual. And then, one day, it happens: you spot a mole that doesn’t seem right to you. What happens next?
First, a quick recap of suspicious skin changes. “Check your skin monthly, and watch for moles with ‘ABCDE’ signs,” said Joshua Tournas, MD, a dermatologist with Banner Health. Those signs are:
- Asymmetry: A healthy mole is typically evenly shaped on both sides. If one half of a mole doesn’t match the other half, it could be a cause for concern.
- Borders that are irregular: If the edges are jagged or blend in with your skin, the mole could be abnormal.
- Colors that are different: Healthy moles tend to be one color. Keep an eye out for moles with multiple colors or shades, especially those that include black, blue or red.
- Diameter: Watch for moles bigger than six millimeters (about the size of a pencil eraser).
- Evolution: Moles that change in size or shape or suddenly change in appearance should get your attention.
You might feel worried or anxious if you find a suspicious mole. But don’t delay — contact your health care provider right away. Getting care early makes it more likely that if you need treatment, it will be successful.
Getting your mole checked out
Call your primary care provider or dermatologist and explain that you’re concerned about a mole and you’d like to schedule an appointment. You might also be able to book your appointment online or with an app.
At the appointment, your provider will ask what you’ve noticed about the mole. Be honest about its appearance, what you’ve seen and any itching, bleeding or pain.
Your provider will look closely at the mole to check its size, shape, color and texture and look for other concerning signs. “They may use a magnifying lens, or a special tool called a dermatoscope to get a closer look,” Dr. Tournas said. If they’ve taken photos of your moles in the past, they may compare them to those photos.
Sometimes, a visual exam will give your provider all the information they need. In other cases, they may want you to have further testing.
Other tests you might need
The main way providers examine suspicious moles further is with a biopsy. That’s a test that removes some or all of the mole so an expert can check it in a lab and see if it’s cancerous.
Your provider may recommend one of these types of biopsies based on the size, location and characteristics of the mole:
- Shave biopsy: The top layers of the mole are shaved off using a scalpel or razor blade. This type of biopsy is typically used for moles located on the skin's surface.
- Punch biopsy: A circular tool removes a small tissue core from the mole. It gets a deeper sample of the mole than a shave biopsy.
- Excisional biopsy: The entire mole and a small amount of tissue around it are removed. Your provider might recommend this type of biopsy if they suspect a more serious or invasive form of skin cancer.
“The more concerned your doctor is about how deeply the mole has penetrated, the deeper they’re going to biopsy,” Dr. Tournas said.
Biopsies are usually quick and relatively painless. Your provider will use a local anesthetic to numb the area. You might have some minor bleeding or bruising, but serious complications are rare.
You can usually have a biopsy in your provider’s office and get right back to your normal activities. You may be able to have the biopsy in the same appointment as the visual exam, or your insurance may require you to come back for a separate appointment.
Waiting for results
It can take several days to get your biopsy results, depending on the exact testing you need and the work process at the lab. It’s natural to feel worried and anxious while you’re waiting. It may help to:
- Acknowledge and validate your feelings rather than trying to suppress them.
- Keep yourself busy with activities you enjoy to distract yourself from worrying about the results. Whether it’s spending time with loved ones, pursuing hobbies or engaging in relaxation techniques like yoga or meditation, find activities that bring you comfort and peace.
- Lean on friends, family members or support groups. Talk about your feelings with someone you trust.
- Take care of yourself physically and emotionally. Make sure to prioritize sleep, eat nourishing foods and try to relax.
- Step away from the internet. It’s natural to want answers, but constantly searching for information online or looking for stories of other people in similar situations can make you more anxious. Plus, you might not find accurate or relevant information.
If you’re struggling with overwhelming anxiety or uncertainty, reach out to your health care provider for support. They can address any concerns or questions you have.
Possible outcomes
The waiting is over — your results are in. Your provider will let you know that your mole is either benign (non-cancerous) or malignant (cancerous).
Usually, benign moles don’t need any more treatment. Your provider may want to watch it for any new changes. Malignant moles, on the other hand, could be melanoma, which is the most serious type of skin cancer. It can spread quickly if not treated early.
“In between are moles that are atypical, meaning they are concerning and may become melanoma,” Dr. Tournas said.
You may have heard about some other types of skin cancer — basal cell carcinoma and squamous cell carcinoma. These types of skin cancers don’t typically develop from moles.
Your health care provider will review your diagnosis with you, answer your questions and discuss your next steps.
Treatment options
Depending on the type of atypical mole or skin cancer you have and how advanced it is, your provider will recommend treatments. Skin cancer treatment aims to remove the cancerous cells with minimal scarring, keeping the skin’s function and appearance as normal as possible.
Surgery
With surgery, your provider cuts out the cancerous tissue and a small area of healthy tissue around it. In many cases, that’s all the treatment you need. If you have melanoma that has penetrated more deeply, you may need to see a surgical oncologist to see if the melanoma has spread to nearby lymph nodes.
Immunotherapy
Immunotherapy uses medications to boost your immune system’s ability to recognize and destroy cancer cells. It may be used to treat melanoma that has spread to other parts of the body.
Medications like checkpoint inhibitors or targeted therapies work by targeting specific molecules on cancer cells or by removing the “brakes” on the immune system so it can attack the cancer better.
Your health care provider can explain the benefits and risks of each treatment option and help you weigh your choices. Ask questions and share your concerns and preferences so you get the best possible care.
The bottom line
If you discover a suspicious mole, feeling anxious or afraid is normal. But even if it turns out to be skin cancer, most are highly treatable when you catch them early. Reach out to your primary care provider or dermatologist to get the evaluation process started and connect with the care you need.
If you spot a mole that seems unusual and you don’t have a health care provider, don’t delay. Reach out to an expert at Banner Health to get the compassionate care you need.
