Skin Checks: The Spots Worth Showing a Doctor

Why does my skin feel like a stranger's right now?

You may have noticed new freckles, darker patches, or moles that seem to have changed shape since your periods became unpredictable. That is not your imagination. Estrogen and progesterone affect melanocytes, the cells that make pigment, so when those hormones swing, your skin can respond with more color, less color, or spots that behave differently than they used to.

This is also the decade when cumulative sun exposure from your teens and twenties starts to show up. A mole that was stable for fifteen years can begin to evolve now. That does not mean something is wrong. It means your skin is living through the same hormonal shift as the rest of you, and it deserves a closer look than it got last year.

What are the ABCDEs, in plain language?

A is asymmetry: if you drew a line through the middle, one half would not match the other. B is border: the edges are ragged, scalloped, or blurry instead of smooth. C is color: there are two or more shades in one spot, like tan mixed with brown, black, red, or white. D is diameter: wider than a pencil eraser, though some serious spots are smaller. E is evolving: it changes in size, shape, color, or starts itching or bleeding.

The E is the one that matters most. A spot that is new, or one that is changing, is worth showing a doctor even if it does not tick the other four boxes. You are not being dramatic by asking. You are being accurate about what you see on your own body, and that is exactly the kind of information a dermatologist needs.

But I have darker skin, so am I really at risk?

Yes. Melanoma can develop on any skin tone, and when it appears in people with darker skin, it often shows up in places that never see the sun: the soles of the feet, the palms, under a fingernail or toenail, inside the mouth, or on the genitals. These are called acral and mucosal melanomas, and they are not caused by UV exposure the way other melanomas are.

Because the common warning signs are taught with sun-exposed skin in mind, these spots get missed. A dark line under a nail that does not grow out, a bruise on your foot that never fades, a new dark patch in your mouth, or a mole on your scalp that someone else notices before you do, all deserve a professional look. Darker skin is not protection. It is simply different terrain.

How often should I actually be checking?

Once a month, in good light, with a hand mirror and a second mirror for your back and scalp. That sounds like a lot until you realize it takes about ten minutes. Pick a day you will remember, like the first of the month or the day you refill your vitamins. The goal is not to memorize every freckle. It is to notice what is new or different from last month.

If you have a personal or family history of melanoma, many moles, or a history of blistering sunburns, ask your provider whether an annual skin exam with a dermatologist makes sense for you. If you find a spot that is changing, bleeding, itching, or not healing, call a provider rather than waiting for your next appointment. You do not need a referral to ask a question about your own skin.

What helps

• Do your monthly check in the same well-lit room each time, using a hand mirror and a second mirror for your back and scalp.
• Photograph any spot that concerns you with a ruler or coin beside it, so next month you can compare size and color accurately.
• Ask your partner or a friend to check your scalp, back, and the backs of your legs, since those are the areas you cannot see well.
• Keep a simple note on your phone with the date and location of any spot you are watching, and bring it to your next appointment.
• Use a broad-spectrum sunscreen on your face, neck, and hands daily, since those areas get incidental sun even on cloudy days.

This page includes affiliate links. As an Amazon Associate, WOMO earns from qualifying purchases, at no extra cost to you.

Mae’s picks

• Hand mirror with long handle — For seeing your back, scalp, and behind your knees
• Broad-spectrum SPF 30+ face moisturizer — Daily sun protection for face, neck, and hands
• Body mole mapping journal — To track dates, locations, and changes in spots