When to get a mole checked: the changes a dermatologist looks for

When to get a mole checked: the short answer

Most people with a mole on their mind aren't asking about removal yet. They want to know when to get a mole checked, and whether the spot they keep looking at in the mirror is one of the ones that matter.

I'm Dr. Hyo Seop Ryu, a board-certified dermatologist and a chief director at WELLS in Apgujeong, Seoul. This is general background to help you decide when to be seen. It is not a diagnosis, and nothing online can replace an examination.

As a rule of thumb, have a dermatologist look at a mole that is new, changing, or behaving differently from your others. That covers most of the situations that bring people in.

• A new mole that appears in adulthood, or one that is clearly growing
• A change in shape, border or colour
• A mole that bleeds, crusts or does not heal
• An itchy mole that stays itchy, or one that has become tender
• A raised mole that used to be flat
• A spot that looks unlike every other mole on your skin

If a mole is changing or bleeding, see a dermatologist where you are now. Don't hold it for a future trip to Seoul.

What does a benign mole usually look like?

A mole is a cluster of pigment cells in the skin, and most moles are harmless. A typical benign mole tends to be one colour, roughly symmetrical, with a smooth edge, and it stays much the same over time.

Raised is not the same as worrying. Many soft, raised moles on the face and body are ordinary and have been there for years; what matters most is change, not whether a mole is flat or raised.

It also helps to know your own pattern. Most people's moles look broadly alike, so a spot that stands out from the rest, sometimes called the ugly duckling sign, is worth a closer look even if it doesn't tick any other box.

The ABCDE signs, in plain English

Dermatologists often use a simple memory aid called ABCDE. It is a guide for when to get a mole checked, not a test you can pass or fail at home.

• A — Asymmetry: one half does not match the other.
• B — Border: the edge is ragged, notched or blurred rather than smooth.
• C — Colour: several shades of brown, black, red, white or blue in one mole.
• D — Diameter: a mole noticeably larger than your others, or one that keeps getting bigger.
• E — Evolving: any change in size, shape, colour, height, or new symptoms such as itching or bleeding.

Of the five, evolving is the one I take most seriously. A mole that looks slightly unusual but has been the same for many years is a different conversation from a mole that has changed in the last few months.

None of these signs means something is wrong. Each one is simply a reason to have a trained eye look at it rather than to keep watching it alone.

Itchy mole, raised mole, new mole: what each change can mean

An itchy mole

Moles can itch for ordinary reasons, such as dry skin, friction from clothing or irritation after shaving. An itchy mole that stays itchy, or one that is also changing, should be examined.

A raised mole

A mole that has always been raised is usually part of your normal pattern. A mole that was flat and has become raised, or has a new lump within it, is a change and deserves a check.

A new mole

New moles are common in childhood and early adulthood. A new mole later in adult life, or one that grows quickly, is generally worth showing to a dermatologist.

Not every small spot is a mole. On the face, flat warts, milia, sebaceous hyperplasia and syringoma can look like tiny moles or bumps in the mirror, and each sits at a different depth in the skin. Our guide on how to get rid of milia under eyes explains how those four differ.

Mole checker apps and photos: useful, but not a diagnosis

A mole checker app or a folder of phone photos can be genuinely helpful. The value is in tracking change over time, which is exactly the thing that is hardest to remember.

• Photograph the same mole in the same light, from the same distance, with a ruler or coin beside it for scale.
• Check your skin every so often in good light, using a mirror or a partner for your back and scalp.
• Bring the photos to your appointment, so the dermatologist can see how a spot has changed.

What an app cannot do is examine the mole in person, feel its surface, or compare it with the rest of your skin. I would never tell someone a mole is fine from a photo alone, and I'd be cautious of any tool that seems to promise that.

What happens at a mole check with a dermatologist?

Skin problems that look alike can have different causes and stages, so accurate diagnosis decides what happens next. At WELLS, every skin condition is diagnosed and treated by a board-certified dermatologist, and the clinic is certified by the Korean Dermatological Association.

A check starts with your history: how long the spot has been there, whether it has changed, and whether it itches or bleeds. Then the dermatologist examines it closely and looks at your other moles for comparison.

If a mole looks ordinary, we can talk about whether you want it removed. If a mole shows warning signs, laser removal is not the next step; generally it needs further examination of the tissue, and I will explain plainly what that involves and where it should happen.

This diagnosis-first approach is described on our skin diseases page. For small bumps that turn out not to be moles, our warts and syringoma page explains why syringoma should be confirmed before it is treated.

When removal makes sense, and why deep moles are staged

Plenty of people want a benign mole removed simply because they don't like it, or because it catches on clothing. Once a dermatologist has examined it, that is a reasonable choice.

At WELLS, mole removal is done with a laser by a dermatologist. Some moles extend into deeper layers of the skin, and forcing a deep mole out at once can scar, so we treat those in several sessions two to three months apart.

The price for mole removal is confirmed at consultation, because size, depth and number all change the plan. Our guide to mole removal cost in Seoul explains what sets the price.

For background, I was a clinical instructor and then an assistant professor in dermatology at Seoul National University Bundang Hospital. Consultations at WELLS are available in English, and the clinic is a five-minute walk from Apgujeong Station, Exit 3.

Results and recovery vary by individual. Every treatment carries possible side effects, which are explained at the consultation. Prices are in Korean won, excluding 10% VAT, and confirmed at your consultation. This article is general information from the clinic, not a diagnosis.

Written by

Dr. Hyo Seop Ryu

Medical Director · M.D., Ph.D. · WELLS Clinic, Apgujeong

• Board-certified dermatologist, M.D., Ph.D.
• Clinical instructor, Department of Dermatology, Seoul National University Bundang Hospital
• Assistant professor, Seoul National University Bundang Hospital
• Visiting professor, Dubai Maris Clinic, through International St. Mary's Hospital
• Former chief director, Bundang Bon Dermatology Clinic

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