Checking your own skin

Overview

Detected early, skin cancer can in many cases be treated well. Alongside regular medical screening you can contribute yourself by looking at your skin at fixed intervals and paying attention to changes. If you know your own skin, you are more likely to notice when a mole is new or looks different from before.

The ABCDE rule serves as a memory aid for assessing moles: Asymmetry, Border, Colour, Diameter and Evolution. The fifth criterion is particularly important. A mole that changes deserves medical attention, even if the other features look unremarkable.

The limit is important: checking your own skin does not replace the dermatological examination. It helps you to notice anything unusual between appointments and to book an appointment in good time. Whether a change is harmless or needs to be investigated is decided in the examination, where needed with dermoscopy and the other methods used in skin cancer screening.

Areas of application

• All adults, in addition to the annual skin cancer screening
• People with many moles (pigmented naevi)
• Cases of skin cancer in your own family
• Frequent sunburn in the past, fair skin type, intensive use of UV light or tanning beds
• After a skin cancer that has already been treated, between follow-up appointments
• A mole that seems new to you or looks different from before

Procedure

1. Create good conditions

   Take your time when you are undisturbed, for example after a shower. You need daylight or a bright lamp, a large mirror and a hand mirror for your back and the backs of your legs. For the scalp and the back, help from someone you trust is useful.

2. From head to toe in a fixed order

   Always proceed in the same order so that no region is left out: face, ears, neck and scalp, then chest and abdomen, the arms with armpits, hands and fingers, then in the mirror your back, buttocks and the backs of your legs, and finally legs, feet, soles and the spaces between the toes.

3. Pay particular attention to the sun terraces

   Some areas are exposed to the sun especially strongly, the so-called sun terraces: the bridge of the nose, the area around the eyes, ears, lips, chin, shoulders, back, buttocks, the tops of the feet and, in people going bald, the scalp. Look at these regions with particular care.

4. Assess every mole with the ABCDE rule

   For each mole, look at shape, edge, colour and size and compare with what you know from earlier checks. A mole that stands out because it looks different from all the others deserves a second look.

5. Record changes

   Note down what you noticed, or photograph the spot with something for scale, such as a ruler next to it. That way you and the practice can tell next time whether anything has changed.

6. Book an appointment if anything stands out

   If a mole shows one or more ABCDE features, bleeds, itches or feels rough, please book an appointment promptly. Do not wait for the next routine screening.

Related pages

• Skin Cancer Screening & Skin Check →
• Sun rules →

What to expect

• Checking your own skin should be done regularly at fixed intervals, regardless of whether you noticed anything last time. That gives you a comparison if a mole changes.
• Most moles are harmless. The self-check is not meant to worry you, but to help you notice changes in good time.
• With every check you get to know your skin better. A new or changed mole is then easier to spot.
• Bring your notes or photos to the screening appointment. In the practice, a mole atlas created with the FotoFinder® system can add to the comparison over time.
• The annual skin cancer screening remains the fixed appointment; where the risk is increased or after a skin cancer, shorter intervals may make sense. The self-check is added to it.

Risks & notes

• Some changes cannot be seen with the naked eye, and not every skin cancer shows the ABCDE features: the rule is designed for the early detection of malignant melanoma, and non-melanoma skin cancer can look different.
• A single ABCDE feature does not mean that skin cancer is present. Many moles are naturally somewhat irregular in shape or colour. The assessment takes place in the examination, where needed with dermoscopy and the other methods used in skin cancer screening.
• Please do not treat or remove suspicious skin changes yourself, not even with over-the-counter products. That makes the assessment and an examination under the microscope more difficult.
• If you are unsure, it is better to come once too often than once too rarely. A visit to the practice is worthwhile even if it turns out that everything is fine.

The ABCDE rule

Assess every mole against these five features:

• A – Asymmetry: the mole has an irregular shape.
• B – Border: the edges are blurred or appear to have run.
• C – Colour: irregular colouring with light and dark, sometimes deep-black tones.
• D – Diameter: the mole is larger than 6 mm.
• E – Evolution: the mole changes over time (size, shape, colour, elevation) or begins to itch or bleed.

When you should book an appointment promptly

Have the following changes assessed by a doctor quickly:

• bleeding of a skin lesion
• itching
• a rough, sandpaper-like surface
• new or increasing localised discolouration
• rapid change in size, shape or colour

Places that are easily overlooked

These regions are easily missed when checking your own skin. Please include them deliberately:

• the scalp, parting by parting with a comb or hairdryer
• behind the ears and inside the outer ear
• the nape of the neck and the back, with a hand mirror or help
• the armpits
• the buttocks and the backs of the thighs
• the palms and the soles of the feet
• the spaces between the fingers and toes
• the fingernails and toenails
• the genital and anal region

Frequently asked questions

How often should I check my own skin?

Regularly and at fixed intervals, so that you notice changes by comparison. [PLATZHALTER: Empfohlenen Abstand der Selbstkontrolle bestätigen; die alte Website nennt keinen.] The annual dermatological screening comes on top.

What does the E in the ABCDE rule stand for?

E stands for evolution, meaning change over time: a mole grows, changes shape or colour, becomes raised, or begins to itch or bleed. This criterion is particularly important, because it also catches moles that look unremarkable under A to D.

One of my moles meets one of the criteria. Do I have skin cancer?

Not necessarily. Many harmless moles are somewhat irregular in shape or colour. The rule helps to pick out moles that should be looked at by a doctor. The assessment takes place in the practice, where needed with dermoscopy, FotoFinder® or Nevisense®. Book an appointment and we will take a look.

Can I skip the medical screening if I check myself regularly?

No. The self-check does not replace the examination. The back and the scalp are hard to assess on your own, and dermoscopy shows structures that cannot be seen with the naked eye. Forms of skin cancer without the typical ABCDE features are also more likely to be picked up in the examination.

How can I remember what a mole looked like before?

Photograph noticeable moles with something for scale, such as a ruler, and note the date. Proceed in the same order at every check. In the practice, a mole atlas can additionally be created with the FotoFinder® system, which allows a comparison over time.